Nokea
In which direction does the nurse hold the syringe when irrigating the ear to remove wax?
- A. Toward the roof of the canal
- B. Toward the eardrum
- C. Toward the nasal cavity
- D. Toward the helix
Correct Answer: A
Rationale: Directing the stream toward the roof of the canal helps dislodge wax without damaging the eardrum.
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A 27-year-old male client develops malignant hyperthermia during a herniorrhaphy; his temperature is 105.4 degrees F. The client has had no previous health problems other than hypertension. A nurse orienting in the OR says, 'I thought only people with brain tumors had this problem.' Which of the following answers explains malignant hyperthermia?
- A. Epinephrine increased the basal metabolic rate as soon as the general anesthesia was administered.
- B. The blood flow to active muscles increased with a concurrent decrease in the blood flow to the organs not needed for rapid activity.
- C. The catecholamines released led to activation of the sympathetic nervous system.
- D. Malignant hyperthermia is an inherited disorder of muscle metabolism that causes fever, increased heart rate, and rapid breathing.
Correct Answer: D
Rationale: Epinephrine is a hormone employed in the fight-or-flight stress response. It does not contribute to malignant hyperthermia. Stimulation of the sympathetic adrenal medullary mechanism helps the body cope with stress. It does not contribute to malignant hyperthermia. Catecholamine release is one of the physiological effects of stress. It does not contribute to malignant hyperthermia. Malignant hyperthermia is an inherited disorder of muscle metabolism that increases intracellular calcium, which causes generalized muscle rigidity, fever, tachycardia, and tachypnea.
When the nurse prepares to administer a preoperative medication to a patient, the patient tells the nurse that she really does not understand what the surgeon plans to do. What action should be taken by the nurse? What criterion of informed consent has not been met in this situation?
- A. Inform the surgeon immediately.
- B. Document the patient's statement.
- C. Administer the medication as ordered.
- D. Delay medication until the surgeon clarifies.
Correct Answer: A
Rationale: Informed consent requires that the patient understands the procedure, which hasn't been met here.
Allison Lynn, 20, is a student in a health sciences class and asks you to further explain the reason for lack of insulin in Type I Diabetes. You state that the most accepted theory is that:
- A. the insulin produced is not effective at the tissue level.
- B. not enough insulin is made to manage the metabolic needs.
- C. inflammation of the pancreas causes irregular release of insulin.
- D. the body's immune system destroyed the cells that make insulin.
Correct Answer: D
Rationale: Type I diabetes is the definition of that disease process that occurs when no insulin is produced, so there is no insulin to get to the cell level. Some Type II diabetes occurs because of insulin resistance. No insulin is being produced. This is one pathophysiological cause of Type II diabetes. Pancreatitis does cause irregular release of insulin, but not all people with pancreatitis develop Type I diabetes An autoimmune process is the most accepted theory of the root cause of Type I diabetes. The body produces an antibody which attacks and destroys the beta cells, leading to a lack of insulin.
Which of the following is a definitive sign of pregnancy?
- A. Amenorrhea
- B. Positive hCG
- C. Morning sickness
- D. Fetal heart sounds
Correct Answer: D
Rationale: Fetal heart sounds are a definitive sign of pregnancy, confirming the presence of a viable fetus.
8. What is acupuncture used for (select all that apply)?
- A. Relieve pain by causing counterirritation in another area of the body.
- B. Reestablish the flow of Qi through meridians to simulate the body’s self-healing mechanism.
- C. Create an inflammatory response at an acupoint, increasing blood circulation and healing energy.
- D. Relieve nausea and vomiting postoperatively, with pregnancy, or related to chemotherapy.
Correct Answer: B
Rationale: Acupuncture is commonly used to reestablish the flow of Qi (option B) and relieve nausea and vomiting (option D), among other therapeutic uses.