Nokea
Which of the following theories of pain are you utilizing when you recognize the fact that some of the factors that open this 'gate' to pain are low endorphins and anxiety and that some of the factors that close this 'gate' to pain are decreased anxiety and fear?
- A. Moritz Schiff's theory of pain
- B. The Intensive Theory of Pain
- C. Melzack and Wall's theory of pain
- D. The Specificity Theory of Pain
Correct Answer: C
Rationale: Melzack and Wall's Gate Control Theory posits that pain perception is modulated by factors like anxiety (opening the gate) and reduced anxiety or endorphins (closing the gate).
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A client with a diagnosis of gout is prescribed febuxostat (Uloric). The nurse should instruct the client to:
- A. Take the medication with food to reduce stomach upset.
- B. Avoid drinking alcohol.
- C. Limit fluid intake.
- D. Take the medication at bedtime only.
Correct Answer: A,B
Rationale: Taking febuxostat with food reduces gastrointestinal upset, and avoiding alcohol prevents uric acid buildup.
The nurse is preparing to perform a Mantoux tuberculin skin test. Which interventions apply to the administration of this test? Select all that apply.
- A. Explain the procedure to the client.
- B. Obtain a 3-mL syringe with a 1/2-inch needle for the injection.
- C. Mark the test area to locate it for reading 48 to 72 hours after injection.
- D. Bunch up the skin and insert the needle with the needle bevel facing downward.
- E. Cleanse the injection site on the lower dorsal surface of the forearm with alcohol and allow it to dry.
- F. Ask the client about a history of receiving a positive purified protein derivative (PPD) reaction.
Correct Answer: A,C,E,F
Rationale: The nurse should always explain the procedure to the client and then assess him or her for a history of a PPD reaction. The test should not be administered if the client has such a history. The nurse should use a tuberculin syringe (not a 3-mL syringe) with a 1/2-inch 26- or 27-gauge needle. The injection site on the lower dorsal surface of the forearm is cleansed with alcohol and allowed to dry. The skin is stretched taut, and 0.1 mL of solution containing 0.5 tuberculin units of PPD is injected. The injection is made just under the surface of the skin with the needle bevel facing upward to provide a discrete elevation of the skin (a wheal) 6 to 10 mm in diameter. The test area is marked to locate it for reading and the test area is read 48 to 72 hours after injection.
Which of the following nursing diagnoses should the nurse implement as part of the long-term care for a child with hemophilia?
- A. Deficient knowledge
- B. Risk for injury
- C. Situational low self-esteem
- D. Acute pain
Correct Answer: B
Rationale: Risk for injury is a priority nursing diagnosis for a child with hemophilia due to the risk of bleeding from minor trauma. Other diagnoses may apply but are less critical long-term.
When giving a change of shift report, which of the following statements by the nurse is not appropriate?
- A. Randi Smith is a 38-year-old female client of Dr. Born with cholecystitis and cholelithiasis.'
- B. Mrs. Jones' pain is best relieved in the left lateral Sims position.'
- C. Mr. Levi is just contrary today and nothing is going to please him.'
- D. Mr. Emmert was able to walk around the unit twice today with no complaint of dizziness.'
Correct Answer: C
Rationale: Subjective statements like 'contrary' are inappropriate in a professional report, as they lack objectivity and clinical relevance.
The first thing that you should do immediately after a client accident is to:
- A. Notify the doctor.
- B. Render care.
- C. Assess the client.
- D. Notify the nurse manager.
Correct Answer: C
Rationale: The first action after a client accident is to assess the client to determine the extent of injury and immediate needs, following the nursing process.