The coronary vessels, unlike any other blood vessels in the body, respond to sympathetic stimulation by
- A. Vasoconstriction
- B. Vasodilatation
- C. Decreases force of contractility
- D. Decreases cardiac output
Correct Answer: B
Rationale: The coronary vessels are unique because they respond to sympathetic stimulation with vasodilatation, unlike most other blood vessels which constrict. Sympathetic stimulation activates the fight-or-flight response, increasing heart rate and oxygen demand. To meet this demand, the coronary arteries dilate to supply more blood to the heart muscle. Vasoconstriction (A) is incorrect as it would reduce blood flow, countering the heart's needs during stress. Decreases in force of contractility (C) or cardiac output (D) are unrelated to the vascular response and pertain more to myocardial function, not the coronary vessels' behavior. This vasodilatation is mediated by beta-adrenergic receptors, ensuring adequate perfusion during heightened activity, making B the correct choice.
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The nurse is caring for a client receiving oxygen therapy via a nasal cannula. Which action by the nurse is appropriate when providing oral care to the client?
- A. Removing the nasal cannula during oral care
- B. Increasing the oxygen flow rate during oral care
- C. Applying petroleum jelly to the client's lips before oral care
- D. Instructing the client to breathe through the mouth during oral care
Correct Answer: A
Rationale: Removing the nasal cannula during oral care (A) allows thorough hygiene without interference, briefly tolerable given short duration. Increasing flow (B) is unnecessary. Petroleum jelly (C) isn't for oral care. Mouth breathing (D) isn't needed if removed. Removal, per nursing practice, ensures effective care.
Which intervention is important in preventing pressure ulcers in immobilized patients?
- A. Frequent repositioning
- B. Encouraging immobility
- C. Maintaining prolonged periods of immobility
- D. Applying tight dressings over bony prominences
Correct Answer: A
Rationale: Frequent repositioning prevents pressure ulcers in immobilized patients by relieving pressure on skin over bones, boosting circulation, and reducing tissue breakdown risk. Sustaining or promoting immobility heightens this risk, as does tight dressings that add pressure and impair blood flow. Nurses implement this intervention shifting positions every two hours, for instance to protect skin integrity, a fundamental strategy in caring for those unable to move independently, prioritizing prevention over reactive treatment.
You are the nurse working with an elderly, competent client who refuses a vitamin B injection ordered by the physician. The family insists that this injection be given, and you give it while the client is objecting. Even though the client improves, the client contacts a lawyer. From your knowledge of nursing and the law, you realize that you:
- A. did the right thing because the client improved.
- B. should have had the family put their request in writing.
- C. have commited an assault against the client.
- D. have committed an act of battery against the client.
Correct Answer: D
Rationale: Administering a vitamin B injection to a competent client who refuses it, despite family insistence and subsequent improvement, constitutes battery. Battery is the unlawful physical contact with a person without consent, and in healthcare, consent is a fundamental right for competent adults. The client's objection overrides family wishes, and giving the injection violates autonomy, a core ethical principle. The outcome of improvement doesn't justify the action legally or ethically. Assault involves threatening harm, whereas battery is the act itself, making this the correct classification. Getting family requests in writing or focusing on the outcome doesn't negate the lack of consent. This scenario underscores the importance of respecting patient rights and the legal consequences of disregarding them, even with good intentions.
When an LVN/LPN is working for a health-care organization that has professional liability insurance, the nurse needs to base a decision on whether to buy individual professional liability insurance on which of the following things?
- A. the possibility that the organization could countersue the nurse in a lawsuit
- B. the cost of professional liability insurance to the nurse
- C. the amount and type of coverage the health-care organization carries
- D. the number of hours worked and the type of nursing work
Correct Answer: A
Rationale: Deciding whether to purchase individual professional liability insurance as an LVN/LPN involves weighing personal risk, and the possibility of the organization countersuing the nurse in a lawsuit is a critical factor. Organizational insurance typically covers nurses acting within their scope, but if a lawsuit arises and the organization's interests diverge such as alleging nurse negligence they might countersue to deflect liability. Individual insurance provides independent protection, ensuring legal defense and coverage tailored to the nurse's needs. Cost, organizational coverage, and work hours are relevant but secondary; cost affects feasibility, coverage might leave gaps, and hours or work type influence risk but don't address the specific threat of a countersuit. This choice emphasizes proactive self-protection in a litigious environment, safeguarding the nurse's career and finances.
Mr. Gary moved from hospital to rehab with a care plan. This is an example of?
- A. Care transition
- B. Chronic disease management
- C. Health promotion
- D. Nursing informatics
Correct Answer: A
Rationale: Moving from hospital to rehab with a plan is care transition (A) setting shift, per definition. Management (B) ongoing, promotion (C) preventive, informatics (D) tech not transition-specific. A fits care handoff, making it correct.
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