Nokea
What is the priority action for a client who presents with symptoms of stroke?
- A. Perform a CT scan
- B. Monitor blood pressure
- C. Administer aspirin
- D. Administer thrombolytics
Correct Answer: A
Rationale: The correct answer is A: Perform a CT scan. This is the priority action because it helps determine if the stroke is ischemic or hemorrhagic, guiding treatment decisions. Monitoring blood pressure (B) is important but not the priority. Administering aspirin (C) can be considered after confirming the type of stroke. Administering thrombolytics (D) is indicated for ischemic stroke but should only be done after ruling out hemorrhagic stroke with a CT scan.
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Which fetal heart monitor pattern can indicate cord compression?
- A. variable decelerations
- B. early decelerations
- C. bradycardia
- D. tachycardia
Correct Answer: A
Rationale: The correct answer is A: variable decelerations. Variable decelerations are abrupt decreases in fetal heart rate that vary in depth, duration, and timing, which can indicate cord compression. The variability in these decelerations suggests that the umbilical cord is being compressed intermittently.
Early decelerations (B) are usually caused by head compression during contractions and mirror the contractions, not indicating cord compression. Bradycardia (C) is a slow heart rate, which can be caused by various factors but is not specific to cord compression. Tachycardia (D) is a fast heart rate, which can also be caused by various factors but is not typically associated with cord compression.
A nurse is caring for a patient who has had a myocardial infarction. Which of the following medications should the nurse expect to be prescribed for this patient?
- A. Lisinopril.
- B. Acetaminophen.
- C. Furosemide.
- D. Hydrochlorothiazide.
Correct Answer: A
Rationale: Step 1: Lisinopril is an ACE inhibitor commonly prescribed post-myocardial infarction to reduce strain on the heart and prevent further damage.
Step 2: ACE inhibitors like Lisinopril help lower blood pressure and improve heart function.
Step 3: By reducing the workload on the heart, Lisinopril can help prevent complications post-MI.
Step 4: Acetaminophen (B) is a pain reliever and does not address the cardiovascular issues post-MI.
Step 5: Furosemide (C) and Hydrochlorothiazide (D) are diuretics typically used for managing fluid retention, not the primary focus after an MI.
Summary: Lisinopril is the correct choice as it helps improve heart function and prevent complications post-MI, unlike the other options which do not directly address the cardiovascular issues associated with MI.
A nurse is caring for a patient with diabetes who is experiencing diabetic neuropathy. The nurse should educate the patient to prioritize which of the following?
- A. Inspecting feet daily for signs of injury.
- B. Exercising to increase circulation.
- C. Taking pain medication for relief.
- D. Increasing protein intake to support healing.
Correct Answer: A
Rationale: The correct answer is A: Inspecting feet daily for signs of injury. This is crucial in diabetic neuropathy to prevent complications such as infections and ulcers. By inspecting the feet daily, the patient can identify any injuries early and seek prompt treatment. Exercising (choice B) is important, but not the top priority. Taking pain medication (choice C) only addresses symptoms, not the root cause. Increasing protein intake (choice D) may be beneficial for healing, but foot inspection is more directly related to preventing complications in diabetic neuropathy.
Which food helps lower cholesterol?
- A. Fiber-rich foods
- B. Reduce diabetic ketoacidosis
- C. Lower cholesterol
- D. Reduce the need for folate
Correct Answer: C
Rationale: The correct answer is C: Lower cholesterol. Foods that help lower cholesterol typically include sources of soluble fiber, plant sterols, and healthy fats like omega-3 fatty acids. These components can lower LDL (bad) cholesterol levels and reduce the risk of heart disease. Fiber-rich foods (choice A) are beneficial for lowering cholesterol due to their ability to bind to cholesterol and remove it from the body. Reduce diabetic ketoacidosis (choice B) is unrelated to lowering cholesterol and is a serious complication of diabetes. Reduce the need for folate (choice D) is not directly related to cholesterol levels. Thus, the correct choice is C as it directly addresses the question about lowering cholesterol.
What should a nurse base their response on when a client asks about an increase in opioid dose for chronic pain?
- A. Body has developed tolerance, requiring more drug
- B. The client is preoccupied with the drug
- C. Addiction is the term for physical dependence
- D. Dual diagnosis of substance abuse and chronic pain
Correct Answer: A
Rationale: The correct answer is A because tolerance is a physiological phenomenon where the body adapts to a drug, requiring higher doses for the same effect. This is a common occurrence with opioids in chronic pain management. Choice B is incorrect as it refers to drug-seeking behavior, not tolerance. Choice C is incorrect because addiction and physical dependence are different concepts. Choice D is incorrect as it relates to a specific scenario of substance abuse alongside chronic pain, not the mechanism behind the need for increased opioid doses in chronic pain management.