What is the primary complication of untreated otitis media?
- A. Hearing loss
- B. Meningitis
- C. Cholesteatoma
- D. All of the above
Correct Answer: D
Rationale: Untreated otitis media can lead to serious complications, including hearing loss, meningitis, and cholesteatoma.
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Which measures or drugs may be effective in controlling pain in the physiologic pain process stage of transduction (select all that apply)?
- A. Distraction
- B. Corticosteroids
- C. Epidural opioids
- D. Local anesthetics
Correct Answer: D
Rationale: The correct answers are D, Local anesthetics, distraction, and NSAIDs target the transduction stage.
When teaching a client with chronic obstructive pulmonary disease who will start using fluticasone via MDI twice daily, which instruction should the nurse include?
- A. Monitor your heart rate before each dose.
- B. Inspect your mouth for lesions daily.
- C. Do not use this medication to relieve an acute attack.
- D. Do not skip the morning dose even if symptom-free.
Correct Answer: B
Rationale: The correct answer is B: Inspect your mouth for lesions daily. This instruction is essential because fluticasone, a corticosteroid, can cause oral thrush as a side effect. By inspecting the mouth daily, the client can detect any lesions early and seek appropriate treatment. Monitoring heart rate (A) is not necessary for fluticasone use, as it does not typically affect heart rate. While it is important not to skip doses (D), the specific instruction about the morning dose is not as crucial. Avoiding the use of fluticasone for acute attacks (C) is correct, but it is not the most important instruction in this scenario.
A client with chronic obstructive pulmonary disease is receiving dietary teaching from a nurse. Which of the following instructions should the nurse include?
- A. Eat 3 balanced meals each day.
- B. Limit fluid intake with meals.
- C. Reduce sodium intake.
- D. Take a bronchodilator 1 hour before eating.
Correct Answer: B
Rationale: The correct answer is B: Limit fluid intake with meals. This instruction is important for a client with COPD because excessive fluid intake during meals can lead to increased stomach distention, which can worsen breathing difficulties. By limiting fluid intake with meals, the client can reduce the risk of feeling bloated and experiencing shortness of breath.
A: Eating 3 balanced meals each day is generally a good recommendation, but it does not specifically address the needs of a client with COPD.
C: Although reducing sodium intake can be beneficial for managing COPD, it is not as directly related to dietary considerations during meals.
D: Taking a bronchodilator 1 hour before eating is not a dietary instruction and does not address the issue of fluid intake during meals.
What symptoms would a nurse suspect in a client with acoustic neuroma?
- A. Altered facial sensation
- B. Vertigo only when standing
- C. Tinnitus in the unaffected ear
- D. Impaired facial movement when smiling
Correct Answer: A
Rationale: Acoustic neuromas often affect cranial nerve VII, leading to altered facial sensation.
A 25-year-old client is admitted for a tonsillectomy and informs the nurse of having had episodes of muscle cramps, weakness, and an unexplained temperature elevation. Many years ago, the client's father died shortly after surgery subsequent to developing a high fever. The surgeon has ordered dantrolene sodium (Dantrium) prophylactically prior to the tonsillectomy to reduce the risk of:
- A. a postoperative infection.
- B. malignant hyperthermia.
- C. neuroleptic malignant syndrome.
- D. a postoperative fever.
Correct Answer: B
Rationale: Dantrolene sodium (Dantrium) is a peripheral skeletal muscle relaxant and would have no effect on a postoperative infection. Dantrolene sodium (Dantrium) is indicated prophylactically for clients with malignant hyperthermia or with a family history of the disorder. The mortality rate for malignant hyperthermia is high. Neuroleptic malignant syndrome is an exercise-induced muscle pain and spasm and is not related to malignant hyperthermia. Dantrolene sodium (Dantrium) is a peripheral skeletal muscle relaxant and would have no effect on a postoperative fever.
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