Nokea
To prevent a common, adverse effect of prolonged use of phenytoin sodium (Dilantin), patients taking the drug are instructed to
- A. avoid crowds and obtain an annual influenza vaccination.
- B. drink at least 2 L of fluids daily, including 8 to 10 glasses of water.
- C. eat a potassium-rich, low-sodium diet.
- D. practice good dental hygiene and report gum swelling or bleeding.
Correct Answer: D
Rationale: Phenytoin can cause gum hyperplasia, so good dental hygiene is essential.
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A patient scheduled for hip replacement surgery in the early afternoon is NPO but receives and ingests a breakfast tray with clear liquids on the morning of surgery. What response does the nurse expect when the anesthesia care provider is notified?
- A. Surgery will be done as scheduled.
- B. Surgery will be rescheduled for the following day.
- C. Surgery will be postponed for 8 hours after the fluid intake.
- D. A nasogastric tube will be inserted to remove the fluids from the stomach.
Correct Answer: A
Rationale: Clear liquids are generally acceptable up to 2 hours before surgery, allowing the procedure to proceed as planned.
When should discharge planning begin for a patient in a tertiary-care facility?
- A. On the day of admission
- B. After the acute crisis is resolved
- C. When the physician writes the discharge order
- D. When the patient demonstrates readiness to discuss posthospitalization needs
Correct Answer: A
Rationale: Rationale:
A: Discharge planning should begin on the day of admission to ensure a smooth transition. This early start allows for comprehensive assessment and coordination of post-discharge needs.
B: Waiting until after the acute crisis is resolved may lead to rushed planning and potential gaps in care.
C: Discharge planning should not solely rely on the physician's discharge order as it may not address all aspects of the patient's needs.
D: Patient readiness is important, but starting planning early ensures sufficient time for assessment and interventions.
What nursing measure assumes priority for Mr. Johnson with sudden diarrhea and high fever?
- A. Determine if he had been working on an air-conditioning unit of a high-rise building
- B. Place the patient in isolation
- C. Monitor respiratory status carefully and observe for signs of hypoxia
- D. Begin discharge teaching
Correct Answer: C
Rationale: The correct answer is C, to monitor respiratory status and observe for signs of hypoxia. This is because sudden diarrhea and high fever can indicate a potential infectious illness, which can lead to respiratory complications such as pneumonia. Monitoring respiratory status is crucial to detect any signs of respiratory distress or hypoxia early on.
A: Determining his work on an air-conditioning unit is not a priority at this time as it does not directly address his immediate health concerns.
B: Placing the patient in isolation may be necessary later depending on the diagnosis, but it is not the priority at this moment.
D: Beginning discharge teaching is not appropriate as the patient is currently experiencing acute symptoms that require immediate attention.
In summary, monitoring respiratory status is the priority to ensure early detection and intervention for any potential respiratory complications in a patient with sudden diarrhea and high fever.
What are these sensory phenomena called when a client hears voices or sees images that do not objectively exist?
- A. Mania
- B. Delusions
- C. Seasonal affective disorder
- D. Hallucinations
Correct Answer: D
Rationale: Hallucinations involve perceiving things that are not present, such as hearing voices or seeing images.
A client is scheduled for a coronary artery bypass graft (CABG) in the morning using a saphenous vein. The physician does not use the internal mammary artery for the bypass graft, because the internal mammary artery:
- A. takes more time to remove.
- B. has a greater risk of becoming reoccluded.
- C. is smaller in diameter.
- D. has too many valves.
Correct Answer: A
Rationale: Many physicians do not use the internal mammary artery because it is time consuming. Removing the internal mammary artery does not pose a greater risk of reocclusion. In fact, it may stay patent longer. The internal mammary artery is larger in diameter than the saphenous vein. The internal mammary artery does not have too many valves.