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A nurse assesses a postoperative patient 2 days after chest surgery. What four findings indicate that the patient has inadequate pain control?

Bradypnea

Irritability

Tachycardia

Hypoglycemia

Poor cough effort

Drowsiness

Refusal to participate in physical therapy

Answer and Explanation

Correct Answer : B,C,E,G

Choice A: Bradypnea

Bradypnea, or slow breathing, is not typically associated with inadequate pain control. It is more often related to the effects of certain medications, such as opioids, or underlying respiratory conditions. Inadequate pain control is more likely to cause increased respiratory rate (tachypnea) rather than decreased.

Choice B: Irritability

This is a correct answer. Irritability can be a sign of inadequate pain control. Pain can cause significant discomfort and distress, leading to changes in mood and behavior. Patients who are in pain may become irritable, anxious, or agitated.

Choice C: Tachycardia

This is another correct answer. Tachycardia, or an increased heart rate, can be a physiological response to pain. When a patient is in pain, the body’s stress response is activated, leading to the release of stress hormones like adrenaline, which can increase heart rate.

Choice D: Hypoglycemia

Hypoglycemia, or low blood sugar, is not directly related to pain control. It is more commonly associated with diabetes management, fasting, or certain medications. While it is important to monitor blood sugar levels, hypoglycemia is not a typical indicator of inadequate pain control.

Choice E: Poor cough effort

This is a correct answer. Poor cough effort can indicate inadequate pain control, especially after chest surgery. Pain can make it difficult for patients to take deep breaths or cough effectively, which is essential for preventing respiratory complications such as pneumonia.

Choice F: Drowsiness

Drowsiness is not typically a sign of inadequate pain control. It is more often a side effect of pain medications, particularly opioids. While it is important to monitor for excessive sedation, drowsiness alone does not indicate that pain is not being adequately managed.

Choice G: Refusal to participate in physical therapy

This is the final correct answer. Refusal to participate in physical therapy can be a sign of inadequate pain control. Pain can make movement and physical activity difficult and uncomfortable, leading patients to avoid necessary rehabilitation exercises. Effective pain management is crucial for encouraging participation in physical therapy and promoting recovery.

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Correct Answer is ["B","C"]

Explanation

Choice A: Hyponatremia - Dehydration
Hyponatremia occurs when the sodium levels in the blood are abnormally low. While dehydration can contribute to hyponatremia, it is not the most common cause. Hyponatremia is more frequently caused by conditions that lead to an excess of water in the body, diluting the sodium levels. These conditions include heart failure, kidney disease, and the syndrome of inappropriate antidiuretic hormone secretion (SIADH).
Choice B: Hypomagnesemia - Chronic alcoholism
This is a correct pairing. Hypomagnesemia, or low magnesium levels in the blood, is often associated with chronic alcoholism. Alcoholism can lead to poor dietary intake of magnesium, increased urinary excretion of magnesium, and gastrointestinal losses due to vomiting and diarrhea. These factors contribute to the development of hypomagnesemia in individuals with chronic alcoholism.
Choice C: Hyperkalemia - Kidney failure
This is also a correct pairing. Hyperkalemia, or high potassium levels in the blood, is commonly caused by kidney failure. The kidneys are responsible for excreting excess potassium from the body. When the kidneys are not functioning properly, they cannot remove potassium efficiently, leading to its accumulation in the blood. Other causes of hyperkalemia include certain medications, such as potassium-sparing diuretics, and conditions that cause cellular breakdown, such as rhabdomyolysis.

A. Monitor for signs and symptoms of infection. B. Provide all patients with bottled water. C. Provide education on infection prevention. D. Request an antibiotic order for a febrile patient. E. Create a clean, safe environment.

Correct Answer is ["A","C","E"]

Explanation

Choice A: Monitor for signs and symptoms of infection

Monitoring for signs and symptoms of infection is a fundamental strategy in infection prevention. Early detection of infections allows for timely intervention, which can prevent the spread of pathogens and reduce the severity of the infection. Common signs and symptoms include fever, redness, swelling, pain, and discharge. Regular monitoring helps healthcare providers identify infections early and take appropriate actions, such as isolating the patient or starting treatment.

Choice B: Provide all patients with bottled water

Providing all patients with bottled water is not a standard infection prevention strategy. While ensuring access to clean drinking water is important, it is not specifically aimed at preventing infections. In healthcare settings, tap water is usually safe to drink if it meets regulatory standards. Bottled water may be provided in certain situations, such as during an outbreak of waterborne pathogens, but it is not a routine infection prevention measure.

Choice C: Provide education on infection prevention

Providing education on infection prevention is crucial for both healthcare providers and patients. Education helps individuals understand how infections spread and what measures they can take to prevent them. This includes proper hand hygiene, respiratory etiquette, and the importance of vaccinations. Educating patients and staff can significantly reduce the incidence of healthcare-associated infections by promoting adherence to infection control practices.

Choice D: Request an antibiotic order for a febrile patient

Requesting an antibiotic order for a febrile patient is not an infection prevention strategy but rather a treatment approach. Antibiotics are used to treat bacterial infections, not to prevent them. Overuse of antibiotics can lead to antibiotic resistance, making it crucial to use them judiciously and only when necessary. Infection prevention focuses on measures to prevent the occurrence of infections rather than treating them once they occur.

Choice E: Create a clean, safe environment

Creating a clean, safe environment is essential for infection prevention in healthcare settings. This involves regular cleaning and disinfection of surfaces, proper waste disposal, and maintaining hygiene standards. A clean environment reduces the risk of healthcare-associated infections by minimizing the presence of pathogens. Effective cleaning protocols and environmental controls are critical components of infection prevention strategies.

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A nurse assesses a postoperative patient 2 days after chest surgery. What four findings indicate that the patient has inadequate pain control?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for patients with electrolyte imbalances on a medical-surgical unit. Which common causes are correctly paired with the corresponding electrolyte imbalance?

Correct Answer is ["B","C"]

Explanation

Infection prevention strategies include:

Correct Answer is ["A","C","E"]

Explanation

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