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Which of the ff. conditions places a patient at risk for respiratory complications following his splenectomy?
- A. A low platelet count
- B. Early ambulation
- C. An incision near the diaphragm
- D. Early discharge
Correct Answer: C
Rationale: The correct answer is C: An incision near the diaphragm. Following a splenectomy, an incision near the diaphragm can lead to respiratory complications due to potential irritation or injury to the diaphragm. This can result in impaired breathing and increased risk of respiratory issues such as pneumonia.
A: A low platelet count is not directly related to respiratory complications following a splenectomy.
B: Early ambulation is generally encouraged to prevent complications such as blood clots but does not specifically impact respiratory complications.
D: Early discharge may not directly lead to respiratory complications, as long as the patient is adequately monitored postoperatively.
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A client with pernicious anemia is receiving parenteral vitamin B12 therapy. Which client statement indicates effective teaching about this therapy?
- A. “I will receive parenteral vitamin B12 therapy until my signs and symptoms disappear.”
- B. “I will receive parenteral vitamin B12 therapy until my vitamin B12 level returns to normal.”
- C. “I will receive parenteral vitamin B12 therapy monthly for 6 months to a year.”
- D. “I will receive parenteral vitamin B12 therapy for the rest of my life.”
Correct Answer: D
Rationale: The correct answer is D: “I will receive parenteral vitamin B12 therapy for the rest of my life.” This statement is correct because pernicious anemia is a lifelong condition requiring ongoing vitamin B12 supplementation. Patients with pernicious anemia lack intrinsic factor, which is needed to absorb vitamin B12 from food. Therefore, they need lifelong B12 therapy to prevent complications such as anemia and neurological damage.
Choices A, B, and C are incorrect because they suggest a limited duration of therapy. Pernicious anemia is a chronic condition that necessitates continuous treatment. Choice A implies therapy until signs and symptoms disappear, which may not address the underlying cause of the deficiency. Choice B mentions therapy until vitamin B12 levels normalize, which may not prevent recurrence. Choice C suggests monthly therapy for a fixed period, which may not be sufficient for lifelong management.
Bacterial meningitis alters intracranial physiology, causing:
- A. Cerebral edema
- B. Raised intracranial pressure
- C. Increased permeability of the blood-barrier
- D. All of the above changes
Correct Answer: D
Rationale: The correct answer is D. Bacterial meningitis alters intracranial physiology by causing cerebral edema, raised intracranial pressure, and increased permeability of the blood-brain barrier. Cerebral edema is the accumulation of fluid in the brain tissue, leading to increased pressure. Raised intracranial pressure occurs due to the inflammation and swelling caused by the infection. Increased permeability of the blood-brain barrier allows substances to pass through that would normally be blocked, contributing to the inflammatory response. Therefore, all of these changes are interconnected and commonly observed in bacterial meningitis cases. Choices A, B, and C individually describe specific alterations seen in bacterial meningitis but do not encompass the full spectrum of changes that occur, making them incorrect options.
A client who is receiving a blood transfusion begins to experience chills, shortness of breath, nausea, excessive perspiration, and a vague sense of uneasiness. What is the nurse’s first best action?
- A. Report the signs and symptoms to the
- B. Monitor the client’s vital signs
- C. Assess respiratory status
- D. Stop the infusion
Correct Answer: D
Rationale: The correct answer is D: Stop the infusion. This is the best action because the client is likely experiencing a transfusion reaction. Stopping the infusion immediately is crucial to prevent further complications. Reporting the signs and symptoms to the healthcare provider (A) can cause a delay in addressing the reaction. While monitoring vital signs (B) and assessing respiratory status (C) are important, stopping the infusion takes precedence to ensure the client's safety and prevent a severe reaction.
What name is given to tools that are used to communicate a standardized interdisciplinary plan of care for clients within a case management health care delivery system?
- A. Kardex care plans
- B. Computerized plans of care
- C. Clinical pathways
- D. Student care plans
Correct Answer: C
Rationale: The correct answer is C: Clinical pathways. Clinical pathways are standardized, evidence-based interdisciplinary plans of care used in case management to guide the treatment and management of clients. They outline the expected course of treatment, interventions, and outcomes for specific health conditions. Kardex care plans (A) are outdated paper-based patient information systems, not specifically for interdisciplinary care plans. Computerized plans of care (B) may refer to electronic health records but do not necessarily imply standardized interdisciplinary plans. Student care plans (D) are educational tools for students and not typically used in case management for clients.
With pulmonary edema, there is usually an alteration in:
- A. Afterload
- B. Preload
- C. Contractility
- D. All of the above
Correct Answer: D
Rationale: Pulmonary edema causes an increase in pressure in the pulmonary circulation, leading to an alteration in afterload due to increased resistance. It also causes fluid accumulation in the pulmonary vessels, affecting preload. Additionally, the heart may compensate by increasing contractility. Therefore, all of the above choices are altered in pulmonary edema. The incorrect choices are A, B, and C individually as they only represent one aspect of the alterations seen in pulmonary edema, while the correct answer D encompasses all three factors affected in this condition.