Nokea
You are caring for a patient who has had a transurethral resection of the prostate for benign prostatic hypertrophy. There is continuous bladder irrigation setup. You would notify the physician if you noted
- A. Any signs of hematuria.
- B. A change from clear red output to thicker, bright red output.
- C. A decrease in the amount of blood in the urine.
- D. The development of uremic pruritis.
Correct Answer: B
Rationale: Thicker, bright red output indicates potential bleeding requiring medical attention.
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A client complaining of severe shortness of breath is diagnosed with congestive heart failure. The nurse observes a falling pulse oximetry. The client's color changes to gray and she expectorates large amounts of pink frothy sputum. The first action of the nurse would be which of the following?
- A. Call the health care provider.
- B. Check vital signs.
- C. Position in high Fowler's.
- D. Administer oxygen.
Correct Answer: D
Rationale: Oxygen administration is immediate to address hypoxemia.
What is first-line therapy for insomnia?
- A. Complementary therapies such as melatonin
- B. Cognitive-behavioral therapies such as relaxation therapy
- C. Benzodiazepine-receptor-like agents (e.g., zolpidem [Ambien])
- D. Over-the-counter medication such as diphenhydramine (Benadryl)
Correct Answer: B
Rationale: The correct answer is B. Cognitive-behavioral therapy (CBT) is the first-line treatment for insomnia due to its effectiveness and lack of side effects. Melatonin (A) and over-the-counter medications (D) are secondary options, while benzodiazepines (C) are reserved for short-term use.
A client is postoperative following an intermaxillary fixation due to multiple facial fractures. Which type of equipment should be at the client's bedside?
- A. Wire cutters
- B. NG tube
- C. Urinary catheter tray
- D. IV infusion pump
Correct Answer: A
Rationale: The correct answer is A: Wire cutters. In postoperative intermaxillary fixation, wire cutters are essential at the bedside in case of an emergency airway obstruction or need for immediate removal of the fixation. Wire cutters allow quick access to the airway without causing harm to the client.
B: NG tube is not necessary for postoperative intermaxillary fixation.
C: Urinary catheter tray is not directly related to the client's airway or fixation.
D: IV infusion pump is not specifically required for managing intermaxillary fixation emergencies.
In summary, wire cutters are crucial for ensuring client safety and airway management in postoperative intermaxillary fixation, making it the most appropriate equipment to have at the bedside.
What would be the best response by the nurse to a quiet and uncommunicative client?
- A. Think over the following questions.
- B. Discuss them with your instructor or peers.
- C. Acknowledge their feelings and encourage expression.
- D. Offer silence and wait patiently.
Correct Answer: D
Rationale: Silence can provide the client with space to open up when they feel ready, fostering trust and rapport.
Patients with a paralytic ileus typically have
- A. Intravenous fluid replacement and a nasogastric tube connected to suction.
- B. Surgical correction of the problem.
- C. Endoscopic injection of botulinum toxin or esophageal dilation.
- D. Endoscopy to allow biopsy followed with broad-spectrum antibiotics.
Correct Answer: A
Rationale: Paralytic ileus requires decompression of the gastrointestinal tract.