Nokea
Which of the following is one of the discharge criteria from ambulatory surgery for patients following surgery?
- A. Able to drive self home
- B. IV narcotics given less than 30 minutes
- C. Has home telephone before discharge
- D. Understands discharge instructions
Correct Answer: D
Rationale: Understanding discharge instructions is one of the key criteria for discharging patients following surgery in an ambulatory setting. It ensures that the patient comprehends how to care for themselves post-surgery and reduces the risk of complications or the need for readmission. While the other options may also be important factors, having a clear understanding of discharge instructions is crucial for the patient's recovery and overall well-being.
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Which of the following may be the first abnormal sign detected in a client with cardiomyopathy?
- A. Ascites c.Chest pain
- B. Heart murmur
- C. Dyspnea
Correct Answer: C
Rationale: Dyspnea, or difficulty breathing, may be the first abnormal sign detected in a client with cardiomyopathy. Cardiomyopathy is a disease of the heart muscle, which can lead to impaired heart function. As the heart's ability to pump blood effectively is compromised, the body may not receive an adequate supply of oxygen-rich blood. This can result in symptoms such as dyspnea, especially during physical exertion or when lying down. Ascites (fluid accumulation in the abdomen), chest pain, and heart murmur may also be seen in clients with cardiomyopathy but are not typically the first signs to present. Dyspnea is often a key indicator that should prompt further evaluation and monitoring for cardiac issues.
A client suspected of having colorectal cancer will require which diagnostic study to confirm the diagnosis?
- A. Stool hematest
- B. Abdominal computed tomography (CT)
- C. Carcinoembryonic antigen (CEA) scan
- D. Sigmoidoscopy
Correct Answer: D
Rationale: Sigmoidoscopy is a diagnostic study that allows direct visualization of the lower part of the colon and rectum using a flexible tube with a camera at its end, called a sigmoidoscope. This procedure enables the healthcare provider to visually inspect the lining of the colon and rectum, identify any abnormal growths, such as tumors or polyps, and obtain tissue samples for biopsy if necessary. In the case of suspected colorectal cancer, sigmoidoscopy is crucial for confirming the diagnosis by directly visualizing any cancerous lesions or abnormal tissue changes in the colon and rectum. Other diagnostic tests, such as stool hematest, abdominal CT, and CEA scan, may aid in the evaluation and staging of colorectal cancer but are not as effective in confirming the diagnosis as sigmoidoscopy. Thus, sigmoidoscopy is the preferred diagnostic study for definitively diagnosing colorectal cancer in a client suspected of having the disease.
The nurse is assessing a child with croup and a sore throat in the ED. The child is drooling and agitated. The nurse should know that examining the child's throat using a tongue depressor might precipitate which of the following?
- A. Profuse coughing
- B. Inspiratory stridor
- C. Complete obstruction
- D. Increased agitation
Correct Answer: C
Rationale: When assessing a child with croup who is drooling and agitated, the nurse should be aware that examining the throat using a tongue depressor can potentially precipitate a complete airway obstruction. Croup is characterized by upper airway inflammation, particularly around the larynx and trachea, leading to a barking cough, hoarseness, and respiratory distress. In a child with croup who is already showing signs of airway compromise such as drooling and agitation, any manipulation in the throat area can cause further swelling and lead to a complete obstruction of the airway. This can be a life-threatening emergency requiring immediate intervention to secure the airway and ensure adequate oxygenation. Therefore, utmost caution should be taken when performing any procedures that may exacerbate the child's respiratory distress in this situation.
During thoracentesis, which of the following nursing intervention will be most crucial?
- A. Place patient in a quiet and cool room
- B. Maintain strict aseptic technique
- C. Advice patient to sit perfectly still during needle insertion until it has been withdrawn from the chest
- D. Apply pressure over the puncture site as soon as the needle is withdrawn
Correct Answer: B
Rationale: Maintaining strict aseptic technique during thoracentesis is the most crucial nursing intervention. Thoracentesis is a procedure where a needle is inserted into the pleural space to obtain a sample of fluid for diagnostic purposes or to drain excess fluid for therapeutic relief. It is essential to prevent the introduction of pathogens or contaminants into the pleural space, as this can lead to serious complications such as infection. By following strict aseptic technique, the risk of complications can be minimized, ensuring the safety and well-being of the patient undergoing the procedure.
Which medication is most likely included in post-operative care of a child with repair of bladder exstrophy?
- A. Lasix
- B. Mannitol
- C. Meperidine
- D. Oxybutynin
Correct Answer: D
Rationale: Oxybutynin helps control bladder spasms and improves comfort after urinary reconstructive surgery.