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What should the nurse do if Wendy develops moderate hypotension and irregular pulse while receiving aminophylline?
- A. Check apical pulse and blood pressure every 10 minutes and continue present aminophylline administration
- B. Discontinue the aminophylline drip and call the physician
- C. Rapidly administer epinephrine 1:1000 intravenously
- D. Slow the rate of aminophylline administration, monitor vital signs, and notify physician
Correct Answer: D
Rationale: Adjusting the infusion rate prevents further adverse effects.
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Describe the relationship between receptors and neurotransmitters.
- A. Increased alertness
- B. Lower immune response
- C. Faster metabolism
- D. Enhanced digestion
Correct Answer: B
Rationale: The correct answer is B because it is the most appropriate response based on physiological and medical principles.
Following chemotherapy, a patient is being closely monitored for tumor lysis syndrome. Which laboratory value requires particular attention?
- A. Platelet count.
- B. Electrolytes.
- C. Hemoglobin.
- D. Hematocrit.
Correct Answer: B
Rationale: Electrolyte imbalances, particularly hyperkalemia and hyperuricemia, are hallmark features of tumor lysis syndrome and must be closely monitored.
Josie is the mother of a healthy 19-year-old woman having surgery tomorrow. After the surgeon discusses the surgery, risks, and benefits with the patient and her mother, the mother wants to sign the consent form. The most appropriate response to this would be:
- A. Of course, she can sign the consent form; after all, the patient is her daughter.
- B. No, she cannot sign the form.
- C. While you appreciate her concern for her daughter, the patient is a consenting adult and legally needs to sign her own consent form.
- D. Encourage both the patient and her mother to sign the form.
Correct Answer: C
Rationale: A 19-year-old is considered a consenting adult and must sign their own consent form unless they are deemed legally incompetent. The mother's role is supportive but does not override the patient's legal rights.
What is the first sign that the condition of a dying client is worsening?
- A. Pulmonary function impairment
- B. Peripheral circulation changes
- C. Central nervous system alterations
- D. Failing cardiac function
Correct Answer: C
Rationale: Central nervous system changes, such as confusion or lethargy, often indicate declining health in terminal stages.
A client had a stroke involving the right cerebral hemisphere. The nurse should monitor for which of the following findings?
- A. Poor impulse control
- B. Inability to discriminate words and letters
- C. Deficits in the right visual field
- D. Motor retardation
Correct Answer: A
Rationale: The correct answer is A: Poor impulse control. When a client has a stroke involving the right cerebral hemisphere, it can affect their ability to regulate emotions and impulses. The right hemisphere is responsible for inhibiting impulsive behavior, so damage to this area can lead to poor impulse control. This can manifest as impulsivity, lack of judgement, and difficulty controlling emotions.
Summary of Incorrect Choices:
B: Inability to discriminate words and letters - This is typically associated with left cerebral hemisphere damage, not right hemisphere.
C: Deficits in the right visual field - This is associated with damage to the left occipital lobe, not the right hemisphere.
D: Motor retardation - Motor functions are controlled by the opposite side of the brain, so right hemisphere damage would typically affect the left side of the body, not motor function in general.