Nokea
The nurse provides information to a preoperative client who will be receiving relaxation therapy. What effects should the nurse teach the client to expect regarding this type of therapy? Select all that apply.
- A. Increased heart rate
- B. Improved well-being
- C. Lowered blood pressure
- D. Increased respiratory rate
- E. Decreased muscle tension
- F. Increased neural impulses to the brain
Correct Answer: B,C,E
Rationale: Relaxation is the state of generalized decreased cognitive, physiological, and/or behavioral arousal. Relaxation elongates the muscle fibers, reduces the neural impulses to the brain, and thus decreases the activity of the brain and other systems. The effects of relaxation therapy include improved well-being; lowered blood pressure, heart rate, and respiratory rate; decreased muscle tension; and reduced symptoms of distress in persons who need to undergo treatments, those experiencing complications from medical treatment or disease, or those grieving the loss of a significant other. This therapy does not cause an increased heart rate, increased respiratory rate, or increased neural impulses to the brain.
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The nurse is caring for a client scheduled for a bilateral adrenalectomy for treatment of an adrenal tumor. What information should the nurse give the client about the postsurgical needs?
- A. You will need to undergo chemotherapy after surgery.
- B. You will need to wear an abdominal binder after surgery.
- C. You will not need any special long-term treatment after surgery.
- D. You will need to take daily hormone replacements beginning after the surgery.
Correct Answer: D
Rationale: The major cause of primary hyperaldosteronism is an aldosterone-secreting tumor called an aldosteronoma. Surgery is the treatment of choice. Clients undergoing a bilateral adrenalectomy require permanent replacement of adrenal hormones. Options 1, 2, and 3 are inaccurate statements regarding this surgery.
The client is prescribed sotalol 80 mg orally twice daily. Which assessment finding indicates that the client is experiencing an adverse effect of the medication?
- A. Dry mouth
- B. Palpitations
- C. Diaphoresis
- D. Difficulty swallowing
Correct Answer: B
Rationale: Sotalol is a beta-adrenergic blocking agent that may be prescribed to treat chronic angina pectoris. Adverse effects include palpitations, bradycardia, an irregular heartbeat, difficulty breathing, signs of heart failure, and cold hands and feet. Gastrointestinal disturbances, anxiety and nervousness, and unusual tiredness and weakness can also occur. Options 1, 3, and 4 are not adverse effects of this medication.
Tretinoin gel has been prescribed for a client with acne. What is the nurse's response when the client calls and reports that her skin has become very red and is beginning to peel?
- A. Discontinue the medication immediately.
- B. Come to the clinic immediately for an assessment.
- C. I'll notify your primary health care provider of these results.
- D. This is a normal occurrence with the use of this medication.
Correct Answer: D
Rationale: Tretinoin decreases cohesiveness of the epithelial cells, increasing cell mitosis and turnover. It is potentially irritating, particularly when used correctly. Within 48 hours of use, the skin generally becomes red and begins to peel. Options 1, 2, and 3 are incorrect statements to the client.
The nurse is preparing to administer an opioid to a client via an epidural catheter. Before administering the medication, the nurse aspirates and obtains 5 mL of clear fluid. Based on this finding, which action should the nurse take?
- A. Inject the opioid slowly.
- B. Notify the anesthesiologist.
- C. Inject the aspirate back into the catheter and administer the opioid.
- D. Flush the catheter with 6 mL of sterile water before injecting the opioid.
Correct Answer: B
Rationale: Aspiration of clear fluid of less than 1 mL is indicative of epidural catheter placement. More than 1 mL of clear fluid or bloody return means that the catheter may be in the subarachnoid space or a vessel. Therefore, the nurse would not inject the medication and would notify the anesthesiologist. Options 1, 3, and 4 are incorrect actions.
The nurse is sending an arterial blood gas (ABG) specimen to the laboratory for analysis. What information should the nurse include on the laboratory requisition? Select all that apply.
- A. Ventilator settings
- B. A list of client allergies
- C. The client's temperature
- D. The date and time the specimen was drawn
- E. Any supplemental oxygen the client is receiving
- F. Extremity from which the specimen was obtained
Correct Answer: A,C,D,E
Rationale: An ABG requisition usually contains information about the date and time the specimen was drawn, the client's temperature, whether the specimen was drawn on room air or using supplemental oxygen, and the ventilator settings if the client is on a mechanical ventilator. The client's allergies and the extremity from which the specimen was drawn do not have a direct bearing on the laboratory results.