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When a patient return from the recovery room following a subtotal thyroidectomy, the nurse should immediately
inspect the incision.
- A. instruct the patient not to speak.
- B. keep the patient supine for 24 hours.
- C. place a tracheostomy set at the bedside.
Correct Answer: D
Rationale: Thyroid surgery sometimes results in accidental removal of the parathyroid glands. A resultant hypocalcemia may lead to contraction of the glottis, causing airway obstruction; edema also causes obstruction. Having a tracheostomy set ready is critical.
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Which of the following clients is at greatest risk for postpartal hemorrhage?
- A. A gravida 1 para 1 with an uncomplicated delivery of a 7-pound infant
- B. A gravida 1 para 0 with a history of polycystic ovarian disease
- C. A gravida 2 para 2 with a history of low birth weight infants
- D. A gravida 4 para 3 with a Caesarean section
Correct Answer: D
Rationale: A gravida 4 para 3 with a Caesarean section is at higher risk for postpartal hemorrhage due to multiparity and surgical delivery, which can lead to uterine atony and increased bleeding risk.
Teaching the client with gonorrhea how to prevent reinfection and further spread is an example of:
- A. primary prevention.
- B. secondary prevention.
- C. tertiary prevention.
- D. primary health care prevention.
Correct Answer: B
Rationale: Secondary prevention targets the reduction of disease prevalence and disease morbidity through early diagnosis and treatment. Physiological Adaptation
A client has been taking perphenazine (Trilafon) by mouth for two days and now displays the following: head turned to the side, neck arched at an angle, stiffness and muscle spasms in neck. The nurse would expect to give which of the following as a PRN medication?
- A. Promazine (Sparine).
- B. Biperiden (Akineton).
- C. Thiothixene (Navane).
- D. Haloperidol (Haldol).
Correct Answer: B
Rationale: The symptoms describe acute dystonia, an extrapyramidal side effect of perphenazine. Biperiden, an antiparkinsonian agent, counteracts these effects. Promazine, thiothixene, and haloperidol (A, C, D) are antipsychotics and would not relieve dystonia.
The nurse prepares a 25-year-old woman for a cesarean section. The patient says she had major surgery several years ago and asks if she will receive a similar 'shot' before surgery. The nurse's response should be based on an understanding that the preoperative medication given before a cesarean section
- A. contains a lower overall dosage of medication than is given before general surgery.
- B. contains reduced amounts of sedatives and hypnotics than are given before general surgery.
- C. contains reduced amounts of narcotics than are given before general surgery.
- D. contains medications similar in type and dosages to those given before general surgery.
Correct Answer: C
Rationale: Preoperative medications for cesarean sections typically include reduced amounts of narcotics to minimize the risk of respiratory depression in the newborn, as narcotics cross the placental barrier. Sedatives and hypnotics are used in similar doses as in general surgery, and the overall dosage is not necessarily lower.
The nurse is teaching a client with chronic obstructive pulmonary disease (COPD) about energy conservation. Which of the following strategies should the nurse recommend?
- A. Perform all activities in the morning when energy is highest.
- B. Use a shower chair when bathing.
- C. Avoid using a pursed-lip breathing technique.
- D. Walk quickly to complete tasks efficiently.
Correct Answer: B
Rationale: Using a shower chair conserves energy by reducing exertion during bathing, a taxing activity for COPD patients. Morning activity (A) may not suit all, pursed-lip breathing (C) aids respiration, and quick walking (D) increases oxygen demand.