A client is hospitalized with oat cell carcinoma of the lung. To manage severe pain, the physician prescribes a continuous I.V. infusion of morphine. Which formula should the nurse use to check that the morphine dose is appropriate for the client?

Correct Answer: C

Rationale: The correct formula to calculate the appropriate morphine dose for the client is 5 mg/kg of body weight. This is the most suitable formula because morphine dosing is typically based on weight to ensure appropriate pain management and to prevent adverse effects. By using this formula, the nurse can calculate the exact dose based on the client's weight, providing personalized care. Choice A (1 mg/kg of body weight) is too low of a dose and may not effectively manage severe pain. Choice B (5 mg/70kg of body weight) is not ideal as it does not account for variations in weight among individuals. Choice D (10mg/70kg of body weight) would result in an overdose for most patients, potentially causing serious harm. Therefore, by using the formula of 5 mg/kg of body weight, the nurse can ensure that the morphine dose is appropriate and safe for the client.

Correct Answer: A

Rationale: The correct answer is A. Prednisone is a corticosteroid that can cause adverse reactions such as increased weight due to fluid retention, hypertension due to sodium retention, and insomnia due to its stimulating effects. Vaginal bleeding, jaundice, inflammation, stupor, breast lumps, pain, dyspnea, numbness, and headache are not commonly associated with prednisone use. Monitoring for weight changes, blood pressure, and sleep patterns is essential when administering prednisone to a client with rheumatoid arthritis for early detection and management of adverse reactions.

Correct Answer: C

Rationale: The correct answer is C (50% to 55% carbohydrate, 35% fat, and 10% to 15% protein) for managing diabetes. Carbohydrates impact blood sugar levels the most, so a moderate intake is crucial. The fat percentage is lower to reduce the risk of cardiovascular issues, common in diabetics. Protein intake is moderate for muscle maintenance. Choice A has higher fat and lower carbohydrate, not ideal for diabetes. Choice B has too high carbohydrate, which can spike blood sugar. Choice D has the highest carbohydrate percentage, which is not recommended for diabetes management.

Correct Answer: B

Rationale: The correct answer is B because it encourages the patient to reflect on their own thoughts and identify potential causes of their fatigue. It allows the patient to express their own insights and helps the nurse understand the underlying reasons for the fatigue. Choice A focuses on stress, which may not be the main cause of fatigue. Choice C is irrelevant to exploring the fatigue further. Choice D assumes that lack of sleep is the main issue, which may not be the case for the patient.

Correct Answer: D

Rationale: The correct answer is D: Pathological fractures. In multiple myeloma, abnormal plasma cells can weaken the bones, leading to fractures even with minimal trauma. The nurse should monitor for signs of bone pain, decreased mobility, and pathological fractures to prevent complications. Uncontrolled bleeding (A) is not typically associated with multiple myeloma. Liver engorgement (B) is more commonly seen in conditions like congestive heart failure or liver disease. Respiratory distress (C) is not a common manifestation of multiple myeloma. Therefore, the nurse should focus on monitoring for pathological fractures as a priority in a patient with multiple myeloma.

Correct Answer: C

Rationale: The correct answer is C: 12 to 18 g/100mL. Normal hemoglobin values typically range from 12 to 18 g/100mL in adults. This range reflects the normal concentration of hemoglobin in the blood and is commonly used as a reference range in clinical practice. Choices A, B, and D are incorrect because they do not fall within the typical normal range for hemoglobin levels. Choice A (38% to 48%) is a percentage range, not a direct measurement of hemoglobin concentration. Choice B (48 to 54 mg%) and Choice D (27 to 36 g/dL) are outside the normal range for hemoglobin levels in adults. Therefore, the most appropriate and accurate choice among the options provided is C (12 to 18 g/100mL) based on standard reference values for hemoglobin concentration in the blood.

Correct Answer: A

Rationale: Step 1: Level of consciousness is the most reliable index of cerebral state because it directly reflects the functioning of the brain. Changes in consciousness can indicate alterations in cerebral perfusion and potential increases in intracranial pressure. Step 2: Unilateral papillary dilatation may suggest an increase in intracranial pressure, but it is not as reliable as level of consciousness in assessing overall cerebral state. Step 3: Increased systolic blood pressure can occur due to various reasons and may not specifically indicate changes in intracranial pressure. Step 4: Decreased pulse pressure may be related to factors such as hypovolemia or cardiac conditions, but it is not a direct indicator of cerebral state or intracranial pressure.

Correct Answer: C

Rationale: The correct answer is C. Aling Maria is admitted for myxedema, which is severe hypothyroidism. Symptoms of hypothyroidism include lethargy, weight gain, slow speech, and decreased respiratory rate. Bradycardia, weight loss, heart failure, and diarrhea are not typical symptoms of myxedema. Tachycardia, constipation, and exopthalmus are more commonly associated with hyperthyroidism. Hypothermia, weight loss, and increased respiratory rate are not consistent with myxedema. Thus, choice C is the most appropriate initial assessment for Aling Maria.

Correct Answer: D

Rationale: The correct answer is D: Reduce airway inflammation. Corticosteroids like methylprednisolone are used in emphysema to reduce inflammation in the airways, which can help improve lung function and symptoms. Corticosteroids work by suppressing the immune response that leads to inflammation in the airways. This can help decrease swelling, mucus production, and constriction of the airways, all of which contribute to the symptoms of emphysema. Dry secretions (choice A) and improving oxygen-carrying capacity (choice B) are not the primary purposes of corticosteroid treatment in emphysema. Treating infection that causes a low level of hemoglobin (choice C) is not relevant to corticosteroid treatment for emphysema.