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Which is a maladaptive coping mechanism for a client with stress?
- A. Anger
- B. Hardiness
- C. Alcohol
- D. Self mutilation
Correct Answer: C
Rationale: Substance abuse, such as alcohol, is a common maladaptive coping mechanism that can exacerbate stress and lead to further health issues.
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Which patient is ready for discharge from Phase I PACU care to the clinical unit?
- A. Arouses easily, pulse is 112 bpm, respiratory rate is 24, dressing is saturated, SaO2 is 88%
- B. Difficult to arouse, pulse is 52, respiratory rate is 22, dressing is dry and intact, SaO2 is 91%
- C. Awake, vital signs stable, dressing is dry and intact, no respiratory depression, SaO2 is 92%
- D. Arouses, blood pressure (BP) higher than preoperative and respiratory rate is 10, no excess bleeding, SaO2 is 90%
Correct Answer: C
Rationale: Stable vital signs, intact dressing, and adequate oxygenation indicate readiness for transfer.
A patient with a history of pulmonary embolism asks how to lower the risk of experiencing another pulmonary embolism. You respond by saying
- A. Take vitamin K with heparin.
- B. Avoid confined spaces.
- C. Avoid sitting and standing for too long and do not cross your legs.
- D. Jog 5 miles each day.
Correct Answer: C
Rationale: Prolonged immobility increases the risk of pulmonary embolism.
2. What therapies are included in the mind-body medicine National Center for Complementary and Alternative Medicine (NCCAM) category (select all that apply)?
- A. Use of hands to realign energy flow
- B. Communication with the Creator or the Sacred
- C. Learned control of physiologic responses of the body
- D. Self-directed practice of focusing, centering, and relaxing
Correct Answer: C
Rationale: The correct answers are C. Mind-body medicine focuses on techniques like learned control of physiological responses (e.g., biofeedback) and self-directed practices such as meditation or relaxation, which align with options C and D.
A client in the emergency department is being cared for by a nurse and has cardiogenic pulmonary edema. The client's assessment findings include anxiousness, dyspnea at rest, crackles, blood pressure 110/79 mm Hg, and apical heart rate 112/min. What is the nurse's priority intervention?
- A. Provide the client with supplemental oxygen at 5 L/min via facemask.
- B. Place the client in high-Fowler's position with their legs in a dependent position
- C. Give the client sublingual nitroglycerin
- D. Administer morphine sulfate IV
Correct Answer: A
Rationale: The correct answer is A: Provide the client with supplemental oxygen at 5 L/min via facemask. In cardiogenic pulmonary edema, the priority intervention is to improve oxygenation. Supplemental oxygen helps increase oxygen levels and alleviate respiratory distress, reducing the workload on the heart. This intervention addresses the client's dyspnea and anxiousness by improving oxygen delivery.
Choice B is incorrect as placing the client in high-Fowler's position with legs in a dependent position can help with breathing but does not address the immediate need for oxygenation.
Choice C is incorrect as sublingual nitroglycerin is typically used for angina and not the priority intervention for cardiogenic pulmonary edema.
Choice D is incorrect as morphine sulfate IV may be indicated for pain relief and anxiety, but it is not the priority intervention to address the client's oxygenation needs in cardiogenic pulmonary edema.
When assessing a patient for anaphylaxis, you would be alert for
- A. Chest pain and indigestion.
- B. Hives and dyspnea.
- C. Hypertension and blurred vision.
- D. Headache and photophobia.
Correct Answer: B
Rationale: Anaphylaxis often presents with hives and difficulty breathing.