Nokea
What is the main drawback of the botulism antitoxin that the nurse should be aware of?
- A. It causes 9% hypersensitivity.
- B. It requires monthly booster dosages.
- C. It is not available from the CDC.
- D. It is not available as a pre-exposure vaccine.
Correct Answer: D
Rationale: The correct answer is D because botulism antitoxin is not available as a preventive vaccine.
You may also like to solve these questions
You are admitting an elderly client to the medical unit. Which factor indicates that this client has a risk for acid-base imbalances?
- A. Myocardial infarction 1 year ago
- B. Occasional use of antacids
- C. Shortness of breath with extreme exertion
- D. Chronic renal insufficiency
Correct Answer: D
Rationale: The correct answer is D: Chronic renal insufficiency. Chronic renal insufficiency can lead to metabolic acidosis or alkalosis due to impaired kidney function in regulating acid-base balance. Renal insufficiency can cause retention or loss of bicarbonate ions, leading to imbalances. Myocardial infarction, occasional use of antacids, and shortness of breath with extreme exertion are not direct risk factors for acid-base imbalances.
Paralytic ileus may occur as a postoperative complication. Which of the following patients would you be most concerned about the development of paralytic ileus?
- A. Kim, a 27-year-old postlaparoscopic appendectomy.
- B. Joyce, a 39-year-old post–open right hemicolectomy.
- C. Nancy, a 56-year-old postmediastinoscopy.
- D. John, a 47-year-old post–total joint replacement.
Correct Answer: B
Rationale: Paralytic ileus is more common after abdominal surgeries, particularly those involving bowel manipulation, such as an open right hemicolectomy. Joyce is at the highest risk due to the nature of her surgery.
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.
The nurse is caring for a client with acute pancreatitis. After pain management, which intervention should be included in the plan of care?
- A. Cough and deep breathe every 2 hours.
- B. Place the client in contact isolation.
- C. Provide a diet high in protein.
- D. Institute seizure precautions.
Correct Answer: A
Rationale: Encouraging coughing and deep breathing helps prevent pulmonary complications.
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.