Nokea
The nurse has attended a staff development conference regarding patient-controlled analgesia. Which of the following statements by the nurse indicates effective understanding?
- A. A client may be prescribed a loading dose before they are able to activate their own prescribed dosage.
- B. PCAs are not recommended for individuals with acute pain.
- C. PCAs decrease the need for a client to have pain assessments.
- D. When a client receives a PCA via a continuous basal rate, it decreases their risk for adverse effects.
Correct Answer: A
Rationale: A loading dose is often used in PCA to achieve initial pain control before the patient begins self-administering doses. PCAs are suitable for acute pain, do not eliminate the need for pain assessments, and continuous basal rates may increase adverse effect risks.
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A female receiving radiation therapy for lung cancer complains to the nurse that she is having difficulty sleeping. Which of the following nursing actions is most appropriate?
- A. Suggest the client stop watching television before bed.
- B. Assess the client's usual sleep patterns, amount of sleep, and bedtime rituals.
- C. Tell the client sleeplessness is expected with radiation therapy.
- D. Suggest that the client stop drinking coffee until the therapy is completed.
Correct Answer: B
Rationale: Assessing sleep patterns, amount of sleep, and bedtime rituals provides a comprehensive understanding of the client's insomnia, enabling tailored interventions.
During the initial stage of adaptation to the diagnosis of cancer and its treatment, the nurse can facilitate the client's adaptation by:
- A. Encouraging the client to maintain her usual role.
- B. Facilitating family-related disagreements and conflicts.
- C. Supporting the client in her use of denial as a coping strategy.
- D. Arranging transportation and child care on treatment days.
Correct Answer: D
Rationale: Arranging transportation and child care addresses practical barriers, facilitating the client's ability to focus on treatment and adapt to the diagnosis.
The nurse is preparing to administer prescribed medications to a client via a nasogastric tube connected to low-intermittent suction. The nurse should take which appropriate action? Select all that apply.
- A. Position the client in Trendelenburg position.
- B. Verify correct placement of the tube before medication administration.
- C. Turn off the suction during medication administration.
- D. Resume low-intermittent wall suction immediately after medication administration.
- E. Irrigate the nasogastric tube (NGT) with sterile water.
Correct Answer: B,C
Rationale: Verifying tube placement and turning off suction ensure safe medication administration; Trendelenburg is inappropriate, and sterile water is not required.
Which of the following instructions should the nurse include in the teaching plan for a client who is experiencing gastroesophageal reflux disease (GERD)?
- A. Limit caffeine intake to two cups of coffee per day.
- B. Do not lie down for 2 hours after eating.
- C. Follow a low-protein diet.
- D. Take medications with milk to decrease irritation.
Correct Answer: B
Rationale: Avoiding lying down for 2 hours after eating prevents reflux of stomach contents into the esophagus, a key strategy for managing GERD. The other options are incorrect or exacerbate symptoms.
The nurse is unable to palpate the client's left pedal pulses. Which of the following actions should the nurse take next?
- A. Auscultate the pulses with a stethoscope
- B. Call the physician
- C. Use a Doppler ultrasound device
- D. Inspect the lower left extremity
Correct Answer: C
Rationale: If pedal pulses are not palpable, the next step is to use a Doppler ultrasound device to detect blood flow, as pulses may be weak due to PVD or other causes. Auscultation is not used for peripheral pulses, calling the physician is premature, and inspection is less specific than Doppler assessment.