Nokea
Which measures or drugs may be effective in controlling pain in the physiologic pain process stage of transduction (select all that apply)?
- A. Distraction
- B. Corticosteroids
- C. Epidural opioids
- D. Local anesthetics
Correct Answer: D
Rationale: The correct answers are D, Local anesthetics, distraction, and NSAIDs target the transduction stage.
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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.
A 35-year-old female client has returned to her room following surgery on her right femur. She has an IV of D5 1/2 NS infusing at 125 cc/hr, and is receiving morphine sulfate 10-15 mg IM q4h prn for pain. The client last voided 5 1/2 hours ago when she was given her preoperative medication. To monitor and promote the return of urinary function after surgery, the nurse should:
- A. provide food and fluids at the client's request.
- B. maintain the IV, increasing the rate hourly until the client voids.
- C. report to the surgeon if the client is unable to void within 8 hours of surgery.
- D. hold the morphine sulfate injections for pain until the client voids, explaining to the client that morphine sulfate can cause urinary retention.
Correct Answer: C
Rationale: Provision of food and fluids promotes bowel elimination. Postoperative nutritional needs are physician determined, not client determined. Increasing IV fluids postoperatively will not cause a client to void. Any change in the rate of administration of IV fluids is determined by the physician, not the nurse. If the postoperative client with normal kidney function cannot void 8 hours after surgery, the client is retaining urine. The client may need catheterization or medication. The physician will provide orders for either, as necessary. While morphine sulfate can cause urinary retention, withholding pain medication will not ensure that the client will void. The client with uncontrolled pain will probably not be able to void.
Treatment of the patient with appendicitis includes
- A. Transfusion to replace blood loss.
- B. Bowel preparation for cleansing.
- C. Surgical removal of appendix.
- D. Medications to lower pH within stomach.
Correct Answer: C
Rationale: Surgical removal of the appendix is the definitive treatment for appendicitis.
A 55-year-old smoker who is normally in good health reports having had a bad cough for the past 3 weeks. He does not have crackles, rhonchi, or discolored blood-tinged sputum. What would you expect his physician to rule out?
- A. Asthma.
- B. Pneumonia.
- C. The flu.
- D. Lung cancer.
Correct Answer: D
Rationale: Persistent cough in smokers raises suspicion for lung cancer.
What is the main drawback of the botulism antitoxin that the nurse should be aware of?
- A. It causes 9% hypersensitivity.
- B. It requires monthly booster dosages.
- C. It is not available from the CDC.
- D. It is not available as a pre-exposure vaccine.
Correct Answer: D
Rationale: The correct answer is D because botulism antitoxin is not available as a preventive vaccine.