Nokea
Peripheral blood flow is dependent on which of the following variables?
- A. Blood viscosity and diameter of vessels
- B. Diameter and resistance of vessels
- C. Force of contraction of the heart and resistance of vessels
- D. Pressure differences in the arterial and venous systems and resistance
Correct Answer: D
Rationale: Peripheral blood flow depends on pressure differences between the arterial and venous systems (driving force) and vascular resistance (opposing force). This relationship is governed by Poiseuille's law and Ohm's law for fluid flow, where flow is proportional to the pressure gradient and inversely proportional to resistance. The other options are incomplete or incorrect combinations of factors.
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A client with breast cancer presents with back pain, weakness, and difficulty urinating. The nurse suspects spinal cord compression. The priority nursing action is to:
- A. Administer analgesics immediately.
- B. Notify the physician for urgent evaluation.
- C. Encourage bed rest in a supine position.
- D. Perform a bladder scan.
Correct Answer: B
Rationale: Spinal cord compression is a medical emergency requiring urgent physician evaluation for imaging and interventions like corticosteroids or surgery to prevent permanent neurologic damage.
A nurse is assessing a client with a urinary tract infection who takes an antihypertensive drug. The nurse reviews the client’s urinalysis results (see chart). The nurse should:
- A. Encourage the client to increase fl uid intake.
- B. Withhold the next dose of antihypertensive medication.
- C. Restrict the client’s sodium intake.
- D. Encourage the client to eat at least half of a banana per day
Correct Answer: A
Rationale: The client’s urine specifi c gravity is elevated. Specific gravity is a refl ection of the concentrating ability of the kidneys. This level indicates that the urine is concentrated. By increasing fluid intake, the urine will become more dilute. Antihypertensives do not make urine more concentrated unless there is a diuretic component within them. The nurse should not hold a dose of antihypertensive medication. Sodium tends to pull water with it; by restricting sodium, less water, not more, will be present. Bananas do not aid in the dilution of urine.
The physician ordered I.V. naloxone (Narcan) to reverse the respiratory depression from morphine administration. After administration of the naloxone the nurse should:
- A. Check respirations in 5 minutes because naloxone is immediately effective in relieving respiratory depression.
- B. Check respirations in 30 minutes because the effects of morphine will have worn off by then.
- C. Monitor respirations frequently for 4 to 6 hours because the client may need repeated doses of naloxone.
- D. Monitor respirations each time the client receives morphine sulfate 10 mg I.M.
Correct Answer: C
Rationale: Naloxone has a shorter half-life than morphine, so respiratory depression may recur. Frequent monitoring for 4-6 hours ensures timely detection and additional doses if needed.
The nurse is assessing a client with a casted arm for signs of infection. Which finding is most concerning?
- A. Mild itching under the cast.
- B. Foul odor from the cast.
- C. Warmth at the cast edges.
- D. Slight swelling of fingers.
Correct Answer: B
Rationale: A foul odor from the cast suggests infection, requiring immediate evaluation.
For which of the following preoperative clients should the nurse assess the glucose level? Select all that apply.
- A. A client with diabetes mellitus controlled by diet.
- B. A client with a high stress response to surgery.
- C. A client receiving corticosteroids for the past 3 months.
- D. A client with a family history of diabetes receiving dextrose 5% in lactated Ringer's solution (D5LR) I.V. fluids.
- E. A client who consumes a high carbohydrate diet.
Correct Answer: A,B,C,D
Rationale: Clients at risk for hyperglycemia include those with diabetes (A), high stress response (B, due to cortisol release), recent corticosteroid use (C, which raises glucose), and those receiving dextrose-containing IV fluids with a family history of diabetes (D). A high carbohydrate diet alone (E) is less likely to warrant immediate glucose monitoring.