Nokea
Which statements are correct for lithium?
- A. Effective for all
- B. Has a delay of 10 to 28 days in achieving therapeutic benefits
- C. Has a narrow range of safety between a therapeutic serum level and toxic levels
- D. May be therapeutic when administered in combination with any other drugs
Correct Answer: C
Rationale: Lithium has a narrow therapeutic window, requiring careful monitoring to prevent toxicity.
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Cognitive changes include memory problems, confusion, and disorientation. These changes:
- A. Occur in 75% of patients over age 65
- B. Are not a normal part of aging
- C. Are due to enhanced cerebral blood flow
- D. Cause senile plaques and neurofibrillary tangles
Correct Answer: B
Rationale: Cognitive decline is not a normal part of aging; it may indicate underlying conditions such as dementia or Alzheimer's disease. Normal aging involves mild forgetfulness but not significant impairment.
A client is 12 hours postoperative and has a chest tube to a disposable water-seal drainage system with suction. The healthcare provider should intervene for which of the following observations?
- A. Constant bubbling in the suction-control chamber
- B. Continuous bubbling in the water-seal chamber
- C. Bloody drainage in the collection chamber
- D. Fluid-level fluctuations in the water-seal chamber
Correct Answer: B
Rationale: The correct answer is B: Continuous bubbling in the water-seal chamber. Continuous bubbling in the water-seal chamber indicates an air leak in the system, which can lead to lung collapse. The water-seal chamber should have intermittent bubbling during exhalation but should not bubble continuously. Constant bubbling in the suction-control chamber (A) is expected and indicates proper suction is being applied. Bloody drainage in the collection chamber (C) is common in the immediate postoperative period. Fluid-level fluctuations in the water-seal chamber (D) can be normal due to changes in intrathoracic pressure.
What type of procedural information should be given to a patient in preparation for ambulatory surgery (select all that apply)?
- A. How pain will be controlled
- B. Any fluid and food restrictions
- C. Characteristics of monitoring equipment
- D. What odors and sensations may be experienced, Technique and practice of coughing and deep breathing, if appropriate
Correct Answer: D
Rationale: Providing comprehensive procedural information prepares the patient physically and mentally for surgery.
Priority Decision: A patient in the PACU has emergence delirium manifested by agitation and thrashing. What should the nurse assess for first in the patient?
- A. Hypoxemia
- B. Neurologic injury
- C. Distended bladder
- D. Cardiac dysrhythmias
Correct Answer: A
Rationale: Hypoxemia is a common cause of agitation and delirium during emergence from anesthesia.
To offer the most effective program with the best outcomes, the nurses should initially
- A. Search for an article that describes nursing interventions that are effective for smoking cessation
- B. Develop a clinical question that will allow them to compare different cessation methods during the program
- C. Keep comprehensive records that detail each patient’s progress and ultimate outcomes from participation in the program
- D. Use evidence-based clinical practice guidelines developed from reviews of randomized controlled trials of smoking cessation methods
Correct Answer: D
Rationale: Using evidence-based guidelines ensures the program is grounded in proven methodologies, leading to better outcomes.