Nokea
Which of the following blood gas parameters primarily reflects respiratory function?
- A. PCO2
- B. CO2 content of the blood
- C. HCO3
- D. Base excess
Correct Answer: A
Rationale: The lungs are responsible for regulation of CO2, and this parameter primarily reflects respiratory function.
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A 35-year-old client is receiving psychopharmacological treatment of his major depression with tranylcypromine sulfate (Parnate), a monoamine oxidase (MAO) inhibitor. The nurse teaches the client that while he is taking this type of antidepressant, he needs to restrict his dietary intake of:
- A. Potassium-rich foods
- B. Tryptophan
- C. Tyramine
- D. Saturated fats
Correct Answer: C
Rationale: The client may need to avoid some potassium-rich foods (such as bananas, raisins, etc.). However, this is not because of the potassium content of these foods. Tryptophan is an essential amino acid that is present in high concentrations in animal and fish protein. The client will need to watch his dietary intake of tyramine. Tyramine is a by-product of the conversion of tyrosine to epinephrine. Tyramine is found in a variety of foods and beverages, ranging from aged cheese to caffeine drinks. Ingestion of tyramine-rich foods while taking a MAO inhibitor may lead to an increase in blood pressure and/or a life-threatening hypertensive crisis. To maintain a healthy lifestyle, restriction of dietary saturated fats is advisable.
The nurse would assess the client's correct understanding of the fertility awareness methods that enhance conception, if the client stated that:
- A. My sexual partner and I should have intercourse when my cervical mucosa is thick and cloudy.'
- B. At ovulation, my basal body temperature should rise about 0.5F.'
- C. I should douche immediately after intercourse.'
- D. My sexual partner and I should have sexual intercourse on day 14 of my cycle regardless of the length of the cycle.'
Correct Answer: B
Rationale: A slight rise in basal body temperature (about 0.5°F) after ovulation, due to progesterone, indicates correct understanding of fertility awareness.
The nurse is trying to help a mother understand what is happening with her son who has recently been diagnosed with paranoid schizophrenia. At present, he is experiencing hallucinations and delusions of persecution and suffers from poor hygiene. The nurse can best help her understand her son's condition by which of the following statements?
- A. Sometimes these symptoms are caused by an overstimulation of a chemical called dopamine in the brain.'
- B. Has anyone in your family ever had schizophrenia?'
- C. If your son has a twin, he probably will eventually develop schizophrenia, too.'
- D. Some of his symptoms may be a result of his lack of a strong mother-child bonding relationship.'
Correct Answer: A
Rationale: The most plausible theory to date is that dopamine causes an overstimulation in the brain, which results in the psychotic symptoms.
A female client was recently diagnosed with gastric cancer. She entered the hospital and had a total gastrectomy with esophagojejunostomy. Her postoperative recovery was uneventful. On conducting discharge teaching, the nurse discusses changes in bodily function and lifestyle changes with the client. In order to prevent pernicious anemia, the nurse stresses that the client must:
- A. Receive monthly blood transfusions
- B. Increase the amount of iron in her diet
- C. Eat small quantities several times daily until she is able to tolerate food in moderate portions
- D. Understand the need for Vitamin B12 replacement therapy
Correct Answer: D
Rationale: Monthly blood transfusions are not indicated postgastrectomy. Increasing iron in the client's diet may cause irritation and will not alleviate pernicious anemia. It may be necessary that the client eat small meals several times per day, but this measure has no relevance to prevention of pernicious anemia. Pernicious anemia is caused by lack of Vitamin B12, and replacement therapy will be necessary because the client's stomach has been removed.
To prevent fungal infections of the mouth and throat, the nurse should teach clients on inhaled steroids to:
- A. Rinse the plastic holder that aerosolizes the drug with hydrogen peroxide every other day
- B. Rinse the mouth and gargle with warm water after each use of the inhaler
- C. Take antacids immediately before inhalation to neutralize mucous membranes and prevent infection
- D. Rinse the mouth before each use to eliminate colonization of bacteria
Correct Answer: B
Rationale: It is sufficient to rinse the plastic holders with warm water at least once per day. It is important to rinse the mouth after each use to minimize the risk of fungal infections by reducing the droplets of the glucocorticoid left in the oral cavity. Antacids act by neutralizing or reducing gastric acid, thus decreasing the pH of the stomach. 'Neutralizing' the oral mucosa prior to inhalation of a steroid inhaler does not minimize the risk of fungal infections. Rinsing prior to the use of the glucocorticoid will not eliminate the droplets left on the oral mucous membranes following the use of the inhaler.