Nokea
What nursing measure would be most helpful in obtaining Mr. Smith’s compliance with treatment?
- A. Involve Mrs. Smith in the teaching sessions
- B. Teach Mr. Smith about his prescribed medications
- C. Ask the social worker to talk to Mr. Smith
- D. Refer the Smiths to the American Lung Association
Correct Answer: B
Rationale: Education empowers patients to understand and adhere to their treatment plans.
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A client is considering laser abdominal surgery and asks the nurse if there is any advantage in having this type of surgery. The nurse's response should be based upon the knowledge that laser surgery:
- A. has a smaller postoperative infection rate than routine surgery.
- B. will eliminate the need for preoperative sedation.
- C. will result in less operating time.
- D. generally eliminates problems and complications.
Correct Answer: A
Rationale: A lower postoperative infection rate has been documented as a result of laser therapy versus routine surgery. Clients who choose laser surgery will still need preoperative sedation to facilitate anxiety reduction. Operating time may actually increase in some laser surgeries. The client who chooses laser surgery must still be observed for postoperative complications.
A postoperative 68-year-old opioid-naive patient is receiving morphine by patient-controlled analgesia (PCA) for postoperative pain. What is the rationale for not initiating the PCA analgesic with a basal dose of analgesic as well?
- A. Opioid overdose
- B. Nausea and itching
- C. Adverse respiratory outcomes
- D. Lack of pain control
Correct Answer: C
Rationale: The correct answer is C. Basal doses increase the risk of adverse respiratory outcomes.
Jill Means, 36, has had a vaginal radium implant placed as one of the treatments for her cervical cancer. She calls to tell you that during a coughing spell it has 'been pushed out'. You should:
- A. place signs on the door stating radioactivity danger.
- B. have Jill reinsert the applicator like a tampon.
- C. call the physician and apprise him of the situation.
- D. use forceps to place the applicator in the receptacle.
Correct Answer: D
Rationale: Signs should be placed on the door after the implant has been done, and not just when the implant is dislodged. By picking the applicator up, Jill would experience burns on her fingers/hands that would be avoidable, so need to teach her not to do so. The applicator has been contaminated, it would not be replaced in any case. Calling the physician and apprising him would certainly be necessary, but would be done after the applicator has been taken care of. Lead containers should be available to place the applicator in, and forceps would be used to do so to protect from radiation burns.
Why does the circulating nurse remove a tightly rolled blanket from under Mrs. West’s knees?
- A. Prevent damage to nerves and circulation
- B. Provide a flat surface for the sterile field
- C. Stretch lower leg muscles to prevent strain
- D. Facilitate access to the surgical site
Correct Answer: A
Rationale: Improper positioning can cause nerve compression and circulatory issues.
An 80-year-old patient is placed in isolation when infected with methicillin-resistant Staphylococcus aureus. The patient was alert and oriented on admission, but is now having visual hallucinations and can follow only simple directions. The medical-surgical nurse recognizes that the changes in the patient's mental status are related to
- A. a fluid and electrolyte imbalance.
- B. a stimulating environment.
- C. sensory deprivation.
- D. sundowning.
Correct Answer: C
Rationale: Isolation can lead to sensory deprivation, affecting cognitive function.