Nokea
The nurse is caring for a client who is postoperative day 1 following a laparoscopic appendectomy. The client reports shoulder pain. Which of the following actions should the nurse take?
- A. Administer an analgesic as ordered.
- B. Notify the physician immediately.
- C. Explain that this is referred pain from residual gas.
- D. Place the client in a prone position.
Correct Answer: C
Rationale: shoulder pain after laparoscopic surgery is often due to referred pain from residual carbon dioxide used during the procedure
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The nurse is caring for the client following a thyroidectomy when suddenly the client becomes nonresponsive and pale, with a BP of 60 systolic. The nurse's initial action should be to:
- A. Lower the head of the bed
- B. Increase the infusion of normal saline
- C. Administer atropine IV
- D. Obtain a crash cart
Correct Answer: B
Rationale: Increasing normal saline infusion addresses hypovolemic shock, likely due to post-thyroidectomy hemorrhage, as the priority action.
Which client is at risk for opportunistic diseases such as pneumocystis pneumonia?
- A. The client with cancer who is being treated with chemotherapy
- B. The client with Type I diabetes
- C. The client with thyroid disease
- D. The client with Addison's disease
Correct Answer: A
Rationale: Chemotherapy suppresses the immune system, increasing the risk of opportunistic infections like pneumocystis pneumonia.
A client is 4 hours post-op left carotid endarterectomy. Which assessment finding would cause the nurse the most concern?
- A. Temperature 99.4°F, heart rate 110, respiratory rate 24
- B. Drowsiness, urinary output of 50 mL the past hour, 1 cm blood drainage noted on surgical dressing
- C. BP 120/60, lethargic, right-sided weakness
- D. Alert and oriented, BP 168/96, heart rate 70
Correct Answer: C
Rationale: Right-sided weakness post-left carotid endarterectomy suggests a neurological deficit, possibly from stroke or hematoma, requiring immediate intervention.
The physician has ordered an infusion of Osmitrol (mannitol) for a client with increased intracranial pressure. Which finding indicates the direct effectiveness of the drug?
- A. Increased pulse rate
- B. Increased urinary output
- C. Decreased diastolic blood pressure
- D. Increased pupil size
Correct Answer: B
Rationale: Mannitol is an osmotic diuretic that reduces intracranial pressure by increasing urinary output, drawing fluid out of the brain tissue.
A client with chronic obstructive pulmonary disease (COPD) is admitted to the respiratory unit. Which physician prescription should the nurse question?
- A. Oâ‚‚ at 5 L/min by nasal cannula
- B. Solu Medrol 125 mg IV push every 6 hours
- C. Ceftriaxone (Rocephin) 1gram IVPB daily
- D. Darvocet N 100 po prn pain
Correct Answer: A
Rationale: High-flow oxygen (5 L/min) can suppress the hypoxic drive in COPD clients, risking CO2 retention. Low-flow oxygen (1-2 L/min) is safer and should be questioned.