Nokea
What therapeutic outcome does the nurse expect for a client who has received a premedication of glycopyrrolate (Robinul)?
- A. Increased heart rate.
- B. Increased respiratory rate.
- C. Decreased secretions.
- D. Decreased amnesia.
Correct Answer: C
Rationale: Glycopyrrolate is an anticholinergic that reduces salivary and respiratory secretions, improving airway management during surgery.
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A client says, 'I hate the idea of being an invalid after they cut off my leg.' Which of the following would be the nurse's most therapeutic response?
- A. At least you will still have one good leg to use.'
- B. Tell me more about how you're feeling.'
- C. Let's finish the preoperative teaching.'
- D. You're lucky to have a wife to care for you.'
Correct Answer: B
Rationale: Encouraging the client to express feelings fosters coping and addresses emotional concerns.
A client admitted for a myocardial infarction (MI) develops cardiogenic shock. An arterial line is inserted. Which of the following orders should the nurse question?
- A. Call for urine output <30 mL/hour for 2 consecutive hours.
- B. Metoprolol (Lopressor) 5 mg I.V. push.
- C. Symptom for a pulmonary artery catheter insertion.
- D. Titrate Dobutamine (Dobutrex) to keep systolic BP >100.
Correct Answer: B
Rationale: Metoprolol, a beta-blocker, can worsen cardiogenic shock by reducing heart rate and contractility. Other orders are appropriate for monitoring and supporting perfusion in cardiogenic shock.
A 68-year-old client with colon cancer experiences an increase in his feelings of anxiety and depression and has suicidal ideation. He appears to be in great distress. The nurse realizes that he is at which stage in his disease?
- A. Initiation of definitive treatment.
- B. End of his first course of treatment.
- C. End stage of his disease.
- D. Recurrence of the disease.
Correct Answer: C
Rationale: Increased anxiety, depression, and suicidal ideation suggest the client is in the end stage of colon cancer, facing mortality and existential distress.
A 52-year-old client with lung cancer tells the nurse that he has a low-grade fever (100.6°F [38.1°C]), nonproductive cough, and increasing fatigue. He completed the radiation therapy to the mass in his right lung and mediastinum 10 weeks ago and has a follow-up appointment to see the physician in 2 weeks. What is the most appropriate response by the nurse?
- A. Advise the client to take two acetaminophen tablets every 4 to 6 hours for 2 days and call back if his temperature increases to 101°F (38.3°C) or greater.
- B. Advise the client that this is an expected side effect of the radiation therapy and to keep his appointment in 2 weeks.
- C. Advise the client to come to the office to be examined today.
- D. Advise the client to go to the nearest emergency department.
Correct Answer: C
Rationale: Fever, cough, and fatigue post-radiation may indicate infection or pneumonitis, requiring prompt evaluation, especially in a lung cancer patient, so an office visit today is appropriate.
Which of the following goals is a priority for a client who has undergone surgery for retinal detachment?
- A. Control pain.
- B. Prevent an increase in intraocular pressure.
- C. Follow a low-sodium diet.
- D. Maintain a darkened environment.
Correct Answer: B
Rationale: Preventing an increase in intraocular pressure is the priority to protect the surgical repair and prevent complications like re-detachment or hemorrhage.