Nokea
To help minimize the risk of postoperative respiratory complications after a hypophysectomy, during preoperative teaching, the nurse should instruct the client how to:
- A. Use blow bottles.
- B. Turn in bed.
- C. Take deep breaths.
- D. Cough.
Correct Answer: C
Rationale: Deep breathing exercises post-hypophysectomy help expand lungs and prevent atelectasis, reducing respiratory complications.
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A client has been diagnosed with vasospastic disorder (Raynaud's phenomenon) on the tip of the nose and fingertips. The physician has prescribed reserpine (Serpasil) to determine if the client will obtain relief. The client's history reveals that he lives in Vermont and works outside in the logging industry. He smokes two packs of cigarettes a day. Which of the following components are an important part of the discharge plan for this client? Select all that apply.
- A. Stopping smoking
- B. Wearing a face covering and gloves in the winter
- C. Placing fingertips in cool water to rewarm them
- D. Finding employment that can be done in a warm environment
- E. Reporting signs of orthostatic hypotension
Correct Answer: A,B,D,E
Rationale: Rationales: A) Stopping smoking reduces vasoconstriction triggered by nicotine, critical in Raynaud's. B) Face covering and gloves protect against cold, a trigger for vasospasm. D) Working in a warm environment minimizes cold exposure. E) Reserpine may cause orthostatic hypotension, requiring monitoring. C) Cool water worsens vasospasm; warm water is recommended.
Which of the following are expected outcomes for a client with pulmonary disease?
- A. A relatively matched ventilation-to-perfusion ratio.
- B. A low ventilation-to-perfusion ratio.
- C. A high ventilation-to-perfusion ratio.
- D. An equal PaO2 and PaCO2 ratio.
Correct Answer: A
Rationale: A matched ventilation-to-perfusion ratio is the goal in pulmonary disease for efficient gas exchange. Low or high ratios indicate mismatch. Equal PaO2 and PaCO2 is not a standard outcome.
The nurse should monitor the surgical client closely for which clinical manifestation with the administration of naloxone (Narcan)?
- A. Dizziness.
- B. Biliary colic.
- C. Bleeding.
- D. Urine retention.
Correct Answer: A
Rationale: Naloxone can cause dizziness due to rapid reversal of opioid effects, leading to autonomic changes. This is a common side effect to monitor in surgical clients.
What is the nurse's priority for a client with Guillain-Barré syndrome?
- A. Monitor respiratory function.
- B. Assess pain levels.
- C. Check skin integrity.
- D. Evaluate bowel function.
Correct Answer: A
Rationale: Monitoring respiratory function is the priority due to potential respiratory muscle weakness in Guillain-Barré syndrome.
The nurse is aware that the diagnostic tests typically ordered for acute diverticulitis do not include a barium enema. The reason for this is that a barium enema:
- A. Can perforate an intestinal abscess.
- B. Would greatly increase the client's pain.
- C. Is of minimal diagnostic value in diverticulitis.
- D. Is too lengthy a procedure for the client to tolerate.
Correct Answer: A
Rationale: A barium enema is avoided in acute diverticulitis because it can perforate an intestinal abscess, worsening the condition. It may cause discomfort but is not primarily avoided for pain, diagnostic value, or procedure length. CN: Reduction of risk potential; CL: Apply