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NEW QUESTION 31
A 2-year-old child will undergo a cardiac catheterization tomorrow to evaluate his ventricular septal defect.
Based on his developmental stage, the nurse:
- A. Explains the procedure using simple words and sentences just before the preoperative sedation
- B. Asks the parents to leave the room while the preoperative medication and instructions are given
- C. Uses pictures to explain the procedure to the child and his parents that evening
- D. Asks the parents to explain the procedure to the child after she explains it to them
Answer: A
Explanation:
Explanation
(A) A toddler is not capable of conceptualizing about the inside of his body and is concerned about body intactness; therefore, diagrams would not be useful. Also, the previous evening is too far from the procedure for the toddler to remember the instructions. (B) A simple explanation the morning of the procedure is the best developmental strategy to use, because it focuses on the toddler’s need for parental support, body intactness, and short attention span. (C) A relationship between the nurse and the child needs to develop. Also, misinformation may be given to the child if the parents explain the procedure to the child. (D) The parents are the child’s support system and need to be there to strengthen the child.
NEW QUESTION 32
A male client has experienced low back pain for several years. He is the primary support of his wife and six children. Although he would qualify for disability, he plans to continue his employment as long as possible. His back pain has increased recently, and he is unable to control it with non-steroidal anti-inflammatory agents. He refuses surgery and cannot take narcotics and remain alert enough to concentrate at work. His physician has suggested application of a transcutaneous electrical nerve stimulation (TENS) unit. Which of the following is an appropriate rationale for using a TENS unit for relief of pain?
- A. TENS units produce endogenous opioids that affect the central nervous system with analgesic potency comparable to morphine.
- B. TENS units prevent muscle spasms, decrease the potential for further injury, and minimize pressure on joints.
- C. TENS units work on the gate-control theory of pain; biostimulation therapy of large fibers block painful stimuli.
- D. TENS units have an ultrasonic effect that relaxes muscles, decreases joint stiffness, and increases range of motion.
Answer: C
Explanation:
(A) TENS units do not have this effect, but whirlpool therapy does. (B) TENS units do not produce endogenous opioids, only the body can do that. (C) TENS units do work based on the gatecontrol theory of pain control. (D) TENS units do not have this effect, but possibly changing the client’s position would.
NEW QUESTION 33
A child sustains a supracondylar fracture of the femur. When assessing for vascular injury, the nurse should be alert for the signs of ischemia, which include:
- A. Bleeding, bruising, and hemorrhage
- B. Increase in serum levels of creatinine, alkaline phosphatase, and aspartate transaminase
- C. Generalized swelling, pain, and diminished functional use with muscle rigidity and crepitus
- D. Pain, pallor, pulselessness, paresthesia, and paralysis
Answer: D
Explanation:
(A) Bleeding, bruising, and hemorrhage may occur due to injury but are not classic signs of ischemia. (B) An increase in serum levels of creatinine, alkaline phosphatase, and aspartate transaminase is related to the disruption of muscle integrity. (C) Classic signs of ischemia related to vascular injury secondary to long bone fractures include the five “P’s”: pain, pallor, pulselessness, paresthesia, and paralysis. (D) Generalized swelling, pain, and diminished functional use with muscle rigidity and crepitus are common clinical manifestations of a fracture but not ischemia.
NEW QUESTION 34
The physician orders medication for a client’s unpleasant side effects from the haloperidol. The most appropriate drug at this time is:
- A. Triazolam (Halcion)
- B. Benztropine
- C. Thiothixene
- D. Lorazepam
Answer: B
Explanation:
Explanation/Reference:
Explanation:
(A) Lorazepam is a benzodiazepine, or antianxiety agent, that potentiates the effects of _-aminobutyric acid in the CNS, which is not the CNS neurotransmitter EPS. (B) Triazolam is a benzodiazepine sedative- hypnotic whose action is mediated in the limbic, thalamic, and hypothalamic levels of the CNS by ў- aminobutyric acid. (C) Benztropine is an anticholinergic agent, and the drug of choice for blocking CNS synaptic response, which causes EPS. (D) Thiothixene is an antipsychotic and neuroleptic drug that blocks dopamine neurotransmission at the CNS synapses, thereby causing EPS.
NEW QUESTION 35
When administering phenytoin (Dilantin) to a child, the nurse should be aware that a toxic effect of phenytoin therapy is:
- A. Folate deficiency
- B. Stephens-Johnson syndrome
- C. Granulocytosis and nephrosis
- D. Leukopenic aplastic anemia
Answer: B
Explanation:
Explanation/Reference:
Explanation:
(A) Stephens-Johnson syndrome is a toxic effect of phenytoin. (B) Folate deficiency is a side effect of phenytoin, but not a toxic effect. (C) Leukopenic aplastic anemia is a toxic effect of carbamazepine (Tegretol). (D) Granulocytosis and nephrosis are toxic effects of trimethadione (Tridione).
NEW QUESTION 36
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