GCC 676 - 700

The doctor has ordered a patient-controlled analgesia (PCA) pump for the client with chronic pain. The client asks the nurse if he can become overdosed with pain medication using this machine. The nurse demonstrates understanding of the PCA if she states:

• The machine will administer only the amount that you need to control your pain without your taking any action.
• The machine has a locking device that prevents overdosing to occur.
• The machine will administer one large dose every 4 hours to relieve your pain.
• The machine is set to deliver medication only if you need it.
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A client has an order to remove the nasogastric tube. Which is the correct nursing action to remove the tube?

• Apply sterile gloves and untape the tube from the client's face
• Pull the tube out 2 inches, pause for 2 minutes, and repeat until the entire tube is removed
• Instill 30ml of normal saline before removing the tube
• Pull the tube out steadily and smoothly while keeping it pinched
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The physician has prescribed rantidine (Zantac) for a client with erosive gastritis. The nurse should administer the medication:

• 30 minutes before meals
• With each meal
• In a single dose at bedtime
• 60 minutes after meals
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Studies show that collaboration between the members of a multidisciplinary health care team improves quality of client care, decreases length of stay in health care facilities, and decreases the cost of health care to the client. Which members of the multidisciplinary team are responsible for collaboration in client care?

• The primary care physician and the case manager.
• The primary nurse and the case manager.
• All members of the multidisciplinary health care team.
• The primary care physician, all consulting physicians, and the case manager.
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A 3-year-old is immobilized in a hip spica cast. Which discharge instruction should be given to the parents?

• Keep the bed flat, with a small pillow beneath the cast
• Provide crayons and a coloring book for play activity
• Increase her intake of high-calorie foods for healing
• Tuck a disposable diaper beneath the cast at the perineal opening
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A nurse is caring for a client who complains of fatigue, weight loss, afternoon fevers, night sweats, cough, and hemoptysis. The nurse immediately puts the client in isolation. The nurse suspects that the client is suffering from which condition?

• Bronchitis
• Pneumonia
• Pneumothorax
• Tuberculosis
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A client with glomerulonephritis is placed on a low-sodium diet. Which of the following snacks is suitable for the client with sodium restriction?

• Peanut butter cookies
• Grilled cheese sandwich
• Cottage cheese and fruit
• Fresh peach
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A client is admitted with Parkinson's disease. The client has been taking Carbidopa/levodopa (Sinemet) for 1 year. Which clinical manifestation would be most important to report?

• Dryness of the mouth
• Spasmodic eye winking
• Dark urine
• Dizziness
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Assessment of a newborn male reveals that the infant has hypospadias. The nurse knows that:

• The infant should not be circumcised.
• Surgical correction will be done by 6 months of age.
• Surgical correction is delayed until 6 years of age.
• The infant should be circumcised to facilitate voiding.
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The nurse is applying a Transderm Nitro (nitroglycerin) patch to a client with angina. When applying the patch, the nurse should:

• Shave the area before applying a new patch
• Remove the old patch and clean the skin with alcohol
• Cover the patch with plastic wrap and tape it in place
• Avoid cutting the patch because it will alter the dose
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