43. Mr. Gomez, 71 years old, has a history of chronic back pain. He thinks that his family perceives him as a “weakling” because he often asks for pain medication. Which of the following is the most therapeutic response of the nurse?

43. Mr. Gomez, 71 years old, has a history of chronic back pain.
He thinks that his family perceives him as a “weakling”
because he often asks for pain medication. Which of the
following is the most therapeutic response of the nurse?
by

1 Answer

Answer :

A. “It seems that you are worried. Which matter to
you more? What people will say or getting relief
from your pain?”
by

Related questions

71. Before the nurse administers the medication, which of the following is most relevant for the nurse to ask?

Description : 71. Before the nurse administers the medication, which of the following is most relevant for the nurse to ask?

Last Answer : C. “When was your last menstruation?”

When the patient who has experienced trauma to an extremity complains of severe burning pain, vasomotor changes, and muscles spasms in the injured extremity, the nurse recognizes that the patient is likely demonstrating signs of a) reflex sympathetic dystrophy syndrome. RSD is frequently chronic and occurs most often in women.

Description : When the patient who has experienced trauma to an extremity complains of severe burning pain, vasomotor changes, and muscles spasms in the injured extremity, the nurse ... heterotrophic ossification. Heterotrophic ossification causes muscular pain and limited muscular contraction and movement.

Last Answer : a) reflex sympathetic dystrophy syndrome. RSD is frequently chronic and occurs most often in women.

99. The companion asks why the client was advised to avoid iron supplements or vitamins. The correct response of the nurse would be

Description : 99. The companion asks why the client was advised to avoid iron supplements or vitamins. The correct response of the nurse would be

Last Answer : A. “These supplements enhance the production of RBC.”

53. Albert’s mother asks why the client’s breathing is shallow. The correct response of the nurse would be

Description : 53. Albert’s mother asks why the client’s breathing is shallow. The correct response of the nurse would be

Last Answer : D. “Respiratory movement intensifies pericardial pain.

The preferred route of administration of medication in the most acute care situations is which of the following routes? a) Intravenous The IV route is the preferred parenteral route in most acute care situations because it is much more comfortable for the patient, and peak serum levels and pain relief occur more rapidly and reliably. b) Epidural Epidural administration is used to control postoperative and chronic pain. c) Subcutaneous Subcutaneous administration results in slow absorption of medication. d) Intramuscular Intramuscular administration of medication is absorbed more slowly than intravenously administered medication.

Description : The preferred route of administration of medication in the most acute care situations is which of the following routes? a) Intravenous The IV route is the preferred ... ) Intramuscular Intramuscular administration of medication is absorbed more slowly than intravenously administered medication.

Last Answer : a) Intravenous The IV route is the preferred parenteral route in most acute care situations because it is much more comfortable for the patient, and peak serum levels and pain relief occur more rapidly and reliably.

44. Mang Pedring has chronic pain due to osteoarthritis and has impaired speech. Which of the following is the most appropriate to determine his medication needs for pain?

Description : 44. Mang Pedring has chronic pain due to osteoarthritis and has impaired speech. Which of the following is the most appropriate to determine his medication needs for pain?

Last Answer : B. Asking the client to rate his pain on a scale of 0 to 10 by writing on a magic slate

61. A client with gout asks the nurse what food must be avoided so that the family can provide support. Which food has the highest in purine content and must be excluded from the dietary plan?

Description : 61. A client with gout asks the nurse what food must be avoided so that the family can provide support. Which food has the highest in purine content and must be excluded from the dietary plan?

Last Answer : D. Liver

79. A scrub nurse is assisting an emergency Cesarian section on a 39-year-old laundry woman. Before closing the peritoneum, the surgeon asks, “How old is the client?” Holding the fallopian tube, the surgeon asks for a hemostat. The scrub nurse sensing that the surgeon is about to ligate the tube said, “Doctor there is no signed consent for tubal ligation.” The nurse just demonstrated which of the following?

Description : 79. A scrub nurse is assisting an emergency Cesarian section on a 39-year-old laundry woman. Before closing the peritoneum, the surgeon asks, How old is the client? Holding the fallopian ... there is no signed consent for tubal ligation. The nurse just demonstrated which of the following?

Last Answer : C. Advocacy

When the patient tells the nurse that his vision is 20/200, and asks what that means, the nurse informs the patient that a person with 20/200 vision a) sees an object from 20 feet away that a person with normal vision sees from 200 feet away. The fraction 20/20 is considered the standard of normal vision.

Description : When the patient tells the nurse that his vision is 20/200, and asks what that means, the nurse informs the patient that a person with 20/200 vision a) sees an object from 20 feet away that a person ... 20/20 line, the person of normal vision will be standing at a distance of 20 feet from the chart.

Last Answer : a) sees an object from 20 feet away that a person with normal vision sees from 200 feet away. The fraction 20/20 is considered the standard of normal vision.

Nonadherence to therapeutic regimens is a significant problem for which of the following age groups? a) Adults 65 and over Elderly people frequently have one or more chronic illnesses that are managed with numerous medications and complicated by periodic acute episodes, making adherence difficult. b) Teenagers Problems of teenagers, generally, are time limited and specific, and require promoting adherence to treatment to return to health. c) Children In general, the compliance of children depends on the compliance of their parents. d) Middle-aged adults Middle-aged adults, in general, have fewer health problems, thus promoting adherence.

Description : Nonadherence to therapeutic regimens is a significant problem for which of the following age groups? a) Adults 65 and over Elderly people frequently have one or more chronic illnesses that are ... -aged adults Middle-aged adults, in general, have fewer health problems, thus promoting adherence.

Last Answer : a) Adults 65 and over Elderly people frequently have one or more chronic illnesses that are managed with numerous medications and complicated by periodic acute episodes, making adherence difficult.

The nurse recommends which of the following types of therapeutic baths for its antipruritic action? a) Colloidal (Aveeno, oatmeal) Aveeno or oatmeal baths are recommended to decrease itching associated with a dermatologic disorder.

Description : The nurse recommends which of the following types of therapeutic baths for its antipruritic action? a) Colloidal (Aveeno, oatmeal) Aveeno or oatmeal baths are recommended to decrease itching ... Saline Saline baths have the same effects as saline dressings, not known to counteract itching.

Last Answer : a) Colloidal (Aveeno, oatmeal) Aveeno or oatmeal baths are recommended to decrease itching associated with a dermatologic disorder.

Which nerve is assessed when the nurse asks the patient to dorsiflex the ankle and extend the toes? a) Peroneal The motor function of the peroneal nerve is assessed by asking the patient to dorsiflex the ankle and extend the toes while the sensory function is assessed by pricking the skin between the great and center toes. b) Radial The radial nerve is assessed by asking the patient to stretch out the thumb, then the wrist, and then the fingers at the metacarpal joints. c) Median The median nerve is assessed by asking the patient to touch the thumb to the little finger. d) Ulnar Asking the patient to spread all fingers allows the nurse to assess motor function affected by ulnar innervation.

Description : Which nerve is assessed when the nurse asks the patient to dorsiflex the ankle and extend the toes? a) Peroneal The motor function of the peroneal nerve is assessed by asking the patient to ... the patient to spread all fingers allows the nurse to assess motor function affected by ulnar innervation.

Last Answer : a) Peroneal The motor function of the peroneal nerve is assessed by asking the patient to dorsiflex the ankle and extend the toes while the sensory function is assessed by pricking the skin between the great and center toes.

Which nerve is assessed when the nurse asks the patient to spread all fingers? a) Ulnar Asking the patient to spread all fingers allows the nurse to assess motor function affected by ulnar innervation while pricking the fat pad at the top of the small finger allows assessment of the sensory function affected by the ulnar nerve. b) Peroneal The peroneal nerve is assessed by asking the patient to dorsiflex the ankle and extend the toes. c) Radial The radial nerve is assessed by asking the patient to stretch out the thumb, then the wrist, and then the fingers at the metacarpal joints. d) Median The median nerve is assessed by asking the patient to touch the thumb to the little finger.

Description : Which nerve is assessed when the nurse asks the patient to spread all fingers? a) Ulnar Asking the patient to spread all fingers allows the nurse to assess motor function affected by ulnar innervation ... The median nerve is assessed by asking the patient to touch the thumb to the little finger.

Last Answer : a) Ulnar Asking the patient to spread all fingers allows the nurse to assess motor function affected by ulnar innervation while pricking the fat pad at the top of the small finger allows assessment of the sensory function affected by the ulnar nerve.

64. The client was placed on a low sodium diet. The wife asks the nurse which foods to include in the client’s diet while at home. The nurse should instruct to include which of these?

Description : 64. The client was placed on a low sodium diet. The wife asks the nurse which foods to include in the client’s diet while at home. The nurse should instruct to include which of these?

Last Answer : C. Fruits and vegetables

When the patient who has undergone laryngectomy suffers wound breakdown, the nurse monitors him very carefully because he is identified as being at high risk for a) carotid artery hemorrhage. The carotid artery lies close to the stoma and may rupture from erosion if the wound does not heal properly. b) pulmonary embolism. Pulmonary embolism is associated with immobility. c) dehydration. Dehydration may lead to poor wound healing and breakdown. d) pneumonia. Pneumonia is a risk for any postoperative patient.

Description : When the patient who has undergone laryngectomy suffers wound breakdown, the nurse monitors him very carefully because he is identified as being at high risk for a) carotid artery hemorrhage. The ... poor wound healing and breakdown. d) pneumonia. Pneumonia is a risk for any postoperative patient.

Last Answer : a) carotid artery hemorrhage. The carotid artery lies close to the stoma and may rupture from erosion if the wound does not heal properly.

The nurse recognizes that the patient with a duodenal ulcer will likely experience a) pain 2-3 hours after a meal. The patient with a gastric ulcer often awakens between 1-2 A.M. with pain and ingestion of food brings relief. b) vomiting. Vomiting is uncommon in the patient with duodenal ulcer. c) hemorrhage. Hemorrhage is less likely in the patient with duodenal ulcer than the patient with gastric ulcer. d) weight loss. The patient with a duodenal ulcer may experience weight gain.

Description : The nurse recognizes that the patient with a duodenal ulcer will likely experience a) pain 2-3 hours after a meal. The patient with a gastric ulcer often awakens between 1-2 A.M. with pain ... patient with gastric ulcer. d) weight loss. The patient with a duodenal ulcer may experience weight gain.

Last Answer : a) pain 2-3 hours after a meal. The patient with a gastric ulcer often awakens between 1-2 A.M. with pain and ingestion of food brings relief.

The nurse anticipates that the immunosuppressed patient is at greatest risk for which type of shock? a) Septic Septic shock is associated with immunosuppression, extremes of age, malnourishment, chronic illness, and invasive procedures. b) Neurogenic Neurogenic shock is associated with spinal cord injury and anesthesia. c) Cardiogenic Cardiogenic shock is associated with disease of the heart. d) Anaphylactic Anaphylactic shock is associated with hypersensitivity reactions.

Description : The nurse anticipates that the immunosuppressed patient is at greatest risk for which type of shock? a) Septic Septic shock is associated with immunosuppression, extremes of age, ... disease of the heart. d) Anaphylactic Anaphylactic shock is associated with hypersensitivity reactions.

Last Answer : a) Septic Septic shock is associated with immunosuppression, extremes of age, malnourishment, chronic illness, and invasive procedures.

When the nurse observes the patient’s urine to be orange, she further assesses the patient for a) intake of medication such as phenytoin (Dilantin). Urine that is orange may be caused by intake of Dilantin or other medications. Orange to amber colored urine may also indicate concentrated urine due to dehydration or fever.

Description : When the nurse observes the patient's urine to be orange, she further assesses the patient for a) intake of medication such as phenytoin (Dilantin). Urine that is orange may be caused by intake ... white urine may indicate infection, pyruria, or in the female patient, the use of vaginal creams.

Last Answer : a) intake of medication such as phenytoin (Dilantin). Urine that is orange may be caused by intake of Dilantin or other medications. Orange to amber colored urine may also indicate concentrated urine due to dehydration or fever.

For which of the following medications must the nurse contact the pharmacist in consultation when the patient receives all oral medications by feeding tube? a) Enteric-coated tablets Enteric-coated tablets are meant to be digested in the intestinal tract and may be destroyed by stomach acids. A change of form of medication is required by patients with tube feedings.

Description : For which of the following medications must the nurse contact the pharmacist in consultation when the patient receives all oral medications by feeding tube? a) Enteric-coated tablets Enteric-coated ... make an opening in the capsule and squeeze out contents for administration by feeding tube.

Last Answer : a) Enteric-coated tablets Enteric-coated tablets are meant to be digested in the intestinal tract and may be destroyed by stomach acids. A change of form of medication is required by patients with tube feedings.

40. The nurse should ensure that all components of medications are documented. Identify all these components. 1. Dosage, route and frequency 2. Name of client and medication 3. Date and time the medication was ordered 4. Dosage, route, frequency and strength 5. Physician’s signature and specialty 6. Physician’s signature and PRC license number

Description : 40. The nurse should ensure that all components of medications are documented. Identify all these components. 1. Dosage, route and frequency 2. Name of client and medication 3. Date and time ... and strength 5. Physician's signature and specialty 6. Physician's signature and PRC license number

Last Answer : C. All except 5 and 6

38. A nurse encounters a client who refuses to take a prescribed medication. What is the appropriate action of the nurse?

Description : 38. A nurse encounters a client who refuses to take a prescribed medication. What is the appropriate action of the nurse?

Last Answer : C. Explore the possible reason why the client refuses the prescribed medication

Nurse Fely did her admission. She understands that the pain is characterized as A. Tenderness that is generalized in the upper epigastric area B. Pain in the left upper quadrant radiating to the left shoulder C. Tenderness and rigidity at the left epigastric area radiating to the back D. Tenderness and rigidity at the upper right abdomen radiating to the midsternal area

Description : Nurse Fely did her admission. She understands that the pain is characterized as A. Tenderness that is generalized in the upper epigastric area B. Pain in the left upper quadrant radiating to the ... to the back D. Tenderness and rigidity at the upper right abdomen radiating to the midsternal area

Last Answer : D. Tenderness and rigidity at the upper right abdomen radiating to the midsternal area

When the patient with known angina pectoris complains that he is experiencing chest pain more frequently even at rest, the period of pain is longer, and it takes less stress for the pain to occur, the nurse recognizes that the patient is describing a) unstable angina. Unstable angina is also called crescendo or pre-infarction angina and indicates the need for a change in treatment.

Description : When the patient with known angina pectoris complains that he is experiencing chest pain more frequently even at rest, the period of pain is longer, and it takes less stress for the ... or refractory angina produces severe, incapacitating chest pain that does not respond to conventional treatment.

Last Answer : a) unstable angina. Unstable angina is also called crescendo or pre-infarction angina and indicates the need for a change in treatment.

51. Albert came to the hospital with chest pain and fever. After a thorough assessment by the doctor, he was admitted for pericarditis management. The nurse positions the client to reduce pain and discomfort. Describe this position.

Description : 51. Albert came to the hospital with chest pain and fever. After a thorough assessment by the doctor, he was admitted for pericarditis management. The nurse positions the client to reduce pain and discomfort. Describe this position.

Last Answer : C. Sit the client upright and lean forward

72. The client is to have surgery in 10 days. Lugol’s solution 4 gtts po was prescribed in 10 days. The client asked the nurse for the purpose of the drug. Which response of the nurse is correct?

Description : 72. The client is to have surgery in 10 days. Lugol’s solution 4 gtts po was prescribed in 10 days. The client asked the nurse for the purpose of the drug. Which response of the nurse is correct?

Last Answer : A. It decreases the risk of bleeding

62. A 30-year-old client had cholesterol blood test before admission to the hospital. The nurse in charge would teach the family and significant others that the client should exercise to help keep the total cholesterol to a desired level of

Description : 62. A 30-year-old client had cholesterol blood test before admission to the hospital. The nurse in charge would teach the family and significant others that the client should exercise to help keep the total cholesterol to a desired level of

Last Answer : A. 140 mg/dl

Surgical fusion of a joint is termed a) arthrodesis. Arthrodesis of a joint is created surgically to treat chronic pain. b) open reduction with internal fixation (ORIF). ORIF refers to surgery to repair and stabilize a fracture. c) heterotrophic ossification. Heterotrophic ossification refers to formation of bone in the periprosthetic space. d) arthroplasty. Arthroplasty refers to surgical repair of a joint or joint replacement.

Description : Surgical fusion of a joint is termed a) arthrodesis. Arthrodesis of a joint is created surgically to treat chronic pain. b) open reduction with internal fixation (ORIF). ORIF refers to ... periprosthetic space. d) arthroplasty. Arthroplasty refers to surgical repair of a joint or joint replacement.

Last Answer : a) arthrodesis. Arthrodesis of a joint is created surgically to treat chronic pain.

Which of the following terms refers to chest pain brought on by physical or emotional stress and relieved by rest or medication? a) angina pectoris Angina pectoris is a symptom of myocardial ischemia. b) atherosclerosis Atherosclerosis is an abnormal accumulation of lipid deposits and fibrous tissue within arterial walls and lumens. c) atheroma Atheromas are fibrous caps composed of smooth muscle cells that form over lipid deposits within arterial vessels. d) ischemia Ischemia is insufficient tissue oxygenation and may occur in any part of the body.

Description : Which of the following terms refers to chest pain brought on by physical or emotional stress and relieved by rest or medication? a) angina pectoris Angina pectoris is a symptom of myocardial ischemia. ... d) ischemia Ischemia is insufficient tissue oxygenation and may occur in any part of the body.

Last Answer : a) angina pectoris Angina pectoris is a symptom of myocardial ischemia.

33. The client is scheduled to undergo appendectomy. Preparation for appendectomy includes the following: 1. Intravenous infusion 2. Laxative 3. Pubic area shaving 4. Enema 5. Shower 6. Pain medication

Description : 33. The client is scheduled to undergo appendectomy. Preparation for appendectomy includes the following: 1. Intravenous infusion 2. Laxative 3. Pubic area shaving 4. Enema 5. Shower 6. Pain medication

Last Answer : B. 1, 3, and 5

63. A hypertensive client is taking herbal supplement for his hypertension. He was prescribed antihypertensive medication. The client wants to continue taking his herbal medication to lower his blood pressure. The nurse’s most appropriate action is to

Description : 63. A hypertensive client is taking herbal supplement for his hypertension. He was prescribed antihypertensive medication. The client wants to continue taking his herbal medication to lower his blood pressure. The nurse’s most appropriate action is to

Last Answer : B. Tell the client that herbal supplements have no proven therapeutic effects

The percentage of patients over the age of 70 admitted to the hospital with delirium is about a) 25%. About 25% of patients over the age of 70 admitted to the hospital have delirium. The cause is often reversible and treatable (as in drug toxicity, vitamin B12 deficiency or thyroid disease) or chronic and irreversible. Depression may produce impairment of attention and memory.

Description : The percentage of patients over the age of 70 admitted to the hospital with delirium is about a) 25%. About 25% of patients over the age of 70 admitted to the hospital have delirium. The cause is ... delirium. d) 50%. About 25% of patients over the age of 70 admitted to the hospital have delirium.

Last Answer : a) 25%. About 25% of patients over the age of 70 admitted to the hospital have delirium. The cause is often reversible and treatable (as in drug toxicity, vitamin B12 deficiency or thyroid disease) or chronic and irreversible. Depression may produce impairment of attention and memory.

Which of the following statements accurately describes cancer of the esophagus? a) Chronic irritation of the esophagus is a known risk factor. In the United States, cancer of the esophagus has been associated with the ingestion of alcohol and the use of tobacco. b) It is three times more common in women in the U.S. than men. In the United States, carcinoma of the esophagus occurs more than three times as often in men as in women. c) It is seen more frequently in Caucasians than in African Americans. It is seen more frequently in African Americans than in Caucasians. d) It usually occurs in the fourth decade of life. It usually occurs in the fifth decade of life.

Description : Which of the following statements accurately describes cancer of the esophagus? a) Chronic irritation of the esophagus is a known risk factor. In the United States, cancer of the esophagus has been associated ... occurs in the fourth decade of life. It usually occurs in the fifth decade of life.

Last Answer : a) Chronic irritation of the esophagus is a known risk factor. In the United States, cancer of the esophagus has been associated with the ingestion of alcohol and the use of tobacco.

When the nurse administers intravenous gamma-globulin infusion, she recognizes that which of the following complaints, if reported by the patient, may indicate an adverse effect of the infusion? a) Tightness in the chest Flank pain, tightness in the chest, or hypotension indicates adverse effects of gamma-globulin infusion.

Description : When the nurse administers intravenous gamma-globulin infusion, she recognizes that which of the following complaints, if reported by the patient, may indicate an adverse effect of the infusion? a) ... urination is a sign of urinary tract infection, not an adverse effect of gamma-globulin infusion.

Last Answer : a) Tightness in the chest Flank pain, tightness in the chest, or hypotension indicates adverse effects of gamma-globulin infusion.

In assessing the appropriateness of removing a suprapubic catheter, the nurse recognizes that the patient’s residual urine must be less than which of the following amounts on two separate occasions (morning and evening)? a) 100 cc If the patient complains of discomfort or pain, however, the suprapubic catheter is usually left in place until the patient can void successfully.

Description : In assessing the appropriateness of removing a suprapubic catheter, the nurse recognizes that the patient's residual urine must be less than which of the following amounts on two separate occasions ... urine that is greater than 100 cc indicates that the suprapubic catheter cannot be discontinued.

Last Answer : a) 100 cc If the patient complains of discomfort or pain, however, the suprapubic catheter is usually left in place until the patient can void successfully.

Which of the following observations regarding ulcer formation on the patient’s lower extremity indicate to the nurse that the ulcer is a result of venous insufficiency? a) The border of the ulcer is irregular. The border of an ulcer caused by arterial insufficiency is circular. b) The ulcer is very painful to the patient, even though superficial. Superficial venous insufficiency ulcers cause minimal pain. c) The ulcer base is pale to black. The base of a venous insufficiency ulcer shows beefy red to yellow fibrinous color. d) The ulcer is deep, involving the joint space. Venous insufficiency ulcers are usually superficial.

Description : Which of the following observations regarding ulcer formation on the patient's lower extremity indicate to the nurse that the ulcer is a result of venous insufficiency? a) The border of the ... d) The ulcer is deep, involving the joint space. Venous insufficiency ulcers are usually superficial.

Last Answer : a) The border of the ulcer is irregular. The border of an ulcer caused by arterial insufficiency is circular.

Regarding tolerance and addiction, the nurse understands that a) although patients may need increasing levels of opioids, they are not addicted. Physical tolerance usually occurs in the absence of addiction. b) tolerance to opioids is uncommon. Tolerance to opioids is common. c) addiction to opioids commonly develops. Addiction to opioids is rare. d) the nurse must be primarily concerned about development of addiction by the patient in pain. Addiction is rare and should never be the primary concern for a patient in pain.

Description : Regarding tolerance and addiction, the nurse understands that a) although patients may need increasing levels of opioids, they are not addicted. Physical tolerance usually occurs in the absence of addiction. b ... pain. Addiction is rare and should never be the primary concern for a patient in pain.

Last Answer : a) although patients may need increasing levels of opioids, they are not addicted. Physical tolerance usually occurs in the absence of addiction.

77. Nurse Kristine is to inject Demerol 75 mg to a post-TURP (transurethral resection of the prostate) client who is in pain. When she checked the narcotic cabinet, she found out a vial that is almost empty. She was able to aspirate 60 mg only. Nurse Kristine decided to inject it instead of making the client wait until the next Demerol vial is available. The action of the nurse violates which of the following ethical principles?

Description : 77. Nurse Kristine is to inject Demerol 75 mg to a post-TURP (transurethral resection of the prostate) client who is in pain. When she checked the narcotic cabinet, she found out a ... next Demerol vial is available. The action of the nurse violates which of the following ethical principles?

Last Answer : A. Justice

54. Albert is prescribed NSAID every four hours to relieve, fever, inflammation, and pericardial pain. To maximize the effect of the drug, the nurse would administer it

Description : 54. Albert is prescribed NSAID every four hours to relieve, fever, inflammation, and pericardial pain. To maximize the effect of the drug, the nurse would administer it

Last Answer : C. Round the clock on a consistent basis

52. The nurse is aware that pericarditis pain varies from mild to severe and is typically aggravated by

Description : 52. The nurse is aware that pericarditis pain varies from mild to severe and is typically aggravated by

Last Answer : B. Inspiration, coughing, movement of the upper body

41. For a client complaining of mild musculoskeletal pain, the nurse will anticipate that the treatment for this client’s level of discomfort will include which of the following?

Description : 41. For a client complaining of mild musculoskeletal pain, the nurse will anticipate that the treatment for this client’s level of discomfort will include which of the following?

Last Answer : B. Acetaminophen

The client complained of abdominal pain, nausea and vomiting with abdominal distention. The nurse anticipates which of the following priority management after referring to the surgeon? A. Gastric decompression B. Possible surgery C. Endoscopy D. Rectal tube insertion

Description : The client complained of abdominal pain, nausea and vomiting with abdominal distention. The nurse anticipates which of the following priority management after referring to the surgeon? A. Gastric decompression B. Possible surgery C. Endoscopy D. Rectal tube insertion

Last Answer : A. Gastric decompression

After admitting the patient to the PACU, the first action of the nurse would be to A. Assess patency of the airway B. Check the rate of the IV infusion C. Monitor the vital signs D. Assess the clients pain

Description : After admitting the patient to the PACU, the first action of the nurse would be to A. Assess patency of the airway B. Check the rate of the IV infusion C. Monitor the vital signs D. Assess the clients pain

Last Answer : A. Assess patency of the airway

A patient who has had a previous stroke and is taking warfarin tells the nurse that he started taking garlic to help reduce his blood pressure. The nurse knows that garlic when taken together with warfarin a) can greatly increase the international normalization ratio (INR) and therefore increase the risk of bleeding. Garlic and warfarin taken together can greatly increase the INR, increasing the risk of bleeding.

Description : A patient who has had a previous stroke and is taking warfarin tells the nurse that he started taking garlic to help reduce his blood pressure. The nurse knows that garlic when taken ... headaches. Garlic and warfarin taken together can greatly increase the INR, increasing the risk of bleeding.

Last Answer : a) can greatly increase the international normalization ratio (INR) and therefore increase the risk of bleeding. Garlic and warfarin taken together can greatly increase the INR, increasing the risk of bleeding.

Which of the following is a modifiable risk factor for transient ischemic attacks and ischemic strokes? a) History of smoking. Modifiable risk factors for TIAs and ischemic stroke include hypertension, Type 1 diabetes, cardiac disease, history of smoking, and chronic alcoholism.

Description : Which of the following is a modifiable risk factor for transient ischemic attacks and ischemic strokes? a) History of smoking. Modifiable risk factors for TIAs and ischemic stroke include hypertension, Type ... ) Advanced age Advanced age, gender, and race are non-modifiable risk factors for stroke.

Last Answer : a) History of smoking. Modifiable risk factors for TIAs and ischemic stroke include hypertension, Type 1 diabetes, cardiac disease, history of smoking, and chronic alcoholism.

When the nurse observes diffuse swelling involving the deeper skin layers in the patient who has experienced an allergic reaction, the nurse records the finding as a) angioneurotic edema. The area of skin demonstrating angioneurotic edema may appear normal but often has a reddish hue and does not pit.

Description : When the nurse observes diffuse swelling involving the deeper skin layers in the patient who has experienced an allergic reaction, the nurse records the finding as a) angioneurotic edema. ... the result of increased interstitial fluid and associated with disorders such as congestive heart failure.

Last Answer : a) angioneurotic edema. The area of skin demonstrating angioneurotic edema may appear normal but often has a reddish hue and does not pit.

Which of the following guidelines is appropriate to helping family members cope with sudden death? a) Show acceptance of the body by touching it, giving the family permission to touch. The nurse should encourage the family to view and touch the body if they wish, since this action helps the family to integrate the loss.

Description : Which of the following guidelines is appropriate to helping family members cope with sudden death? a) Show acceptance of the body by touching it, giving the family permission to touch. The nurse ... avoid volunteering unnecessary information (e.g., patient was drinking at the time of the accident).

Last Answer : a) Show acceptance of the body by touching it, giving the family permission to touch. The nurse should encourage the family to view and touch the body if they wish, since this action helps the family to integrate the loss.

Before the patient diagnosed with a concussion is released from the Emergency Department, the nurse teaches the family or friends who will be tending to the patient to contact the physician or return to the ED if the patient a) vomits. Vomiting is a sign of increasing intracranial pressure and should be reported immediately.

Description : Before the patient diagnosed with a concussion is released from the Emergency Department, the nurse teaches the family or friends who will be tending to the patient to contact the physician or ... for short periods of time. Difficulty in waking the patient should be reported or treated immediately.

Last Answer : a) vomits. Vomiting is a sign of increasing intracranial pressure and should be reported immediately.