Nokea
Which of the following nursing actions is helpful for older clients who are experiencing lens changes associated with aging?
- A. Offering teaching aids with large-sized letters
- B. Suggesting reduced visual activity such as reading or watching television
- C. Suggesting the use of eye drops for comfort
- D. Suggesting the use of glasses or contact lenses
Correct Answer: A
Rationale: Large-sized letters help compensate for decreased visual acuity due to aging-related lens changes.
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A 35-year-old client is admitted for elective tubal ligation. During the preoperative teaching, the client states, 'The anesthesiologist said she was going to give me balanced anesthesia. What exactly is that?' The best explanation by the nurse is that balanced anesthesia:
- A. is a type of regional anesthesia.
- B. uses equal amounts of inhalation agents and liquid agents.
- C. does not depress the central nervous system.
- D. is a combination of several anesthetic agents or drugs, which produce a smooth induction with minimal complications.
Correct Answer: D
Rationale: A regional anesthesia does not produce loss of consciousness and is indicated for excision of moles, cysts, and endoscopic surgeries. Varying amounts of anesthetic agents are used when employing balanced anesthesia. The amounts used depend on the age, weight, condition of the client and the surgical procedure. General anesthesia is a drug induced depression of the central nervous system, which produces loss of consciousness and decreased muscle activity. Balanced anesthesia is a combination of a number of anesthetic agents that produce a smooth induction, appropriate depth of anesthesia, and appropriate muscle relaxation with minimal complications.
Stephen Douglas has been in an automobile accident. The most effective IV solution for a patient having hypovolemic shock would be:
- A. hypertonic.
- B. isotonic.
- C. hypotonic.
- D. colloids.
Correct Answer: B
Rationale: Hypertonic IV fluids would be used to draw fluid off tissue in edematous situations such as third spacing. Isotonic solutions are used to increase intravascular volume, to increase perfusion of vital organs. Hypotonic fluids are used to rehydrate tissue in those with severe, or prolonged fluid deprivation. Colloids increase tonicity of intravascular fluids, pulling water into the vascular system from tissue.
A patient who has been taking ibuprofen (Motrin) and imipramine (Tofranil) for control of cancer pain is having increased pain. What would the health care provider recommend as an appropriate change in the medication plan?
- A. Add PO oxycodone (Oxycontin) to the other medications
- B. Substitute PO propoxyphene (Darvon), a mild opioid, for imipramine
- C. Add transdermal fentanyl (Duragesic) to the use of the other medications
- D. Substitute PO hydrocodone with acetaminophen (Lortab, Vicodin) for the other medications
Correct Answer: C
Rationale: The correct answer is C. Adding a stronger opioid like transdermal fentanyl can address increased pain.
The patient will be placed under moderate sedation to allow realignment of a fracture in the emergency department. When the family asks about this anesthesia, what should the nurse tell them?
- A. Includes inhalation agents
- B. Induces high levels of sedation
- C. Frequently used for traumatic injuries
- D. Patients remain responsive and breathe without assistance
Correct Answer: D
Rationale: Moderate sedation keeps patients responsive and maintains spontaneous breathing.
Your patient's physician told him that he has hemophilia. You are asked to teach the signs and symptoms of this disease. You respond by saying
- A. Clot formation, especially in the veins of the lower extremities.
- B. Low blood counts and fatigue due to lack of adequate red blood cell production.
- C. High blood counts and clot formation under the nails.
- D. Excessive bleeding after minor trauma.
Correct Answer: D
Rationale: Hemophilia is characterized by excessive bleeding due to a deficiency in clotting factors.