Nokea
The nurse prepares a 25-year-old woman for a cesarean section.
- A. What should the nurse’s response be based on regarding preoperative medication for a cesarean section?
- B. Contains a lower overall dosage of medication than is given before general surgery.
- C. Contains reduced amounts of sedatives and hypnotics than are given before general surgery.
- D. Contains reduced amounts of narcotics than are given before general surgery.
- E. Contains medications similar in type and dosages to those given before general surgery.
Correct Answer: C
Rationale: Preoperative medication for a cesarean section includes reduced amounts of narcotics to minimize respiratory depression in the newborn due to placental transfer. Sedatives and hypnotics are typically used in similar doses as in general surgery, and the overall dosage is not necessarily lower.
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The nurse is caring for clients on a medical/surgical unit and determines that several situations need to be addressed.
- A. Which situation should the nurse attend to first?
- B. An angry daughter is threatening to sue the hospital because her confused mother fell out of bed during the previous shift.
- C. The nursing assistant is 30 minutes overdue from a dinner break in the cafeteria for the third time this week.
- D. The physician calls the unit to ask the nurse to obtain a client’s laTest serum electrolyte results from the lab.
- E. The husband of a client reports to the nurse that his wife’s nose began bleeding after she returned from radiation therapy.
Correct Answer: D
Rationale: A nosebleed post-radiation therapy is the least stable situation, as it may indicate a serious complication like thrombocytopenia or tissue damage, requiring immediate assessment. Legal threats, staff issues, and lab result requests are less urgent than a potentially life-threatening condition.
As a client is being discharged following resolution of a spontaneous pneumothorax, he tells the nurse that he is now going to Hawaii for a vacation. The nurse would warn him to avoid
- A. Surfing
- B. Scuba diving
- C. Parasailing
- D. Swimming
Correct Answer: B
Rationale: Scuba diving. The nurse would strongly emphasize the need for clients with history of spontaneous pneumothorax problems to avoid high altitudes, flying in unpressurized aircraft and scuba diving. The negative pressures could cause the lung to collapse again.
A patient is being treated in the telemetry unit for cardiac disease. The patient is to receive propranolol hydrochloride (Inderal) 20 mg PO at 9 AM. The nurse finds him wheezing with a nonproductive cough and shortness of breath.
INITIALLY, the nurse should
- A. hold the medication and count the respirations.
- B. hold the medication and call the physician.
- C. take an apical pulse and then give the medication.
- D. give the medication as ordered.
Correct Answer: A
Rationale: Strategy: Determine the outcome of each answer choice. (1) correct-side effects include increased airway resistance, patient is experiencing bronchospasm, should assess then call the physician (2) should assess the patient's condition first (3) experiencing a side effect, medication should not be given (4) medication should be held, experiencing a side effect
The nurse is caring for a client with a history of type 1 diabetes who is receiving insulin glargine (Lantus) 20 units subcutaneously at bedtime. Which of the following findings would be of GREATest concern to the nurse?
- A. Blood glucose of 100 mg/dL.
- B. Heart rate of 80 bpm.
- C. Sweating and irritability.
- D. Blood pressure of 120/80 mmHg.
Correct Answer: C
Rationale: Sweating and irritability indicate hypoglycemia, a serious complication of insulin glargine, requiring immediate treatment with carbohydrates. Options A, B, and D are normal: glucose 100 mg/dL, heart rate 80 bpm, and blood pressure 120/80 mmHg indicate stability.
A client with a perforated bowel secondary to a bowel obstruction.
At the time the diagnosis is made, which of the following should be a priority in the nursing care plan?
- A. Maintain the client in a supine position.
- B. Notify the client's next-of-kin.
- C. Prepare the client for emergency surgery.
- D. Remove the nasogastric tube.
Correct Answer: C
Rationale: Strategy: All answers are implementations. Determine the outcome of each answer choice. Is it desired? (1) client is kept in semi-Fowler's position (2) not a priority action (3) correct-when the bowel perforates as a result of increased intraluminal pressure within the gut, inTest inal contents are released into the peritoneum, leading to peritonitis (4) should not be done