Nokea
Which of these clients is likely to receive sublingual morphine?
- A. A 75-year-old woman in a hospice program
- B. A 40-year-old man who just had throat surgery
- C. A 20-year-old woman with trigeminal neuralgia
- D. A 60-year-old man who has a painful incision
Correct Answer: A
Rationale: The correct answer is a 75-year-old woman in a hospice program. Sublingual morphine is commonly used in hospice care because patients may have difficulty swallowing, and intravenous access can be uncomfortable and not ideal for palliative care. Choice B, a 40-year-old man who just had throat surgery, is less likely to receive sublingual morphine as he may be able to swallow, and other pain management options may be more suitable. Choice C, a 20-year-old woman with trigeminal neuralgia, would typically require specific medications targeting neuropathic pain rather than sublingual morphine. Choice D, a 60-year-old man with a painful incision, may benefit from localized pain relief or other systemic pain management options, but sublingual morphine is not usually the first choice for this type of pain.
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Which food should the assistive personnel be instructed to remove from the child's food tray based on the prescribed treatment for nephrotic syndrome?
- A. Pickle
- B. Wheat toast
- C. Baked chicken
- D. Steamed vegetables
Correct Answer: A
Rationale: In nephrotic syndrome, a no-added-salt diet is recommended to manage the condition. High-sodium foods like pickles should be avoided as they can exacerbate fluid retention and swelling. Wheat toast, baked chicken, and steamed vegetables are generally suitable for individuals with nephrotic syndrome as they are low in sodium and protein, which are important considerations for this condition. Therefore, the correct choice is to remove the pickles from the child's food tray.
When analyzing the results of the urinalysis collected preoperatively from a child with epispadias scheduled for surgical repair, which finding should the nurse most likely expect to note?
- A. Hematuria
- B. Proteinuria
- C. Bacteriuria
- D. Glucosuria
Correct Answer: C
Rationale: Epispadias is a congenital defect characterized by the abnormal placement of the urethral orifice of the penis, often on the dorsum. This anatomical anomaly predisposes individuals to bacterial entry into the urinary tract, leading to bacteriuria. Hematuria, proteinuria, and glucosuria are not typically associated with epispadias. Hematuria refers to the presence of blood in the urine, proteinuria indicates protein in the urine, and glucosuria is the presence of glucose in the urine, none of which are commonly seen in epispadias.
In educating clients on ways to manage pain, which topic can be appropriately delegated to an LPN/LVN who will continue under supervision?
- A. Acupuncture
- B. Guided Imagery
- C. Alternating Rest/Activity
- D. Over-the-counter medications
Correct Answer: C
Rationale: The correct answer is 'Alternating Rest/Activity.' This topic falls within the nursing scope of practice and is typically covered in the training and education of all nurses, including LPN/LVNs. Educating clients on alternating rest and activity is safe, straightforward, and a standard non-pharmacological pain management strategy. Acupuncture (Choice A) and Guided Imagery (Choice B) involve specific skills and techniques that are typically outside the scope of practice for LPN/LVNs. Over-the-counter medications (Choice D) may require additional assessment, monitoring, and considerations that are beyond the usual delegation for LPN/LVNs.
A 4-year-old child with acute glomerulonephritis is admitted to the hospital. The nurse identifies which client problem in the plan of care as the priority?
- A. Infection related to hypertension
- B. Injury related to loss of blood in urine
- C. Excessive fluid volume related to decreased plasma filtration
- D. Retarded growth and development related to a chronic disease
Correct Answer: C
Rationale: In acute glomerulonephritis, the child experiences excessive accumulation of water and retention of sodium, leading to circulatory congestion and edema. Excessive fluid volume is a primary concern due to the disease process. Hypertension and infection are not directly related to acute glomerulonephritis; therefore, they are not the priority client problems. While hematuria (blood in urine) may occur, it typically does not lead to significant injury that takes precedence over excessive fluid volume. Acute glomerulonephritis is an acute condition, not chronic; therefore, retarded growth and development related to a chronic disease is not the priority issue. With proper management, most children recover completely without long-term growth and development issues.
The parents of a newborn with hypospadias are reviewing the treatment plan with the nurse. Which statement by the parents indicates their understanding of the plan?
- A. Caution should be used when straddling my infant on a hip.
- B. Vital signs should be taken daily to check for bladder infection.
- C. Catheterization will be necessary when my infant does not void.
- D. Circumcision has been delayed to save tissue for surgical repair.
Correct Answer: D
Rationale: Hypospadias is a congenital defect involving abnormal placement of the urethral orifice of the penis. In hypospadias, the urethral orifice is located below the glans penis along the ventral surface. It's important not to circumcise the infant, as the dorsal foreskin tissue will be required for surgical repair of the hypospadias. Option A is unrelated to the treatment plan for hypospadias. Option B is not directly related to the surgical repair of hypospadias. Option C is not a routine part of the treatment plan for hypospadias, as catheterization is usually managed by healthcare professionals.