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Questions 158

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Question 1 of 5

A patient with a PCA pump (patient controlled analgesia) asks the nurse if he can become overdosed with pain medication using this machine. Which statement made by the nurse is correct?

Correct Answer: B

Rationale: PCA pumps have a lockout interval and dose limits programmed to prevent overdose, ensuring safe administration of pain medication. The other statements are inaccurate: PCA requires patient action, does not deliver large doses every four hours, and is not based on ‘need’ detection.

Question 2 of 5

The school nurse is assessing an elementary student with hemophilia who fell during recess. Which symptoms indicate hemarthrosis?

Correct Answer: D

Rationale: Hemarthrosis in hemophilia involves bleeding into joints, causing stiffness, aching, and decreased movement due to joint swelling and pain.

Question 3 of 5

A pregnant client during labor is irritable and feels the urge to vomit. The nurse should recognize this as the:

Correct Answer: C

Rationale: The transition stage is characterized by irritability, nausea, and strong contractions as the cervix completes dilation.

Question 4 of 5

The nurse is caring for a client with a history of a stroke who has hemiparesis. The nurse should:

Correct Answer: D

Rationale: A sling supports the affected arm in hemiparesis, preventing subluxation. Positioning varies, passive motion is secondary, and diet depends on needs.

Question 5 of 5

Which of the following procedures is necessary to establish a definitive diagnosis of breast cancer?

Correct Answer: D

Rationale: Diaphanography, also known as transillumination, is a painless, noninvasive imaging technique that involves shining a light source through the breast tissue to visualize the interior. It must be used in conjunction with a mammogram and physical examination. Mammography is a useful tool for screening but is not considered a means of diagnosing breast cancers. Thermography is a pictorial representation of heat patterns on the surface of the breast. Breast cancers appear as a 'hot spot' owing to their higher metabolic rate. Biopsy either by needle aspiration or by surgical incision is the primary diagnostic technique for confirming the presence of cancer cells.

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