Nokea
Which of the following nursing interventions is appropriate after a lumbar puncture?
- A. Have the patient lie flat for 6 to 8 hours
- B. Keep the patient from eating or drinking for 4 hours
- C. Monitor the patient's pedal pulses q4h
- D. Keep the head of the bed elevated 30 degrees for 24 hours
Correct Answer: A
Rationale: After a lumbar puncture, it is important to have the patient lie flat for 6 to 8 hours to help prevent leakage of cerebrospinal fluid. Keeping the patient in this position can reduce the risk of developing a post-lumbar puncture headache. It allows the tiny hole created in the dura to seal properly and helps maintain proper cerebrospinal fluid pressure. This intervention is essential for the patient's safety and optimal recovery following a lumbar puncture procedure.
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Beta-adrenergic agonists such as albuterol are given to Reggie, a child with asthma. Such drugs are administered primarily to do which of the following?
- A. Dilate the bronchioles
- B. Reduce secondary infections
- C. Decrease postnasal drip
- D. Reduce airway inflammation
Correct Answer: A
Rationale: Beta-adrenergic agonists like albuterol primarily work by relaxing and dilating the bronchioles, which are the smaller airways in the lungs. This leads to quick relief of asthma symptoms such as wheezing, shortness of breath, and chest tightness. By opening up the airways, these medications help improve airflow and make it easier for the individual to breathe. Beta-adrenergic agonists do not directly reduce airway inflammation, but they do provide immediate relief during an asthma attack by targeting bronchoconstriction.
A client with suspected lung cancer is scheduled for thoracentesis as part of the diagnostic workup. The nurse reviews the client's history for conditions that might contraindicate this procedure. Which condition is a contraindication for thoracentesis?
- A. A seizure disorder
- B. Anemia
- C. Chronic obstructive pulmonary disease
- D. A bleeding disorder
Correct Answer: D
Rationale: A bleeding disorder is a contraindication for thoracentesis because the procedure involves inserting a needle through the chest wall into the pleural space to drain fluid. Individuals with a bleeding disorder are at an increased risk of bleeding complications during and after the procedure. It is important to ensure adequate clotting function before performing a thoracentesis to prevent excessive bleeding. If a client has a bleeding disorder, alternative diagnostic methods may need to be considered to minimize the risks associated with the procedure.
the vital sign that the nurse should most certainly check before administering digoxin is:
- A. pulse rate
- B. temperature
- C. blood pressure
- D. respiratory rate 99- coarctation of the aorta reflects which of the statements?
Correct Answer: A
Rationale: Before administering digoxin, it is crucial for the nurse to check the patient's pulse rate. Digoxin is a medication commonly used to treat heart conditions such as atrial fibrillation and heart failure by increasing the strength and efficiency of the heart's contractions. However, digoxin can also cause adverse effects such as bradycardia (slow heart rate) or heart block. Therefore, it is important to assess the patient's pulse rate to ensure that it is within the safe range before administering digoxin.
Neonates of mothers with diabetes are at risk for which complication following birth?
- A. Atelectasis
- B. Microcephaly
- C. Pneumothorax
- D. Macrosomia
Correct Answer: D
Rationale: Neonates of mothers with diabetes are at risk for macrosomia following birth. Macrosomia refers to a condition where the newborn baby is significantly larger than average, typically weighing more than 4,000 grams (8 pounds, 13 ounces) at birth. This risk is primarily due to maternal hyperglycemia, which can lead to excessive fetal growth. The elevated glucose levels in the maternal circulation can cross the placenta and stimulate fetal insulin production, resulting in increased growth and potentially leading to macrosomia. Neonates born with macrosomia are at increased risk for complications during delivery, such as shoulder dystocia, birth injuries, and the need for cesarean delivery.
Pneumocystic pneumonia. Which anemias are described as microcytic, hypochromic anemia?
- A. Vitamin B12 and iron deficiency anemia
- B. Folic acid and iron deficiency anemia
- C. Iron deficiency anemia and thalassemia
- D. Sickle cell anemia and anemia if chronic disease
Correct Answer: C
Rationale: Microcytic, hypochromic anemia is characterized by small red blood cells with decreased hemoglobin content. Iron deficiency anemia and thalassemia are the two main types of anemia that present with these characteristics. Iron deficiency anemia is caused by a lack of iron in the body, which is essential for the production of hemoglobin. Thalassemia is a genetic disorder that results in decreased production of normal hemoglobin. Both conditions lead to small, pale red blood cells, fitting the description of microcytic, hypochromic anemia. Other choices such as Vitamin B12 deficiency anemia (choice A), folic acid deficiency anemia (choice B), sickle cell anemia (choice D), and anemia of chronic disease (choice D) typically present as normocytic or macrocytic anemias.