Nokea
What is the most common complication associated with cancer patients taking opioids?
- A. Tolerance
- B. Sedation
- C. Addiction
- D. Constipation
Correct Answer: B
Rationale: The correct answer is B: Sedation. Cancer patients taking opioids commonly experience sedation due to the central nervous system depressant effects of opioids. Opioids can cause drowsiness, fatigue, and decreased alertness. Tolerance (A) is a possible issue but is not the most common complication. Addiction (C) is less common in cancer patients due to the nature of their pain management. Constipation (D) is a common side effect of opioids but is not the most common complication in cancer patients. Sedation is the most prevalent issue affecting the quality of life and daily functioning of cancer patients on opioids.
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A patient of African descent is in the critical care unit to be monitored for shock after an accident. What skin characteristics would the nurse expect to find in this patient?
- A. Ruddy blue
- B. Generalized pallor
- C. Ashen, grey, or dull
- D. Patchy areas of pallor
Correct Answer: C
Rationale: The correct answer is C: Ashen, grey, or dull. In patients of African descent, skin characteristics may appear ashen, grey, or dull when experiencing shock due to reduced blood flow and oxygen delivery. This is because the skin may appear pale or lacking in color due to decreased perfusion.
The other choices are incorrect because:
A: Ruddy blue - Ruddy blue skin color is not typically associated with shock in patients of African descent.
B: Generalized pallor - Generalized pallor refers to an overall paleness of the skin, which is not commonly seen in patients of African descent during shock.
D: Patchy areas of pallor - Patchy areas of pallor suggest uneven skin color changes, which are not typically characteristic of shock in patients of African descent.
When the nurse is assessing a patient for pain, what is the most appropriate action to take?
- A. Ask the patient to rate pain intensity
- B. Ask about any allergies
- C. Ask the patient to describe the pain
- D. Measure pain intensity using a scale
Correct Answer: A
Rationale: The correct answer is A because asking the patient to rate pain intensity using a scale (like 0-10) provides a standardized measure of pain perception. This quantitative data helps healthcare providers assess pain severity accurately and track changes over time. Asking about allergies (B) is important but not directly related to pain assessment. Asking the patient to describe the pain (C) provides qualitative information but may not be as reliable or consistent as a numerical rating. Measuring pain intensity using a scale (D) is similar to the correct answer but does not involve the patient's subjective input, which is crucial in pain assessment.
The nurse is assessing a teenage girl newly admitted to the pediatric unit. What efficient framework provides additional modesty?
- A. Body systems
- B. Functional
- C. Focused
- D. Head to toe
Correct Answer: D
Rationale: The correct answer is D: Head to toe. The head-to-toe assessment is efficient because it follows a systematic approach starting from the head and progressing downward, ensuring that all body parts are assessed while maintaining the patient's modesty. This approach allows the nurse to gather comprehensive data without compromising the patient's privacy.
A: Body systems - While assessing by body systems is important, it may not provide the same level of modesty as the head-to-toe approach.
B: Functional - Assessing by function focuses on specific body functions rather than a comprehensive assessment of all body systems. It may not address all aspects of the patient's health.
C: Focused - A focused assessment targets specific health issues and may not cover all body systems comprehensively, potentially missing important findings.
A patient is admitted to the hospital with an acute myocardial infarction. The nurse should prioritize which of the following actions?
- A. Administering pain medication
- B. Performing a head-to-toe assessment
- C. Establishing an intravenous line
- D. Administering oxygen
Correct Answer: D
Rationale: Correct Answer: D - Administering oxygen
Rationale:
1. Oxygen is crucial in acute myocardial infarction to improve oxygenation and reduce myocardial workload.
2. Administering oxygen helps alleviate ischemia and prevents further damage.
3. Prioritizing oxygenation before pain medication or assessment ensures immediate intervention for the patient's well-being.
Summary of other choices:
A: Administering pain medication - Important for comfort but not the priority in acute myocardial infarction.
B: Performing a head-to-toe assessment - Necessary but not as urgent as ensuring oxygenation.
C: Establishing an intravenous line - Helpful but not as critical as administering oxygen in this scenario.
What is the most important nursing intervention for a client with pneumonia?
- A. Administer antibiotics
- B. Administer fluids
- C. Monitor temperature
- D. Administer vaccines
Correct Answer: A
Rationale: The correct answer is A: Administer antibiotics. Antibiotics are crucial in treating pneumonia caused by bacteria. They help to kill the bacteria causing the infection and prevent its spread. Administering fluids (B) is important for hydration but not the most crucial intervention. Monitoring temperature (C) is important but does not treat the root cause. Administering vaccines (D) may prevent certain types of pneumonia but is not the immediate intervention for an existing infection. Administering antibiotics promptly is vital to effectively treat pneumonia and prevent complications.