Nokea
Pain has been defined as “whatever the person experiencing the pain says it is, existing whenever the patient says it does.” This definition is problematic for the nurse when caring for which type of patient?
- A. A patient placed on a ventilator
- B. A patient with a history of opioid addiction
- C. A patient with decreased cognitive function
- D. A patient with pain resulting from severe trauma
Correct Answer: C
Rationale: The correct answer is C. Patients with decreased cognitive function may have difficulty communicating their pain, making this definition challenging.
You may also like to solve these questions
What cell ingests invading or foreign cells?
- A. Macrophage.
- B. T cell.
- C. B cell.
- D. Erythrocyte.
Correct Answer: A
Rationale: Macrophages engulf and destroy pathogens.
What is the most appropriate response to Harold Smith asking what he can do to prevent black lung disease?
- A. Suggest he seek symptomatic medical treatment
- B. Reassure him that black lung is a disease of the past
- C. Encourage him to change jobs
- D. Recommend psychologic counseling
Correct Answer: C
Rationale: Changing jobs eliminates exposure to coal dust, preventing black lung.
The third stage of labor is when:
- A. Contractions reach their peak
- B. The head is visible
- C. The water breaks
- D. The placenta is delivered
Correct Answer: D
Rationale: The third stage of labor involves the delivery of the placenta after the baby is born.
A client has a chest tube in place connected to a closed chest drainage system. Which of the following findings should indicate to the nurse that the client's lung has re-expanded?
- A. Oxygen saturation of 95%
- B. No fluctuations in the water seal chamber
- C. No reports of pleuritic chest pain
- D. Occasional bubbling in the water-seal chamber
Correct Answer: B
Rationale: The correct answer is B: No fluctuations in the water seal chamber. This finding indicates that the lung has re-expanded because it means there is no air leaking from the lung into the pleural space, causing fluctuations in the water seal chamber. Option A, oxygen saturation of 95%, is not directly related to lung re-expansion. Option C, no reports of pleuritic chest pain, is a subjective symptom and does not provide a direct indication of lung re-expansion. Option D, occasional bubbling in the water-seal chamber, indicates air is escaping from the lung into the pleural space, suggesting incomplete lung re-expansion.
The nurse is caring for a post myocardial infarction client in an intensive care unit. It is noted that urinary output has dropped from 60 -70 ml per hour to 30 ml per hour. This change is most likely due to:
- A. Dehydration.
- B. Diminished blood volume.
- C. Decreased cardiac output.
- D. Renal failure.
Correct Answer: C
Rationale: Decreased cardiac output reduces kidney perfusion, affecting urine output.