A client asks the nurse why a narcotic analgesic makes the client feel nauseated. What would be the basis of the nurse's response?

Correct Answer: B

Rationale: The basis of the nurse's response is the effect on the brain, as narcotic analgesics (opioids) like morphine stimulate the chemoreceptor trigger zone in the medulla, triggering nauseaa central nervous system side effect, not just digestive. This explains its prevalence across opioid types. Choice A, stomach irritation, contributes (e.g., oral opioids), but nausea often persists with IV delivery, pointing to brain involvement over local upset. Choice C, allergic reaction, is unlikelynausea is a common side effect, not a rare hypersensitivity sign like rash. Choice D, rapid absorption, affects onset, not nausea directly; slow-release forms still cause it. Choice B is correct, enabling nurses to explain this CNS effect, reassuring clients it's typical, and offering antiemetics (e.g., ondansetron) to manage it, ensuring narcotic use continues for pain relief without undue distress.

Correct Answer: B

Rationale: The basis of the nurse's response is reduced pain tolerance, as stress elevates cortisol and adrenaline, lowering the threshold for pain perceptionamplifying its intensity without changing its source. This psychological overlay is key. Choice A, increased muscle tension, contributes (e.g., clenched shoulders), but tolerance reduction is broader, affecting all pain types. Choice C, poor circulation, may worsen ischemic pain, but stress's effect is neural, not vascular-specific. Choice D, increased inflammation, needs chronic stress evidenceacute stress heightens perception, not swelling. Choice B is correct, enabling nurses to explain this link, suggesting relaxation (e.g., breathing) or timed meds to boost tolerance, helping clients manage pain's stress-driven spikes effectively.

Correct Answer: D

Rationale: Chloramphenicol is an antibiotic reserved for serious infections due to its potential for severe toxicity, with bone marrow suppression (Choice D) being the most dangerous adverse reaction. This condition can manifest as aplastic anemia, a potentially fatal reduction in blood cell production, affecting red cells, white cells, and platelets. The risk arises because chloramphenicol inhibits protein synthesis in bone marrow mitochondria, leading to suppressed hematopoiesis. Lethal arrhythmias (Choice A) are not a primary concern with this drug, as it doesn't directly affect cardiac ion channels. Malignant hypertension (Choice B) is unrelated, as chloramphenicol doesn't influence vascular tone or blood pressure significantly. Status epilepticus (Choice C), a prolonged seizure state, is also not associated, as the drug's neurotoxicity is more likely to cause peripheral neuropathy than seizures. Bone marrow suppression can lead to life-threatening infections, bleeding, or anemia, requiring close monitoring (e.g., regular complete blood counts). Its severity and irreversibility in some cases make it the most toxic reaction, confirming Choice D as the correct answer.

Correct Answer: C

Rationale: Granulation tissue in an open wound indicates healing, with new, red, vascular tissue forming. Moist, sterile saline gauze (Choice C) is most appropriate because it maintains a moist environment, promoting cell migration and preventing desiccation of granulation tissue, which could halt healing. Dry sterile dressing (Choice A) adheres to the wound, damaging granulation tissue upon removal and delaying healing. Sterile petroleum gauze (Choice B) supports healing but is costlier and less practical for interim use, often reserved for specific wounds like burns. Povidone-iodine-soaked gauze (Choice D) is cytotoxic to healing cells, irritating granulation tissue and slowing repair, making it unsuitable. Research supports moist wound healing (e.g., Winter's 1962 study), showing faster epithelialization with moisture. Until the specialist arrives, moist saline gauze balances efficacy, availability, and safety, protecting the delicate healing process. Thus, Choice C is the correct dressing choice.

Correct Answer: B

Rationale: A blood pressure cuff too small for a client's arm compresses the brachial artery excessively, requiring higher inflation pressure to occlude it, resulting in a false-high measurement (Choice B). The cuff's bladder should encircle 80% of the arm; if undersized (e.g., adult cuff on an obese arm), it overestimates systolic and diastolic readingse.g., 150/90 mmHg might read 160/100 mmHg. Failing to show changes (Choice A) isn't the issue; the reading is inaccurate, not unresponsive. Sciatic nerve damage (Choice C) is unrelated, as the sciatic nerve is in the leg, not arm. A false-low measurement (Choice D) occurs with an oversized cuff, the opposite problem. Studies (e.g., AHA guidelines) confirm small cuffs inflate unevenly, skewing results high. Proper sizing prevents misdiagnosis like hypertension, making Choice B the correct effect.