Nokea
Thirty-six hours postoperatively a patient has a temperature of 100°F (37.8°C). What is the most likely cause of this temperature elevation?
- A. Dehydration
- B. Wound infection
- C. Lung congestion and atelectasis
- D. Normal surgical stress response
Correct Answer: D
Rationale: Low-grade fever within the first 48 hours postoperatively is typically a normal response to surgical stress.
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A client with tuberculosis is starting combination drug therapy. Which of the following medications should the nurse NOT plan to administer?
- A. Rifampin
- B. Isoniazid
- C. Acyclovir
- D. Pyrazinamide
Correct Answer: C
Rationale: The correct answer is C: Acyclovir. Acyclovir is an antiviral medication used to treat herpes infections, not tuberculosis. Rifampin, Isoniazid, and Pyrazinamide are all first-line drugs for tuberculosis treatment. Rifampin is a bactericidal agent, Isoniazid disrupts mycobacterial cell wall synthesis, and Pyrazinamide targets actively replicating bacteria. Therefore, the nurse should not plan to administer Acyclovir as it is not indicated for tuberculosis treatment.
With what are the postoperative respiratory complications of atelectasis and aspiration of gastric contents associated?
- A. Hypoxemia
- B. Hypercapnia
- C. Hypoventilation
- D. Airway obstruction
Correct Answer: A
Rationale: Hypoxemia results from impaired gas exchange due to atelectasis or aspiration.
What interventions can the nurse use to decrease the client's anxiety?
- A. Increase protein intake
- B. Reduce carbohydrate consumption
- C. Drink more water
- D. Take vitamin supplements
Correct Answer: B
Rationale: The correct answer is B because it is the most appropriate response based on physiological and medical principles.
During seizure activity which observation is the priority to enhance further direction of treatment?
- A. Observe the sequence or types of movement.
- B. Note the time from beginning to end.
- C. Identify the pattern of breathing.
- D. Determine if loss of bowel or bladder control occurs.
Correct Answer: B
Rationale: Timing seizures is crucial for determining appropriate interventions.
List at least four factors in this situation that contribute to health disparities.
- A. Geographic isolation (living 'up the mountain')
- B. Limited access to healthcare (refusal of medical care)
- C. Low socioeconomic status (barely making a living)
- D. Lack of social support (children rarely visit)
Correct Answer: D
Rationale: Health disparities are influenced by geographic isolation, lack of access to healthcare, low socioeconomic status, and lack of social support. These factors collectively exacerbate her condition.