Nokea
When preparing a client for intravenous pyelography (IVP), which action by the nurse is most important?
- A. Administering a sedative
- B. Encouraging fluid intake
- C. Administering an oral preparation of radiopaque dye
- D. Questioning the client about allergies to iodine or shellfish
Correct Answer: D
Rationale: The most crucial action for the nurse when preparing a client for intravenous pyelography (IVP) is to question the client about allergies to iodine or shellfish. Some IVP dyes contain iodine, and if the client is allergic to iodine or shellfish, they may experience severe allergic reactions such as itching, hives, rash, throat tightness, difficulty breathing, or bronchospasm. Administering a sedative (Choice A) may be needed for relaxation during the procedure, encouraging fluid intake (Choice B) is generally beneficial but not the most crucial for IVP preparation, and administering radiopaque dye (Choice C) should only be done after confirming the client's safety regarding allergies to iodine or shellfish.
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A nurse has a prescription to insert a nasogastric tube into the stomach of an assigned client. Which action should the nurse take to insert the tube safely and easily?
- A. Placing the tube in warm water
- B. Hyperextending the head while inserting the tube
- C. Removing the tube if any resistance to insertion is met
- D. Asking the client to swallow as the tube is being advanced
Correct Answer: D
Rationale: The correct action for the nurse to take to insert a nasogastric tube safely and easily is asking the client to swallow as the tube is being advanced. This action helps facilitate the passage of the tube through the esophagus into the stomach. Placing the tube in warm water (Choice A) is not a recommended practice for nasogastric tube insertion. Hyperextending the head (Choice B) can cause discomfort and is not necessary for safe insertion. Removing the tube if resistance is met (Choice C) is incorrect as it may cause harm or discomfort to the client. Asking the client to swallow helps the tube pass more smoothly and comfortably.
A nurse is teaching a nursing student how to measure a carotid pulse. The nurse should tell the student to measure the pulse on only one side of the client's neck primarily because:
- A. It is unnecessary to use both hands
- B. Feeling dual pulsations may lead to an incorrect measurement
- C. Palpating both carotid pulses simultaneously could occlude the trachea
- D. Palpating both carotid pulses simultaneously could cause the heart rate and blood pressure to drop
Correct Answer: D
Rationale: The correct answer is D. Applying pressure to both carotid arteries at the same time is contraindicated. Excess pressure to the baroreceptors in the carotid vessels could cause the heart rate and blood pressure to reflexively drop. Palpating both carotid pulses simultaneously could also interfere with the flow of blood to the brain, possibly causing dizziness and syncope. Choices A, B, and C are incorrect. It is necessary to use both hands to measure the carotid pulse accurately. Feeling dual pulsations does not lead to an incorrect measurement, and palpating both carotid pulses simultaneously does not occlude the trachea.
Which is a characteristic that distinguishes sulfonamides from other drugs used to treat bacterial infections?
- A. Sulfonamides are bactericidal.
- B. Sulfonamides are synthetic compounds.
- C. Sulfonamides have antifungal and antiviral properties.
- D. Sulfonamides increase bacterial synthesis of folic acid.
Correct Answer: B
Rationale: The characteristic that distinguishes sulfonamides from other drugs used to treat bacterial infections is that sulfonamides are synthetic compounds, not derived from biologic substances. Choice A is incorrect because sulfonamides are bacteriostatic, not bactericidal. Choice C is incorrect because sulfonamides do not have antifungal and antiviral properties. Choice D is incorrect because sulfonamides act by inhibiting bacterial synthesis of folic acid, not increasing it.
A healthcare professional reviews the blood gas results of a client in respiratory distress. The pH is 7.32, and the PCO2 is 50 mm Hg. Which of the following acid-base imbalances does the professional recognize in these findings?
- A. Metabolic acidosis
- B. Metabolic alkalosis
- C. Respiratory acidosis
- D. Respiratory alkalosis
Correct Answer: C
Rationale: In respiratory acidosis, the pH is low (<7.35) and the PCO2 is increased (>45 mm Hg). These findings indicate that the client is experiencing respiratory acidosis, a condition where there is an excess of carbon dioxide in the blood due to inadequate ventilation, commonly seen in respiratory distress. Metabolic acidosis (Choice A) is characterized by a low pH and decreased bicarbonate levels, which is not the case in this scenario. Metabolic alkalosis (Choice B) is associated with a high pH and increased bicarbonate levels. Respiratory alkalosis (Choice D) is marked by a high pH and decreased PCO2, opposite to the values presented in the blood gas results of this client.
A client without a history of respiratory disease has a pulse oximeter in place after surgery. The nurse monitors the pulse oximeter readings to ensure that oxygen saturation remains above:
- A. 85%
- B. 89%
- C. 95%
- D. 100%
Correct Answer: C
Rationale: Pulse oximetry is a noninvasive method of continuously monitoring the oxygen saturation of hemoglobin (SaO2). In the absence of underlying respiratory disease, the expected oxygen saturation level is at least 95%. Oxygen saturation levels below 95% may indicate hypoxemia, which can compromise tissue perfusion and oxygen delivery to vital organs. Therefore, maintaining oxygen saturation above 95% is crucial to ensure adequate oxygenation post-surgery. Choices A, B, and D are incorrect as they represent oxygen saturation levels that are below the expected value for a client without a history of respiratory disease, which should be at least 95%.