Nokea
Paralytic ileus may occur as a postoperative complication. Which of the following patients would you be most concerned about the development of paralytic ileus?
- A. Kim, a 27-year-old postlaparoscopic appendectomy.
- B. Joyce, a 39-year-old post–open right hemicolectomy.
- C. Nancy, a 56-year-old postmediastinoscopy.
- D. John, a 47-year-old post–total joint replacement.
Correct Answer: B
Rationale: Paralytic ileus is more common after abdominal surgeries, particularly those involving bowel manipulation, such as an open right hemicolectomy. Joyce is at the highest risk due to the nature of her surgery.
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What is the first sign that the condition of a dying client is worsening?
- A. Pulmonary function impairment
- B. Peripheral circulation changes
- C. Central nervous system alterations
- D. Failing cardiac function
Correct Answer: C
Rationale: Central nervous system changes, such as confusion or lethargy, often indicate declining health in terminal stages.
Amitriptyline (Elavil) is prescribed for a patient with chronic pain from fibromyalgia. When the nurse explains that this drug is an antidepressant, the patient states that she is in pain, not depressed. What is the nurse’s best response to the patient?
- A. Antidepressants will improve the patient’s attitude and prevent a negative emotional response to the pain.
- B. Chronic pain almost always leads to depression, and the use of this drug will prevent depression from occurring.
- C. Some antidepressant drugs relieve pain by releasing neurotransmitters that prevent pain impulses from reaching the brain.
- D. Certain antidepressant drugs are metabolized in the liver to substances that numb the ends of nerve fibers, preventing the onset of pain.
Correct Answer: C
Rationale: The correct answer is C. Amitriptyline relieves pain by modulating neurotransmitter release, not solely by treating depression.
If a client denies having a hearing impairment, which question would encourage them to respond?
- A. Do you always ask people to repeat questions? If so, do you think that you have a hearing problem?
- B. Are you cupping your ear for a reason? Do you have trouble hearing?
- C. Both A and B
- D. Neither A nor B
Correct Answer: C
Rationale: Asking open-ended questions increases the likelihood of acknowledgment and discussion of the issue.
Which biologically based practice involves the use of scents to alter emotions and biologic processes?
- A. Herbal supplements
- B. Apitherapy
- C. Probiotics
- D. Aromatherapy
Correct Answer: D
Rationale: Aromatherapy utilizes essential oils to influence mood and biological responses.
Which chief complaint is NOT desirable for recording on the client’s chart?
- A. CC: “cough and temperature elevation,” 2 days duration
- B. CC: “passing black stools,” 1 day duration
- C. CC: “substernal pain,” 2 hours duration
- D. Reason for contact: “physical examination for college”
Correct Answer: D
Rationale: Correct Answer: D
Rationale:
1. Chief complaints should be symptoms or concerns related to the client's health issues.
2. "Physical examination for college" is not a specific symptom or health concern.
3. Chief complaints guide healthcare providers in assessing and treating the client.
4. Recording irrelevant chief complaints can lead to confusion in diagnosis and treatment.
Summary of Incorrect Choices:
A: Describes specific symptoms, suitable for recording.
B: Describes a specific symptom (black stools), suitable for recording.
C: Describes a specific symptom (substernal pain), suitable for recording.