Nokea
To prevent agitation during the patient's recovery from anesthesia, when should the nurse begin orientation explanations?
- A. When the patient is awake
- B. When the patient first arrives in the PACU
- C. When the patient becomes agitated or frightened
- D. When the patient can be aroused and recognizes where he or she is
Correct Answer: B
Rationale: Early orientation helps prevent confusion and agitation as the patient recovers from anesthesia.
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Priority Decision: A patient in the PACU has emergence delirium manifested by agitation and thrashing. What should the nurse assess for first in the patient?
- A. Hypoxemia
- B. Neurologic injury
- C. Distended bladder
- D. Cardiac dysrhythmias
Correct Answer: A
Rationale: Hypoxemia is a common cause of agitation and delirium during emergence from anesthesia.
What should a client with seasonal affective disorder be taught upon discharge?
- A. Use heavy drapes rather than translucent curtains or shades
- B. Jog after sundown and before sunup
- C. Avoid the use of eyeglasses or contact lenses that are coated to shield ultraviolet radiation
- D. Take brief walks outside around midnight without sunglasses
Correct Answer: C
Rationale: Maximizing exposure to natural light helps alleviate symptoms of seasonal affective disorder.
A client is 12 hours postoperative and has a chest tube to a disposable water-seal drainage system with suction. The healthcare provider should intervene for which of the following observations?
- A. Constant bubbling in the suction-control chamber
- B. Continuous bubbling in the water-seal chamber
- C. Bloody drainage in the collection chamber
- D. Fluid-level fluctuations in the water-seal chamber
Correct Answer: B
Rationale: The correct answer is B: Continuous bubbling in the water-seal chamber. Continuous bubbling in the water-seal chamber indicates an air leak in the system, which can lead to lung collapse. The water-seal chamber should have intermittent bubbling during exhalation but should not bubble continuously. Constant bubbling in the suction-control chamber (A) is expected and indicates proper suction is being applied. Bloody drainage in the collection chamber (C) is common in the immediate postoperative period. Fluid-level fluctuations in the water-seal chamber (D) can be normal due to changes in intrathoracic pressure.
Mrs. Dailey tells the nurse that she uses eyedrops which make her pupils get small. Which of the following drugs would produce this effect?
- A. Epinephrine (Adrenalin)
- B. Acetazolamide (Diamox)
- C. Atropine
- D. Pilocarpine
Correct Answer: D
Rationale: Pilocarpine is a miotic agent that constricts the pupil, commonly used in treating glaucoma by improving aqueous humor outflow.
Stephen Douglas has been in an automobile accident. The most effective IV solution for a patient having hypovolemic shock would be:
- A. hypertonic.
- B. isotonic.
- C. hypotonic.
- D. colloids.
Correct Answer: B
Rationale: Hypertonic IV fluids would be used to draw fluid off tissue in edematous situations such as third spacing. Isotonic solutions are used to increase intravascular volume, to increase perfusion of vital organs. Hypotonic fluids are used to rehydrate tissue in those with severe, or prolonged fluid deprivation. Colloids increase tonicity of intravascular fluids, pulling water into the vascular system from tissue.