Nokea
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.
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Which statement best describes emmetropia?
- A. Difficulty with near vision
- B. Difficulty with far vision
- C. Visual distortion caused by an irregularly shaped cornea
- D. Normal vision
Correct Answer: D
Rationale: Emmetropia refers to normal vision where light focuses correctly on the retina without refractive error.
Which signs and symptoms of lithium toxicity should a nurse monitor for?
- A. Constipation
- B. Vomiting
- C. Amnesia
- D. Muscular rigidity
Correct Answer: B
Rationale: Vomiting is a common early sign of lithium toxicity, indicating the need for immediate medical attention.
A healthcare provider is assessing a client immediately after the removal of the endotracheal tube. Which of the following findings should the provider report to the healthcare provider?
- A. Stridor
- B. Copious oral secretions
- C. Hoarseness
- D. Sore throat
Correct Answer: A
Rationale: The correct answer is A: Stridor. Stridor is a high-pitched, harsh respiratory sound that indicates airway obstruction, which can be life-threatening post endotracheal tube removal. Copious oral secretions (B), hoarseness (C), and sore throat (D) are common after endotracheal tube removal but do not indicate immediate airway compromise. Reporting stridor is crucial for prompt intervention to prevent respiratory distress.
A 27-year-old male client develops malignant hyperthermia during a herniorrhaphy; his temperature is 105.4 degrees F. The client has had no previous health problems other than hypertension. A nurse orienting in the OR says, 'I thought only people with brain tumors had this problem.' Which of the following answers explains malignant hyperthermia?
- A. Epinephrine increased the basal metabolic rate as soon as the general anesthesia was administered.
- B. The blood flow to active muscles increased with a concurrent decrease in the blood flow to the organs not needed for rapid activity.
- C. The catecholamines released led to activation of the sympathetic nervous system.
- D. Malignant hyperthermia is an inherited disorder of muscle metabolism that causes fever, increased heart rate, and rapid breathing.
Correct Answer: D
Rationale: Epinephrine is a hormone employed in the fight-or-flight stress response. It does not contribute to malignant hyperthermia. Stimulation of the sympathetic adrenal medullary mechanism helps the body cope with stress. It does not contribute to malignant hyperthermia. Catecholamine release is one of the physiological effects of stress. It does not contribute to malignant hyperthermia. Malignant hyperthermia is an inherited disorder of muscle metabolism that increases intracellular calcium, which causes generalized muscle rigidity, fever, tachycardia, and tachypnea.
What accurately describes the health care system in which future nurses will be employed?
- A. With improvements in medicine there will be fewer patients with chronic illnesses
- B. Rapidly changing technology and expanding knowledge will simplify the health care environment
- C. The Quality and Safety Education for Nurses (QSEN) project measures the ability of nursing graduates to be prepared for the reality of practice
- D. The Joint Commission establishes National Patient Safety Goals and evidence-based solutions for nurses to promote meeting these goals by all caring for the patient
Correct Answer: C
Rationale: The QSEN project focuses on preparing nurses for real-world practice, and The Joint Commission sets safety goals. Chronic illnesses are increasing due to aging populations, and technology adds complexity rather than simplifying the environment.