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Questions 158

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Question 1 of 5

The nurse is caring for a client following a laryngectomy. The nurse can best help the client with communication by:

Correct Answer: A

Rationale: A pad and pencil allow immediate, effective communication for a client post-laryngectomy, who cannot speak due to removal of the voice box.

Question 2 of 5

The physician of a client diagnosed with alcoholism orders neomycin 0.5 g q6h to prevent hepatic coma. Neomycin decreases serum ammonia levels by:

Correct Answer: A

Rationale: Neomycin interferes with protein synthesis in the bacterial cell, causing bacterial death. Neomycin reduces the growth of the ammonia-producing bacteria in the intestines and is used for the treatment of hepatic coma.

Question 3 of 5

A 74-year-old obese man who has undergone open reduction and internal fixation of the right hip is 8 days postoperative. He has a history of arthritis and atrial fibrillation. He admits to right lower leg pain, described as 'a cramp in my leg.' An appropriate nursing action is to:

Correct Answer: B

Rationale: Calf pain with dorsiflexion of the foot (Homans' sign) can be a sign of a deep venous thrombosis; however, it is not diagnostic of the condition. Swelling and warmth along the affected vein are commonly observed clinical manifestations of a deep venous thrombosis as a result of inflammation of the vessel wall. Rubbing or massaging of the affected leg is contraindicated because of the risk of the clot breaking loose and becoming an embolus. A pillow behind the knee can be constricting and further impair blood flow.

Question 4 of 5

In assisting preconceptual clients, the nurse should teach that the corpus luteum secretes progesterone, which thickens the endometrial lining in which of the phases of the menstrual cycle?

Correct Answer: C

Rationale: Progesterone from the corpus luteum causes endometrial swelling in the secretory phase, preparing for potential implantation.

Question 5 of 5

The nurse notes that a post-operative client's respirations have dropped from 14 to 6 breaths per minute. The nurse administers Narcan (naloxone) per standing order. Following administration of the medication, the nurse should assess the client for:

Correct Answer: D

Rationale: Narcan reverses opioid-induced respiratory depression but can precipitate withdrawal, causing sudden pain in opioid-dependent clients. Pupillary changes, vomiting, and wheezing are less immediate concerns.

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