Nokea
The nurse is reviewing new medication prescriptions for assigned clients. The nurse should clarify the prescription for?
- A. PO oxycodone for a client who had a total hip replacement 1 day ago, has a history of buspirone use, and is reporting pain rated as 6 on a scale of 0-10
- B. PO tramadol for a client who had a laparoscopic cholecystectomy 1 day ago, has a history of nicotine use, and is reporting pain rated as 5 on a scale of 0-10
- C. transdermal fentanyl for a client who had an above-the-knee amputation 2 days ago, has a history of cocaine use, and is reporting pain rated as 8 on a scale of 0-10
- D. transdermal lidocaine 5% for a client who has chronic postherpetic neuralgia, has a history of alcohol use, and is reporting pain rated as 7 on a scale of 0-10
Correct Answer: C
Rationale: Transdermal fentanyl is typically reserved for chronic pain, not acute postoperative pain, and requires clarification.
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A 54-year-old male is admitted to the cardiac unit with chest pain radiating to the jaw and left arm. Which enzyme would be most specific in the diagnosis of a myocardial infarction?
- A. Aspartate aminotransferase
- B. Lactic acid dehydrogenase
- C. Hydroxybutyric dehydrogenase
- D. Creatine phosphokinase
Correct Answer: D
Rationale: CK-MB (creatine phosphokinase muscle bond isoenzyme) is the most specific for a myocardial infarction. Troponin is also extremely reliable. Answers A, B, and C are nonspecific to myocardial infarctions, so they are incorrect.
A female client is admitted for a breast biopsy. She says, tearfully to the nurse, 'If this turns out to be cancer and I have to have my breast removed, my partner will never come near me.' The nurse's best response would be which of these statements?
- A. I hear you saying that you have a fear for the loss of love.'
- B. You sound concerned that your partner will reject you.'
- C. Are you wondering about the effects on your sexuality?'
- D. Are you worried that the surgery will lead to changes?'
Correct Answer: D
Rationale: This is a general lead-in type of response that encourages further discussion without focusing on an area that the nurse, but possibly not the client, feels is a problem.
After successful alcohol detoxification, a client remarked to a friend, 'I've tried to stop drinking but I just can't. I can't even work without having a drink.' The client's belief that he needs alcohol indicates his dependence is primarily
- A. psychological
- B. physical
- C. biological
- D. social-cultural
Correct Answer: A
Rationale: With psychological dependence, it is the client's thoughts and attitude toward alcohol that produce craving and compulsive use.
The nurse is performing tracheal suctioning and notes a previously used bottle of saline at the client's bedside. The nurse should:
- A. Lip the bottle and use a pack of sterile 4x4 for the dressing.
- B. Obtain a new bottle and label it with the date and time.
- C. Ask the RN when the solution was requested.
- D. Label the existing bottle with the current date and time.
Correct Answer: B
Rationale: A new, sterile saline bottle is required for suctioning to prevent infection. Reusing or relabeling an opened bottle is unsafe.
A client is admitted to the recovery room following an exploratory laparotomy. Which medication should be kept nearby?
- A. Nitroprusside (Nipride)
- B. Naloxone hydrochloride (Narcan)
- C. Flumazenil (Romazicon)
- D. Diphenhydramine (Benadryl)
Correct Answer: B
Rationale: Naloxone (Narcan) should be kept nearby to reverse opioid-induced respiratory depression, common after surgery due to anesthesia or pain management. Nitroprusside , flumazenil , and diphenhydramine are less relevant.