Nokea
The nurse is caring for a client with a history of peptic ulcer disease. Which medication should the nurse anticipate being prescribed?
- A. Omeprazole (Prilosec)
- B. Ibuprofen (Motrin)
- C. Cimetidine (Tagamet)
- D. Both A and C
Correct Answer: D
Rationale: Peptic ulcer disease is treated with proton pump inhibitors like omeprazole and H2 blockers like cimetidine to reduce acid production and promote healing. Ibuprofen, an NSAID, can worsen ulcers and is avoided.
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A 25-year-old lawyer who is married with three young children works long hours in an effort to become a partner in the law firm. Following a recent hospitalization for a bleeding ulcer, he was referred for therapy to treat this psychophysiological disorder. On meeting with the therapist, he informed him or her that he was a busy man and did not have much time for this 'psych stuff.' When guiding the client to ventilate his feelings, the therapist can expect him to express feelings of:
- A. Guilt
- B. Shame
- C. Despair
- D. Anger
Correct Answer: D
Rationale: Repressed anger is associated with psychophysiological disorders like a bleeding ulcer, as stress and unexpressed emotions contribute to physical symptoms.
An expected response to sodium polystyrene sulfonate (Kayexalate) is:
- A. Increase in serum magnesium
- B. Increase in serum HCO3
- C. Decrease in serum potassium
- D. DecreaseWhole blood is the transfusion component of choice when large volumes of blood need to be replaced. Whole blood contains all blood components that are lost during active bleeding.
- E. Platelets
- F. Fresh frozen plasma
- G. Packed red blood cells
Correct Answer: A
Rationale: Whole blood is the transfusion component of choice when large volumes of blood need to be replaced. Whole blood contains all blood components that are lost during active bleeding.
Which one of the following is considered a reliable indicator for assessing the adequacy of fluid resuscitation in a 3-year-old child who suffered partial- and full-thickness burns to 25% of her body?
- A. Urine output
- B. Edema
- C. Hypertension
- D. Bulging fontanelle
Correct Answer: A
Rationale: Urinary output is a reliable indicator of renal perfusion, which in turn indicates that fluid resuscitation is adequate. IV fluids are adjusted based on the urinary output of the child during fluid resuscitation. Edema is an indication of increased capillary permeability following a burn injury. Hypertension is an indicator of fluid volume excess. Fontanelles close by 18 months of age.
A male client had a right below-the-knee amputation 4 days ago. His incision is healing well. He has gotten out of bed several times and sat at the side of the bed. Each time after returning to bed, he has experienced pain as if it were located in his right foot. Which nursing measure indicates the nurse has a thorough understanding of phantom pain and its management?
- A. Phantom pain is entirely in the client's mind. The client should be instructed that the pain is psychological and should not be treated.
- B. The basis for phantom pain may occur because the nerves still carry pain sensation to the brain even though the limb has been amputated. The pain is real, intense, and should be treated.
- C. The cause of phantom pain is unknown. The nurse should provide the client with support, promote sleep, and handle the injured limb smoothly and gently.
- D. Phantom pain is caused by trauma, spasms, and edema at the incisional site. It will decrease when postoperative edema decreases. It should be treated with nonnarcotic medication whenever possible.
Correct Answer: B
Rationale: This statement is entirely false. Phantom pain may be caused by nerves continuing to carry sensation to the brain even though the limb is removed. It is real, intense, and should be treated as ordinary pain would. Although the cause of phantom pain is still unknown, these measures may promote the relief of any type of pain, not just phantom pain. Phantom pain is not caused by trauma, spasms, and edema and will not be relieved by decreasing edema.
The client is admitted with a diagnosis of placenta accreta. Which complication is most likely to occur?
- A. Maternal hemorrhage
- B. Fetal distress
- C. Preterm labor
- D. All of the above
Correct Answer: D
Rationale: Placenta accreta where the placenta abnormally adheres to the uterine wall increases the risk of maternal hemorrhage (during delivery) fetal distress (from placental dysfunction) and preterm labor (from interventions). All are potential complications.