The nurse is caring for a client with a right-sided mastectomy with immediate reconstruction. Four hours post-op, the nurse should give priority to:

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Dewitt Fundamentals Quizlet LPN Pass Medications Questions

Question 1 of 5

The nurse is caring for a client with a right-sided mastectomy with immediate reconstruction. Four hours post-op, the nurse should give priority to:

Correct Answer: A

Rationale: Checking drains for bright red blood four hours post-mastectomy with reconstruction detects hemorrhage, a priority turning, pain meds, and BP follow bleeding control. Nurses monitor output, reporting excessive bleeding, ensuring stability in the acute post-op phase.

Question 2 of 5

The nurse is preparing a client with a history of seizures for an EEG. Which instruction should be included in the nurse's teaching?

Correct Answer: B

Rationale: Avoiding caffeine before an EEG prevents stimulation that could skew seizure activity readings overnight stays, hyperventilation (if ordered), or 4-hour duration aren't standard. Nurses teach this, ensuring accurate brain wave capture, vital for epilepsy diagnosis.

Question 3 of 5

Which of the following foods are recommended for mania patients:

Correct Answer: A

Rationale: Mania, a feature of bipolar disorder, involves hyperactivity and impulsivity, affecting eating habits. Finger foods (choice A) are portable, easy to eat, and suit restless patients who may not sit for meals, providing nutrition without utensils. Liquid foods (choice B) are less practical for high-energy states, better for sedation or dysphagia. Semi-solid foods (choice C) require more effort, while favourite foods (choice D) may encourage intake but aren't specific to mania's needs. A is correct, as finger foods match the patient's behavior, ensuring caloric intake amidst agitation. Nurses must offer such foods, monitor lithium levels if prescribed, and adapt care to mood swings, supporting nutritional stability.

Question 4 of 5

Key features of kangaroo mother care are all of the following EXCEPT:

Correct Answer: D

Rationale: Kangaroo mother care (KMC) supports preterm/low-birth-weight infants. Skin-to-skin contact (choice A) regulates temperature and bonding. Exclusive breastfeeding (choice B) ensures nutrition. Facility initiation with home continuation (choice C) promotes accessibility. Doing it only for cyanotic babies (choice D) is false; KMC benefits all stable preterm infants, not just those with cyanosis (oxygenation issues). D is correct, as it's the exception. Nurses teach KMC, monitor infant stability, and encourage its broad use, enhancing survival and development.

Question 5 of 5

The initial response of tissue after injury is

Correct Answer: B

Rationale: The initial tissue response to injury is transient vasoconstriction, lasting seconds to minutes, to reduce blood loss by narrowing vessels at the injury site. Immediate vasodilation (A) or transient vasodilation (D) occurs later in inflammation to increase blood flow and deliver immune cells, not initially. Immediate vasoconstriction (C) implies a sustained action, which doesn't fit the brief, temporary nature of this phase. Transient vasoconstriction (B) is followed by vasodilation in the inflammatory process, aligning with the body's hemostatic and healing sequence. This brief vessel narrowing minimizes hemorrhage before the inflammatory cascade begins, making B the precise and correct answer based on physiological response timing.

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