Nursing Elites

1. A client is given an opiate drug for pain relief following general anesthesia. The client becomes extremely somnolent with respiratory depression. The physician is likely to order the administration of:

• A. naloxone (Narcan).
• B. labetalol (Normodyne).
• C. neostigmine (Prostigmin).
• D. thiothixene (Navane).

Correct answer: A

Rationale: When a client becomes extremely somnolent with respiratory depression after being given an opiate drug, the physician is likely to order the administration of naloxone (Narcan). Naloxone is an opiate antagonist that attaches to opiate receptors, blocking or reversing the action of narcotic analgesics. Choices B, C, and D are incorrect. Labetalol is a beta blocker used for hypertension, neostigmine is an anticholinesterase agent used to treat myasthenia gravis and reverse neuromuscular blockade, and thiothixene is an antipsychotic agent used for psychiatric conditions.

2. The nurse is assessing the client recently returned from surgery. The nurse is aware that the best way to assess pain is to:

• A. Take the blood pressure, pulse, and temperature
• B. Ask the client to rate his pain on a scale of 0-5
• C. Watch the client's facial expression
• D. Ask the client if he is in pain

Correct answer: B

Rationale: The best way to evaluate pain levels is to ask the client to rate his pain on a scale. This method provides a more standardized and quantifiable measure of pain compared to subjective observations like facial expressions (choice C) or direct questioning (choice D). Monitoring vital signs (choice A) can be part of pain assessment but is not as specific or reliable as asking the client to self-report pain intensity.

3. The healthcare provider recognizes that which of the following would be most appropriate to wear when providing direct care to a client with a cough?

• A. Mask
• B. Gown
• C. Gloves
• D. Shoe covers

Correct answer: A

Rationale: When providing care to a client with a cough, it is crucial to wear a mask to protect oneself from inhaling respiratory droplets containing infectious agents. The primary mode of transmission for coughs is through airborne droplets, making a mask the most appropriate choice to prevent the spread of respiratory infections. Gloves and gowns are more relevant when there is a risk of contact with bodily fluids, which is not the main concern with a cough. Shoe covers are not necessary in this scenario as the transmission of respiratory infections is not linked to footwear. Therefore, wearing a mask is the best choice to prevent airborne transmission and ensure the safety of the healthcare provider.

4. How can the nurse best communicate to a client that he or she has been listening?

• A. restating the main feeling or thought the client has expressed
• B. making a judgment about the client's problem
• C. offering a leading question such as, 'And then what happened?'
• D. saying, 'I understand what you're saying.'

Correct answer: A

Rationale: The best way for the nurse to communicate to a client that he or she has been listening is by restating the main feeling or thought the client has expressed. Restating helps the client validate the nurse's understanding of the communication, demonstrating active listening skills. Making judgments about the client's problem, as suggested in Choice B, can hinder effective communication by introducing bias and potential misinterpretation. Offering a leading question like in Choice C is not ideal for confirming understanding; it rather seeks more information. Choice D, simply saying 'I understand what you're saying,' may not convey active listening as effectively as restating the client's main feelings or thoughts, as it lacks the validation component present in restating.

5. The nurse is caring for a client scheduled for a surgical repair of a sacular abdominal aortic aneurysm. Which assessment is most crucial during the preoperative period?

• A. Assessment of the client's level of anxiety
• B. Evaluation of the client's exercise tolerance
• C. Identification of peripheral pulses
• D. Assessment of bowel sounds and activity

Correct answer: C

Rationale: The most crucial assessment during the preoperative period for a client scheduled for surgical repair of a sacular abdominal aortic aneurysm is the identification of peripheral pulses. This is essential because during surgery, the aorta will be clamped, potentially affecting blood circulation to the kidneys and lower extremities. Monitoring peripheral pulses helps assess circulation to the lower extremities, ensuring adequate perfusion. While assessing the client's anxiety level (choice A) is important, it is not as critical as monitoring peripheral pulses in this case. Evaluating exercise tolerance (choice B) is not typically recommended preoperatively for this specific condition. Assessing bowel sounds and activity (choice D) is also relevant but takes a lower priority compared to identifying peripheral pulses in this scenario.

Similar Questions