Nokea
Sue is having a minor procedure performed. Which type of anesthesia is most likely to be used?
- A. General.
- B. Epidural.
- C. Regional.
- D. Conscious sedation.
Correct Answer: D
Rationale: Conscious sedation is often used for minor procedures.
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Which action best demonstrates respect for autonomy when working with a client?
- A. Asks if the client has questions before signing a consent form
- B. Provides the client with accurate information when questioned
- C. Honors the promises made to the client and family
- D. Ensures fair treatment of the client compared to others
Correct Answer: A
Rationale: The correct answer is A because asking if the client has questions before signing a consent form shows respect for autonomy by allowing the client to make an informed decision. This action promotes the client's right to self-determination and involvement in the decision-making process. Choice B focuses on providing information when questioned but may not actively involve the client in the decision-making process. Choice C refers to honoring promises and not necessarily respecting autonomy. Choice D relates to fairness but does not directly address autonomy or the client's decision-making ability.
A client is on intravenous heparin to treat a pulmonary embolism. The client's most recent partial thromboplastin time (PTT) was 25 seconds. What action should the nurse anticipate?
- A. Decrease the heparin rate.
- B. Increase the heparin rate.
- C. No change to the heparin rate.
- D. Stop the heparin; start warfarin (Coumadin).
Correct Answer: B
Rationale: The correct answer is B: Increase the heparin rate. A PTT of 25 seconds indicates that the client's blood is not adequately anticoagulated, as the therapeutic range for PTT is typically around 60-80 seconds for heparin therapy. Therefore, the nurse should anticipate increasing the heparin rate to achieve the desired anticoagulant effect and prevent further clot formation.
Incorrect choices:
A: Decreasing the heparin rate would further decrease the anticoagulant effect, potentially putting the client at risk for thrombus progression.
C: No change to the heparin rate would not address the subtherapeutic PTT level and could lead to inadequate anticoagulation.
D: Stopping heparin and starting warfarin is not appropriate at this time as warfarin takes time to reach therapeutic levels, whereas heparin provides immediate anticoagulation for acute situations like a pulmonary embolism.
A nurse assesses a client’s pain level as a 5 out of 10 on the pain scale. The order reads for the client to receive morphine. Which of the following five ways of managing pain does the drug morphine fall under?
- A. Altering pain transmission at the level of the spinal cord
- B. Combining analgesics with adjuvant drugs
- C. Blocking brain perception
- D. Interrupting pain-transmitting chemicals at the site of injury
Correct Answer: A
Rationale: The correct answer is A because morphine primarily works by altering pain transmission at the level of the spinal cord by binding to opioid receptors.
After completing a thorough neurological and physical assessment of a patient who is admitted for a suspected stroke, the medical-surgical nurse anticipates the next step in the immediate care of this patient will include
- A. administering tissue plasminogen activator.
- B. obtaining a CT scan of the head without contrast.
- C. obtaining a neurosurgical consultation.
- D. preparing for carotid Doppler ultrasonography.
Correct Answer: B
Rationale: A CT scan is essential to differentiate between ischemic and hemorrhagic stroke.
What factor would be most important to include in Wendy’s discharge teaching plan?
- A. Effective breathing and coughing techniques
- B. Scheduling of return follow-up visits
- C. Program of recommended and contraindicated activities
- D. Individualized measures to prevent future attacks
Correct Answer: D
Rationale: Preventive measures reduce the likelihood of recurrent attacks.