Match the descriptions to the stages of sleep. Some descriptions may have more than one stage and some stages may be used more than once.

Correct Answer: D

Rationale: In this pharmacology question related to sleep stages, the correct answer is D) Most vivid dreaming occurs, which matches the description of REM (Rapid Eye Movement) sleep. REM sleep is characterized by rapid eye movements, muscle atonia, and vivid dreams. This stage is crucial for memory consolidation and cognitive function. Option A) Brain waves resemble wakefulness is associated with stage 1 of non-REM sleep, characterized by light sleep and easily disrupted by external stimuli. Option B) Deepest sleep, lasting 20 to 40 minutes corresponds to stage 3 of non-REM sleep, also known as slow-wave sleep, which is essential for physical restoration and growth. Option C) Associated with specific EEG waveforms refers to the various stages of non-REM sleep characterized by distinct electrical activity patterns in the brain. Understanding sleep stages is essential in pharmacology as many medications can impact sleep architecture, affecting the quality and quantity of each stage. Educating healthcare professionals about these stages helps in managing sleep disorders and optimizing treatment outcomes for patients.

Correct Answer: D

Rationale: In the immediate postoperative period following an uvulopalatopharyngoplasty (UPPP), the nurse must prioritize monitoring for potential complications to ensure patient safety. The correct answer is D) Airway obstruction and hemorrhage. This is because after UPPP surgery, there is a risk of swelling and bleeding in the surgical site, which can lead to airway compromise and hemorrhage, posing a significant threat to the patient's life. Option A) Snoring and foul-smelling breath are not immediate postoperative complications of UPPP. Snoring may be improved by the surgery, and foul-smelling breath is not typically associated with this procedure. Option B) Infection and electrolyte imbalance are potential complications postoperatively, but they are not specific to the immediate period following UPPP. These complications usually develop over time and may require longer-term monitoring and management. Option C) Loss of voice and severe sore throat are also not immediate postoperative complications of UPPP. While some throat discomfort is expected after this surgery, severe sore throat and loss of voice would not be typical in the immediate period. Educationally, understanding the potential complications of surgical procedures like UPPP is crucial for nurses to provide safe and effective care. By knowing which complications to monitor for, nurses can intervene promptly if issues arise, ensuring better outcomes for their patients. Vigilant monitoring and knowledge of postoperative complications are essential aspects of nursing care in the surgical setting.

Correct Answer: B

Rationale: The correct answer is B) The area should be treated as a painful lesion, using gentle cleansing and dressing. In the context of an unconscious patient with a stage 2 pressure ulcer, it is crucial for the nurse to understand that even though the patient may not be able to verbalize pain, the presence of a pressure ulcer indicates tissue damage that can still elicit a pain response. Therefore, the nurse should treat the area as a painful lesion by using gentle cleansing and appropriate dressing to promote healing while minimizing discomfort for the patient. Option A is incorrect because the absence of a behavioral response does not necessarily mean the patient is not experiencing pain. Pain perception is subjective and can vary among individuals, especially in patients who are unconscious or unable to communicate. Option C is incorrect because assuming that the patient cannot perceive pain due to being unconscious is a dangerous assumption. Pain perception can still occur even in unconscious patients, and aggressive scrubbing can further damage the fragile tissue of a pressure ulcer. Option D is incorrect because not all nociceptive stimuli necessarily lead to the perception of pain. Pain is a complex phenomenon influenced by various factors beyond just the transmission of signals to the brain. This scenario highlights the importance of a comprehensive understanding of pain perception and management in patients, especially those who are unable to communicate their discomfort. Nurses must approach care with empathy, knowledge, and a patient-centered mindset to ensure optimal outcomes and comfort for all patients.

Correct Answer: C

Rationale: In this scenario, the health care provider would recommend adding transdermal fentanyl (Duragesic) to the patient's medication plan due to its potent opioid analgesic properties, making it suitable for severe cancer pain management. Fentanyl is a strong opioid that can provide effective pain relief when other medications are no longer sufficient, as in this case where the patient's pain is increasing. Option A is incorrect because adding PO oxycodone to the current regimen may not provide the necessary increase in pain relief compared to transdermal fentanyl. Option B is incorrect as propoxyphene is not recommended for use due to safety concerns and its withdrawal from the market. Option D is also incorrect as hydrocodone with acetaminophen may not be as potent as transdermal fentanyl for severe cancer pain. Educationally, it is important to understand the principles of opioid selection in pain management, especially in cancer patients. Transdermal fentanyl is often reserved for moderate to severe pain that requires around-the-clock treatment, making it a suitable choice in this situation. It is crucial for healthcare providers to have a strong knowledge of opioid pharmacology to ensure effective pain management in patients with complex needs.

Correct Answer: A

Rationale: In this scenario, the correct answer is Option A: Assess their understanding of what hospice care services are. The first step for the nurse is to gather information about the family's knowledge and beliefs regarding hospice care. This is crucial as it allows the nurse to address any misconceptions, provide accurate information, and facilitate an open discussion about end-of-life care options. Option B is incorrect because asking how they will care for the patient without hospice care assumes that the family is capable or willing to provide appropriate care, which may not always be the case in a complex situation like terminal pancreatic cancer. Option C is incorrect because while it is important to involve the patient and family in decision-making, attempting to change their minds without first understanding their perspectives can lead to conflict and resistance. Option D is incorrect and culturally inappropriate as it assumes all Hispanic families have the same preferences for caring for their loved ones. It is essential to avoid stereotyping and instead focus on individual beliefs and needs. Educationally, this question highlights the importance of cultural competence, effective communication, and patient/family-centered care in end-of-life situations. Nurses must engage in open dialogue, respect diverse beliefs, and provide accurate information to support families in making informed decisions that align with their values and preferences.