Nokea
The nurse teaches the client with chronic cancer pain about optimal pain control. Which of the following recommendations is most effective for pain control?
- A. Get used to some pain and use a little less medication than needed to keep from being addicted.
- B. Take prescribed analgesics on an around-the-clock schedule to prevent recurrent pain.
- C. Take analgesics only when pain returns.
- D. Take enough analgesics around the clock so that you can sleep 12 to 16 hours a day to block the pain.
Correct Answer: B
Rationale: Taking analgesics around-the-clock prevents recurrent pain by maintaining steady drug levels, which is the most effective strategy for chronic cancer pain.
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The nurse notices that a client with Parkinson's disease is coughing frequently when eating. Which one of the following interventions should the nurse consider?
- A. Have the client hyperextend the neck when swallowing.
- B. Tell the client to place the chin firmly against the chest when eating.
- C. Thicken all liquids before offering to the client.
- D. Place the client on a clear liquid diet.
Correct Answer: C
Rationale: Thickening liquids reduces aspiration risk in Parkinson's patients with dysphagia, as coughing indicates swallowing difficulty. Hyperextending the neck or a clear liquid diet increases aspiration risk, and chin tuck is less universally effective.
The nurse in the emergency department (ED) is caring for a 62-year-old male client.
Item 4 of 6
Triage Note
1700:
• The client was brought to the ED after collapsing on a tennis court.
• Vital signs: BP 94/57, T 105° F (40.5° C), P 115, RR 26, Pulse oximetry 95% on room air. • The client is lethargic and confused. Skin is pale, and there is some perspiration on the forehead. Thready peripheral pulses, clear lung fields bilaterally, tachypnea, shallow respirations.
For each possible intervention, click to specify if the intervention is essential or contraindicated.
- A. Seizure precautions
- B. Request a prescription for dextrose 5% in water (D5W)
- C. Measure axillary temperature frequently
- D. Apply a cooling blanket
- E. Encourage the client to consume cool liquids
- F. Establish continuous cardiac monitoring
- G. Insert an indwelling urinary drainage catheter
Correct Answer: A,B,C,D,E,F,G
Rationale: A (Essential), B (Contraindicated), C (Contraindicated), D (Essential), E (Contraindicated), F (Essential), G (Essential). Seizure precautions, cooling blanket, cardiac monitoring, antipyretics, catheter, and clothing removal are essential for heat stroke management. D5W risks fluid overload, axillary temperature is unreliable, and oral fluids are unsafe due to altered mental status.
A client with rheumatoid arthritis tells the nurse, 'I know it is important to exercise my joints so that I won't lose mobility, but my joints are so stiff and painful that exercising is difficult.' Which of the following responses by the nurse would be most appropriate?
- A. You are probably exercising too much. Decrease your exercise to every other day.'
- B. Tell the physician about your symptoms. Maybe your analgesic medication can be increased.'
- C. Stiffness and pain are part of the disease. Learn to cope by focusing on activities you enjoy.'
- D. Take a warm tub bath or shower before exercising. This may help with your discomfort.'
Correct Answer: D
Rationale: Warm baths or showers can reduce joint stiffness and pain, making exercise more tolerable and effective for maintaining mobility.
The client asks the nurse whether he will need surgery to correct his hiatal hernia. Which reply by the nurse would be most accurate?
- A. Surgery is usually required, although medical treatment is attempted first.'
- B. Hiatal hernia symptoms can usually be successfully managed with diet modifications, medications, and lifestyle changes.'
- C. Surgery is not performed for this type of hernia.'
- D. A minor surgical procedure to reduce the size of the diaphragmatic opening will probably be planned.'
Correct Answer: B
Rationale: Most hiatal hernias are managed effectively with diet, medications, and lifestyle changes, making this the most accurate response.
The client with an intestinal obstruction continues to have acute pain even though the nasoenteric tube is patent and draining. Which action by the nurse would be most appropriate?
- A. Reassure the client that the nasoenteric tube is functioning.
- B. Assess the client for a rigid abdomen.
- C. Administer an opioid as ordered.
- D. Reposition the client on the left side.
Correct Answer: B
Rationale: Persistent acute pain despite a patent nasoenteric tube suggests a complication like peritonitis, indicated by a rigid abdomen, which requires immediate assessment. Reassurance, opioids, or repositioning may delay addressing a serious issue. CN: Physiological adaptation; CL: Synthesize