Nokea
Medications are given to older adults for many different conditions. A good rule to follow for medication use in older adults is to:
- A. Use once daily dosing
- B. Take all medications at the same time
- C. Request brand name medications
- D. Use the lowest possible effective dose
Correct Answer: D
Rationale: Older adults are more sensitive to medications due to decreased kidney and liver function. Using the lowest effective dose minimizes side effects and drug interactions.
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What complication can result from tracheal suctioning?
- A. Acute hypoxemia
- B. Gastric dilatation
- C. Hypervolemic shock
- D. Epiglottitis
Correct Answer: A
Rationale: Suctioning temporarily reduces oxygen levels, necessitating careful monitoring.
Which BMI is typically associated with anorexia nervosa?
- A. Increase protein intake
- B. Reduce carbohydrate consumption
- C. Drink more water
- D. Take vitamin supplements
Correct Answer: C
Rationale: The correct answer is C because it is the most appropriate response based on physiological and medical principles.
During an assessment of a patient who sustained a head injury 24 hours ago, the medical-surgical nurse notes the development of slurred speech and disorientation to time and place. The nurse's initial action is to
- A. continue the hourly neurologic assessments.
- B. inform the neurosurgeon of the patient's status.
- C. prepare the patient for emergency surgery.
- D. recheck the patient's neurologic status in 15 minutes.
Correct Answer: B
Rationale: Neurological changes could indicate worsening intracranial pressure, necessitating immediate physician notification.
A client in an emergency department has a sucking chest wound resulting from a gunshot. The client has a blood pressure of 100/60 mm Hg, a weak pulse rate of 118/min, and a respiratory rate of 40/min. Which of the following actions should the nurse take?
- A. Raise the foot of the bed to a 90° angle
- B. Remove the dressing to inspect the wound
- C. Prepare to insert a central line
- D. Administer oxygen via nasal cannula
Correct Answer: D
Rationale: The correct answer is D: Administer oxygen via nasal cannula. In a client with a sucking chest wound, the priority is to ensure adequate oxygenation due to potential respiratory compromise. Administering oxygen via nasal cannula will help improve oxygenation and support the client's respiratory function. This action takes precedence over other interventions as hypoxia can lead to further deterioration.
A: Raising the foot of the bed to a 90° angle is not indicated in this situation as it does not address the immediate need for oxygenation.
B: Removing the dressing to inspect the wound can worsen the condition by disrupting any seals in place to prevent air from entering the chest cavity.
C: Preparing to insert a central line is not the priority in this situation as the client's respiratory status needs to be stabilized first.
A male client has returned to the Unit following a left femoral popliteal bypass graft. Six hours later, the client's dorsalis pedis pulse cannot be palpated and his foot is cool and dusky. The nurse should:
- A. continue to monitor the foot.
- B. immediately notify the physician.
- C. notify the head nurse.
- D. assure the client that his foot is fine.
Correct Answer: B
Rationale: The client is losing the blood supply to his left foot. Continuing to monitor will not restore the blood supply to the foot. The physician should be notified immediately because the client is losing the blood supply to his left foot and is in danger of losing his foot and/or his leg. It is the responsibility of the nurse caring for the client to notify the physician, not the head nurse. This would be giving the client false assurances, which is unethical, demeaning, and could have legal consequences.