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Questions 158

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Question 1 of 5

The nurse would need to monitor the serum glucose levels of a client receiving which of the following medications, owing to its effects on glycogenolysis and insulin release?

Correct Answer: D

Rationale: Norepinephrine's side effects are primarily related to safe, effective care environment and include decreased peripheral perfusion and bradycardia. Dobutamine's side effects include increased heart rate and blood pressure, ventricular ectopy, nausea, and headache. Propranolol's side effects include elevated blood urea nitrogen, serum transaminase, alkaline phosphatase, and lactic dehydrogenase. Epinephrine increases serum glucose levels by increasing glycogenolysis and inhibiting insulin release. Prolonged use can elevate serum lactate levels, leading to metabolic acidosis, increased urinary catecholamines, false elevation of blood urea nitrogen, and decreased coagulation time.

Question 2 of 5

During burn therapy, morphine is primarily administered IV for pain management because this route:

Correct Answer: B

Rationale: IM injections are unreliable in burn patients due to fluid shifts into interstitial spaces, leading to poor absorption. IV administration ensures dependable absorption and effective pain relief.

Question 3 of 5

Discharge teaching for the client who has a total gastrectomy should include which of the following?

Correct Answer: C

Rationale: There will be no need to increase fluid intake excessively, because dumping syndrome could present a problem. Follow-up visits every 3 weeks are not a standard recommendation. Follow-up visits will be highly individualized. With removal of the stomach, intrinsic factor will no longer be produced. Intrinsic factor is necessary for vitamin B12 absorption. Parenteral injections of B12 will be needed on a monthly basis for the rest of the person's life. Smaller, more frequent meals, rather than large, bulky meals, are recommended to prevent problems with dumping syndrome.

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

When planning care for a 9-year-old client, the nurse uses which of the most effective means of helping siblings cope with their feelings about a brother who is terminally ill?

Correct Answer: B

Rationale: When dealing with grief, siblings are usually most comfortable initially with open discussion. Assuming different roles allows children to act out their feelings without fear of reprisals and to gain insight and control. This method may be helpful, but having the child take an active part through role playing is more effective. This technique may be helpful, but being an active participant through role playing is more effective.

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