Nokea
The nurse is assessing a client with a recent history of an above-the-knee amputation presenting with phantom limb pain. The nurse anticipates a prescription for
- A. aripiprazole
- B. oxycodone
- C. amitriptyline
- D. hydroxyzine
Correct Answer: C
Rationale: Amitriptyline, a tricyclic antidepressant, is commonly used for neuropathic pain, including phantom limb pain, due to its effects on nerve signaling.
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When preparing a teaching plan for an adult client about general anesthesia induction, which explanation would be most appropriate?
- A. œYour premedication will put you to sleep.'
- B. œYou will breathe in an inhalant anesthetic mixed with oxygen through a facial mask and receive intravenous medication to make you sleepy.'
- C. œYou will receive intravenous medication to make you sleepy.'
- D. œYou will breathe in medication through a facial mask to make you sleepy.'
Correct Answer: C
Rationale: For adults, explaining that intravenous medication induces sleep is accurate and simple, avoiding overwhelming details while addressing the primary method of general anesthesia induction.
A high-carbohydrate, low-protein diet is prescribed for the client with acute renal failure. The intended outcome of this diet is to:
- A. Act as a diuretic.
- B. Reduce demands on the liver.
- C. Help maintain urine acidity.
- D. Prevent the development of ketosis.
Correct Answer: D
Rationale: A high-carbohydrate, low-protein diet provides energy and prevents ketosis by reducing protein breakdown in acute renal failure.
The nurse teaches a client with chronic obstructive pulmonary disease for signs and symptoms of right-sided heart failure. Which of the following signs and symptoms should be included in the teaching plan?
- A. Clubbing of nail beds.
- B. Hypertension.
- C. Peripheral edema.
- D. Increased appetite.
Correct Answer: C
Rationale: Right-sided heart failure (cor pulmonale) in COPD causes peripheral edema due to increased venous pressure. Clubbing reflects chronic hypoxia, not heart failure. Hypertension and increased appetite are unrelated.
In preparing the client and the family for a postoperative stay in the intensive care unit (ICU) after open heart surgery, the nurse should explain that:
- A. The client will remain in the ICU for 5 days.
- B. The client will sleep most of the time while in the ICU.
- C. Noise and activity within the ICU are minimal.
- D. The client will receive medication to relieve pain.
Correct Answer: D
Rationale: Pain management is a priority post-open heart surgery, and clients receive medications to ensure comfort in the ICU.
Before undergoing a transsphenoidal hypophysectomy, the client asks the nurse how the surgeon will close the incision made in the dura. The nurse should respond based on the knowledge that:
- A. Dissolvable sutures are used to close the dura.
- B. Nasal packing provides pressure until normal wound healing occurs.
- C. A patch is made with a piece of fascia.
- D. A synthetic mesh is placed to facilitate healing.
Correct Answer: C
Rationale: A fascial patch is commonly used to repair the dura during transsphenoidal hypophysectomy to prevent CSF leaks.