Nokea
Sue is diagnosed with congestive heart failure. What medication would you expect to administer to strengthen myocardial contractility?
- A. Nitroprusside.
- B. Digoxin.
- C. Nitroglycerine ointment.
- D. Furosemide.
Correct Answer: B
Rationale: Digoxin enhances myocardial contractility in CHF.
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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.
A 72-year-old female client is lifted to the surgery table in preparation for a total knee replacement. The client is in stage III of inhalation anesthesia. An appropriate nursing action for this client is:
- A. to prevent injury by assisting the anesthesiologist to restrain the client, if necessary.
- B. to prepare the operative site.
- C. to promote restoration of ventilation and vasomotor tone.
- D. to reduce external stimuli.
Correct Answer: B
Rationale: Preventing injury by restraining the client, if necessary, is a nursing action of stage II, which extends from loss of consciousness to relaxation. Stage III extends from the loss of lid reflex to cessation of voluntary respirations. Operative procedures are performed during stage III of inhalation anesthesia. Promoting restoration of ventilation and vasomotor tone is a nursing action for stage IV in which an overdose has occurred. Respiratory arrest and vasomotor collapse result from medullary paralysis. Reduction of external stimuli is a nursing action for stage I, which extends from induction to loss of consciousness.
Rewrite each of the following questions asked by the nurse so that it is an open-ended question designed to gather information about the patient’s functional health patterns.
- A. Are you having any pain?
- B. Do you have a good relationship with your spouse?
- C. How long have you been ill?
- D. Do you exercise regularly?
Correct Answer: B
Rationale: N/A
Which of the following tests would a nurse use to test whether air conduction or bone conduction is greater in the client?
- A. Romberg test
- B. Rinne Test
- C. Weber test
- D. Otoscopic examination
Correct Answer: B
Rationale: The Rinne test compares air conduction to bone conduction to identify conductive or sensorineural hearing loss.
A 27-year-old client who is three hours postoperative complains of right leg pain after knee reduction surgery. The first action by the nurse should be to:
- A. assess vital signs.
- B. elevate the extremity.
- C. perform a lower extremity neurovascular check.
- D. remind the client of the PCA pump and re-instruct the client on its use.
Correct Answer: C
Rationale: Vital signs may be altered if there is acute pain or complications related to bleeding or swelling, but it should not be assessed before checking the affected extremity. The extremity can be elevated if ordered by the physician. Assessment of the postoperative area is important to determine the presence of bleeding, swelling, or decreased circulation. Reinforcement of teaching on the use of the patient-controlled anesthesia (PCA) pump is important, but it is not the first action.