Nursing Elites

1. The nurse is caring for a client in a sickle cell crisis. Which is the pain regimen of choice to relieve the pain?

• A. Frequent aspirin (acetylsalicylic acid) and a non-narcotic analgesic
• B. Motrin (ibuprofen), an NSAID, PRN
• C. Demerol (meperidine), a narcotic analgesic, every four (4) hours
• D. Morphine, a narcotic analgesic, every two (2) to three (3) hours PRN

Correct answer: D

Rationale: In a sickle cell crisis, morphine is the preferred analgesic due to its potency and effectiveness in managing severe pain. Choice A is incorrect because aspirin is contraindicated in sickle cell disease due to its potential to cause a further decrease in blood flow. Choice B, Motrin (ibuprofen), is also not the ideal choice as NSAIDs can exacerbate renal complications in sickle cell patients. Choice C, Demerol (meperidine), is not recommended for sickle cell pain management due to its toxic metabolite accumulation which can cause seizures and other complications.

2. What instructions should the nurse discuss with the client diagnosed with Raynaud’s phenomenon?

• A. Explain that exacerbations will not occur in the summer
• B. Use nicotine gum to help quit smoking
• C. Wear extra warm clothing during cold exposure
• D. Avoid prolonged exposure to direct sunlight

Correct answer: C

Rationale: The correct answer is to wear extra warm clothing during cold exposure. This instruction is crucial for managing Raynaud’s phenomenon as it helps prevent vasospasms triggered by cold temperatures. Choice A is incorrect because exacerbations can occur in any season. Choice B is not directly related to managing Raynaud’s phenomenon. Choice D is also irrelevant as direct sunlight exposure does not typically worsen symptoms of Raynaud’s phenomenon.

3. A client diagnosed with acute pancreatitis has developed a pseudocyst that ruptures. Which procedure should the nurse anticipate the healthcare provider ordering?

• A. Paracentesis
• B. Chest tube insertion
• C. Lumbar puncture
• D. Biopsy of the pancreas

Correct answer: B

Rationale: The correct answer is B: Chest tube insertion. A chest tube may be needed if a pancreatic pseudocyst ruptures into the pleural space, causing a pleural effusion. Paracentesis (choice A) involves the removal of fluid from the abdominal cavity, not typically indicated for a pancreatic pseudocyst. Lumbar puncture (choice C) is a procedure to collect cerebrospinal fluid from the spinal canal, not relevant to a pancreatic pseudocyst. Biopsy of the pancreas (choice D) is a diagnostic procedure to obtain tissue samples for examination and is not typically done in the context of a ruptured pseudocyst.

4. Which of the following is a common side effect of the drug metformin?

• A. Weight loss
• B. Weight gain
• C. Drowsiness
• D. Hypertension

Correct answer: A

Rationale: The correct answer is A, weight loss. Metformin is commonly associated with weight loss rather than weight gain. Metformin works by decreasing glucose production in the liver and improving insulin sensitivity, which can lead to weight loss in some individuals. Choices B, C, and D are incorrect. Weight gain is not a typical side effect of metformin. Drowsiness and hypertension are also not commonly associated with metformin use.

5. The healthcare provider is conducting a respiratory assessment and is determining respirations per minute. Which factor(s) generally affect the character of respirations? Select all that apply.

• A. Anxiety
• B. Exercise
• C. Smoking
• D. A, B

Correct answer: D

Rationale: Correct! Anxiety and exercise can significantly alter the character of respirations, increasing the rate and depth. Smoking, while harmful to the respiratory system in the long term, does not directly affect the character of respirations like anxiety and exercise do. Therefore, choices C (Smoking) is incorrect. The correct answer is D (A, B).

Similar Questions