Nokea
In a brief treatment program, what is a realistic short-term goal for a client who was raped?
- A. Identify all psychosocial problems
- B. Eliminate the client's enticing behaviors
- C. Resolve feelings of trauma and fear
- D. Verbalize feelings about the event
Correct Answer: D
Rationale: A realistic short-term goal for a client who was raped and is receiving a brief treatment program is for the client to verbalize feelings about the event. This goal focuses on helping the client express their emotions, which can be a crucial step in the healing process. Options A and C are incorrect because a brief treatment program is not typically aimed at identifying or resolving all psychosocial problems or deep-rooted trauma and fear. Option B is also incorrect as the goal is to support the client in processing their feelings rather than focusing on behaviors.
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While the client is receiving quinidine, the nurse should monitor the ECG for:
- A. Peaked P wave
- B. Elevated ST segment
- C. Inverted T wave
- D. Prolonged QT interval
Correct Answer: D
Rationale: Quinidine can cause widened Q-T intervals and heart block, leading to a prolonged QT interval on the ECG. Other signs of myocardial toxicity associated with quinidine include notched P waves and widened QRS complexes. Common side effects of quinidine include diarrhea, nausea, and vomiting, while less common effects may include tinnitus, vertigo, headache, visual disturbances, and confusion. Monitoring for a prolonged QT interval is crucial due to the potential risk of serious arrhythmias. Choices A, B, and C are not typically associated with the use of quinidine and are therefore incorrect in this context.
Six hours after birth, the infant is found to have an area of swelling over the right parietal area that does not cross the suture line. The nurse should chart this finding as:
- A. A cephalohematoma
- B. Molding
- C. Subdural hematoma
- D. Caput succedaneum
Correct Answer: A
Rationale: The correct answer is A, a cephalohematoma. A cephalohematoma is an area of bleeding outside the cranium but beneath the periosteum, typically not crossing the suture line. Answer B, molding, is the overlapping of the bones of the cranium and does not involve bleeding, making it an incorrect choice. Answer C, a subdural hematoma, involves intracranial bleeding and is typically diagnosed through imaging studies like a CAT scan or x-ray. Answer D, caput succedaneum, is characterized by edema that crosses the suture line, unlike the described swelling in this case.
Narrow therapeutic index medications:
- A. are drug formulations with limited pharmacokinetic variability.
- B. have limited value and require no monitoring of blood levels.
- C. have less than a twofold difference in minimum toxic levels and minimum effective concentration in the blood
- D. have limited potency and side effects.
Correct Answer: C
Rationale: The therapeutic index is the ratio between the median lethal dose and median effective dose of a drug, indicating the safety margin. Narrow therapeutic index medications have a small difference between minimum toxic levels and minimum effective concentration in the blood, making them high-risk drugs that require close monitoring to avoid toxicity. Choice A is incorrect because pharmacokinetics refer to drug absorption, distribution, metabolism, and elimination, not the therapeutic index. Choice B is incorrect because narrow therapeutic index drugs necessitate monitoring due to their narrow margin of safety. Choice D is incorrect because narrow therapeutic index drugs do not necessarily have limited potency but are characterized by a small window between efficacy and toxicity.
The nurse is making assignments for the day. Which client should be assigned to the pregnant nurse?
- A. The client receiving linear accelerator radiation therapy for lung cancer
- B. The client with a radium implant for cervical cancer
- C. The client who has just been administered soluble brachytherapy for thyroid cancer
- D. The client who returned from placement of iridium seeds for prostate cancer
Correct Answer: A
Rationale: The pregnant nurse should not be assigned to any client with radioactivity present. The client receiving linear accelerator therapy is the correct choice because the radiation stays in the department, and the client is not radioactive. Choices B, C, and D involve clients who are radioactive or pose a risk due to radioactivity. The client with a radium implant for cervical cancer (choice B) is radioactive, the client who has just been administered soluble brachytherapy for thyroid cancer (choice C) is radioactive for approximately 72 hours, and the client who returned from placement of iridium seeds for prostate cancer (choice D) is also radioactive, especially right after the procedure. These options are not suitable for assignment to the pregnant nurse.
A client arrives in the emergency room with a possible fractured femur. The nurse should anticipate an order for:
- A. Trendelenburg position
- B. Ice to the entire extremity
- C. Buck's traction
- D. An abduction pillow
Correct Answer: C
Rationale: The correct answer is Buck's traction. This intervention is used to realign the fractured femur, reduce spasms, and alleviate pain. Placing the client in the Trendelenburg position is inappropriate for a femur fracture, making answer A incorrect. While ice may be used post-repair, applying it to the entire extremity is unnecessary, so answer B is wrong. An abduction pillow is typically employed following a total hip replacement, not for a fractured femur, rendering answer D incorrect.