A client with pancreatitis complains of severe epigastric pain, so the nurse administers a prescribed narcotic analgesic. Ten minutes later, the client insists on sitting up and leaning forward. Which intervention should the nurse implement?

Encourage rest until the analgesic becomes effective.

Raise head of bed until at a 90 degree angle.

Place bed in a reverse Trendelenburg position.

Position bedside table so the client can lean across it.

Answer and Explanation

The Correct Answer is D

Choice A: Encourage rest until the analgesic becomes effective. This is not the best intervention, as it does not address the client's preference or comfort level. The analgesic may take some time to relieve the pain, and forcing the client to lie down may increase the pressure on the pancreas and worsen the pain.

Choice B: Raise head of bed until at a 90 degree angle. This is not the best intervention, as it does not address the client's preference or comfort level. Raising the head of bed may help reduce abdominal distension and improve breathing, but it may not relieve the pain as much as leaning forward.

Choice C: Place bed in a reverse Trendelenburg position. This is not the best intervention, as it does not address the client's preference or comfort level. Placing the bed in a reverse Trendelenburg position may help shift the abdominal organs away from the pancreas and reduce inflammation, but it may not relieve the pain as much as leaning forward.

Choice D: Position bedside table so the client can lean across it. This is the best intervention, as it addresses the client's preference and comfort level. Leaning forward may help decrease the tension on the pancreas and relieve the pain. The bedside table can provide support and stability for the client while sitting up.

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Correct Answer is A

Explanation

The correct answer is A. Flushed, peeling skin

Choice A reason: Flushed, peeling skin is a classic sign of scarlet fever, which is a condition that can arise from Streptococcal pharyngitis. Scarlet fever is characterized by a red rash that can cover most of the body and may lead to the skin peeling. This symptom is a direct reaction to the toxins produced by the Streptococcal bacteria.

Choice B reason: Red bumps across the chest could be indicative of many conditions and are not specifically characteristic of the reaction to toxins produced by Streptococcal bacteria. While a rash is common in scarlet fever, it typically starts on the face or neck and spreads to the rest of the body, rather than presenting as isolated red bumps.

Choice C reason: A white coating on the tongue, often referred to as “strawberry tongue,” is indeed associated with scarlet fever. However, it is not the clearest indication of a reaction to the toxins. The white coating usually precedes the strawberry-like appearance, where the tongue becomes red and bumpy.

Choice D reason: While a high fever is a symptom of scarlet fever, it is not specific to the reaction to toxins from Streptococcal bacteria, as many infections can cause high fevers. The term “protracted” suggests a prolonged fever, which could be seen in various conditions.

A. Assess pupillary response to light hourly. B. Initiate seizure precautions. C. Measure urinary output every hour. D. Monitor serum potassium frequently.

Correct Answer is C

Explanation

Choice A: Assessing pupillary response to light hourly is not related to dopamine administration. Dopamine does not affect the pupils or the cranial nerves that control them.

Choice B: Initiating seizure precautions is not necessary for a client receiving dopamine. Dopamine does not lower the seizure threshold or cause convulsions.

Choice C: Measuring urinary output every hour is an important intervention for a client receiving dopamine. Dopamine increases blood pressure and cardiac output, which improves renal perfusion and urine production. Urinary output is an indicator of the effectiveness of dopamine therapy and renal function.

Choice D: Monitoring serum potassium frequently is not directly related to dopamine administration. Dopamine does not affect potassium levels or cause hyperkalemia or hypokalemia. However, potassium levels may be affected by other factors such as fluid balance, renal function, and medications.

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A client with pancreatitis complains of severe epigastric pain, so the nurse administers a prescribed narcotic analgesic. Ten minutes later, the client insists on sitting up and leaning forward. Which intervention should the nurse implement?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A preschool-aged child who is being tested for Streptococcal pharyngitis returns to the clinic for signs of scarlet fever. Which assessment finding provides the clearest indication to the nurse that the child is experiencing a reaction to toxins that are created by Streptococcal bacteria.

Correct Answer is A

Explanation

A client who is hypotensive is receiving dopamine, an adrenergic agonist, IV at the rate of 8 mcg/kg/min. Which intervention should the nurse implement while administering this medication?

Correct Answer is C

Explanation

A patient who is hypotensive is receiving dopamine, an adrenergic agonist IV at the rate of 6 mcg/kg/min. Which intervention should the nurse implement when administering this medication?

When assessing a multigravida on the first postpartum day, the nurse finds a moderate amount of lochia rubra, with the uterus firm and three fingerbreadths above the umbilicus. What action should the nurse implement first?

The nurse is caring for a group of clients with the help of a practical nurse (PN). Which nursing action(s) should the nurse assign to the PN? (Select all that apply)

A client who is hypotensive is receiving dopamine, an adrenergic agonist, IV at the rate of 8 mcg/kg/min. Which intervention should the nurse implement while administering this medication?

The nurse is assigning care of a client with prostatitis to a practical nurse (PN). Which instruction should the nurse provide the PN regarding this client?

The nurse on a pediatric unit observes a distraught mother in the hallway scolding her 3-year-old son for wetting his pants. What initial action should the nurse take?