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When should surgical correction of hypospadias typically occur for a newborn infant as advised by the nurse?
- A. Repair should be done within one month to prevent bladder infections.
- B. Repairs should typically be done before the child is potty-trained.
- C. Delaying the repair until school age reduces castration fears.
- D. To form a proper urethra repair, it should be done after sexual maturity.
Correct Answer: B
Rationale: The correct answer is B because surgical correction of hypospadias is typically recommended before the child is potty-trained. This is important for optimal cosmetic and functional outcomes, as the procedure is more straightforward in infants due to their smaller anatomy. Delaying the surgery can lead to increased risk of complications and potential psychological impact on the child as they grow older.
A: Repair within one month to prevent bladder infections is not the primary reason for early correction of hypospadias.
C: Delaying the repair to school age for reducing castration fears is not a valid reason for postponing the surgery.
D: Waiting until after sexual maturity to form a proper urethra repair is not recommended as early correction typically yields better results.
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A patient with severe pain is prescribed morphine sulfate. What is the most important side effect for the nurse to monitor?
- A. Diarrhea
- B. Hypertension
- C. Respiratory depression
- D. Increased urine output
Correct Answer: C
Rationale: The correct answer is C: Respiratory depression. Morphine sulfate is an opioid analgesic that can suppress the respiratory drive, leading to respiratory depression, which can be life-threatening. Monitoring respiratory status is crucial to prevent complications.
Incorrect choices:
A: Diarrhea - While constipation is a common side effect of opioid use, diarrhea is not a significant concern compared to respiratory depression.
B: Hypertension - Morphine can cause hypotension rather than hypertension, so monitoring blood pressure for hypertension is not the priority.
D: Increased urine output - Morphine can actually cause urinary retention, so increased urine output is not a key side effect to monitor.
A patient with chronic heart failure is prescribed carvedilol. What is the primary purpose of this medication?
- A. Increase cardiac output
- B. Reduce fluid retention
- C. Decrease heart rate
- D. Lower blood pressure
Correct Answer: C
Rationale: The correct answer is C: Decrease heart rate. Carvedilol is a beta-blocker that works by blocking the beta-adrenergic receptors in the heart, leading to a decrease in heart rate. This helps reduce the workload of the heart and improve its efficiency in patients with heart failure. Choice A is incorrect because carvedilol may not necessarily increase cardiac output directly. Choice B is incorrect because carvedilol focuses more on improving heart function rather than directly reducing fluid retention. Choice D is incorrect because while carvedilol may lower blood pressure as a secondary effect, its primary purpose in heart failure is to improve cardiac function by decreasing heart rate.
A client is on a mechanical ventilator. Which client response indicates that the neuromuscular blocker tubocurarine chloride (Tubarine) is effective?
- A. The client's extremities are paralyzed.
- B. The peripheral nerve stimulator causes twitching.
- C. The client clenches fist upon command.
- D. The client's Glasgow Coma Scale score is 14.
Correct Answer: A
Rationale: The correct answer is A because the neuromuscular blocker tubocurarine chloride causes muscle paralysis, leading to the extremities being paralyzed. This indicates that the medication is effectively blocking neuromuscular transmission.
B: Twitching with peripheral nerve stimulation indicates incomplete blockade.
C: Clenching fist upon command indicates preserved muscle strength.
D: Glasgow Coma Scale measures level of consciousness, not neuromuscular blockade.
A patient with type 1 diabetes is prescribed insulin glargine. What is the primary characteristic of this insulin?
- A. Rapid-acting
- B. Intermediate-acting
- C. Long-acting
- D. Short-acting
Correct Answer: C
Rationale: Insulin glargine is a long-acting insulin due to its slow and consistent release, providing basal insulin coverage for about 24 hours. This steady release mimics the body's natural basal insulin secretion pattern. Rapid-acting insulins (A) work quickly to control postprandial glucose levels. Intermediate-acting insulins (B) have a slower onset and last for a moderate duration. Short-acting insulins (D) act quickly but have a shorter duration of action compared to long-acting insulins.
A patient with chronic heart failure is prescribed furosemide. What is the primary action of this medication?
- A. Increase cardiac output
- B. Reduce fluid retention
- C. Decrease heart rate
- D. Lower blood pressure
Correct Answer: B
Rationale: The correct answer is B: Reduce fluid retention. Furosemide is a loop diuretic that works by increasing urine production, leading to the removal of excess fluid and sodium from the body. This helps reduce fluid volume overload in conditions like heart failure. Choice A is incorrect because while reducing fluid retention may indirectly improve cardiac output by reducing preload, furosemide itself does not directly increase cardiac output. Choice C is incorrect as furosemide does not have a direct effect on heart rate. Choice D is incorrect because while furosemide may lower blood pressure as a result of reducing fluid volume, its primary action is to reduce fluid retention, not specifically lower blood pressure.