A nurse is caring for a client who has a herniated disc and is scheduled for a peripheral nerve block. The client tells the nurse. "I am afraid to have this procedure." Which of the following responses should the nurse make?

"After this procedure, you will feel much better."

"Let's discuss your concerns about this procedure."

"Are you afraid of needles that will be used during the procedure?"

"Tell me why you are scared to have this procedure."

Answer and Explanation

The Correct Answer is B

A)   Offering reassurance about the outcome of the procedure may not address the client's specific fears.
B)   Encouraging the client to discuss their concerns allows the nurse to address any misconceptions or fears the client may have and provide appropriate information and support.
C)   Assuming the client's fear is related to needles may not be accurate and may not address their specific concerns.
D)   Asking the client to explain why they are scared is a good approach, but it may not immediately address their fears or provide the support they need.

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Correct Answer is B

Explanation

A. Shellfish has no known interactions with propofol.

B. Propofol, a commonly used anesthetic agent, contains egg lecithin as an emulsifier. Therefore, individuals with egg allergies are at risk of having an allergic reaction to propofol. It's essential for the nurse to identify this allergy to ensure the client's safety during the administration of anesthesia.
C. Strawberries do not interact with propofol.

D. Avocados do not interact with propofol.

A. Potassium chloride 20 mEq/L intravenous PRN potassium less than 5.0 mEq/L B. Initiate cardiac monitoring C. Regular insulin 20 units subcutaneously D. Regular insulin continuous intravenous infusion, titrate per diabetic ketoacidosis (DKA) protocol once potassium is greater than 3.3 mEq/L E. 0.9% sodium chloride at 15 ml/kg/hr for 1 hr and then reduce to 10 ml/kg/hr F. Dextrose 5% in water (D5W) intravenous at 5 ml/kg/hr for 4 hr G. Blood glucose checks every 4 hr H. Monitor urine outputs

Correct Answer is ["D","E","H"]

Explanation

A. This prescription addresses hypokalemia. Potassium chloride is administered intravenously to help normalize potassium levels within the desired range. However, in this case the patient’s potassium is 5.5 hence does not require potassium chloride.

B. The client has mild hyperkalemia; hence, continuous cardiac monitoring is prudent to detect any potential arrhythmias or changes in cardiac status. However, the priority interventions are insulin therapy, hydration, and urinary catheter insertionto monitor input and output.

C. Subcutaneous insulin administration may be appropriate for clients with diabetes mellitus, but in this case, the client's blood glucose level is critically high, and they may be experiencing diabetic ketoacidosis (DKA), which requires rapid correction. Subcutaneous insulin administration would not provide the prompt and aggressive treatment required for DKA.

D. This prescription addresses the client's hyperglycemia and acidosis indicated by the blood glucose level of 468 mg/dL and pH of 7.30, respectively. Continuous intravenous insulin infusion is the standard treatment for diabetic ketoacidosis (DKA) to lower blood glucose levels and correct acidosis.

E. This prescription addresses the client's dehydration indicated by the elevated blood glucose level, decreased blood pressure, and slight tenting of the skin. Intravenous fluid resuscitation with 0.9% sodium chloride is initiated to restore intravascular volume and correct electrolyte imbalances.

F. Administering D5W intravenously is contraindicated in the setting of hyperglycemia and diabetic ketoacidosis (DKA) because it would exacerbate the already elevated blood glucose levels. D5W contains glucose and would further increase blood glucose levels, worsening the client's condition.

G. While monitoring blood glucose levels is important for clients with diabetes, checking it every 4 hours is not sufficient in this scenario, especially given the client's markedly elevated blood glucose level of 468 mg/dL and symptoms suggestive of diabetic ketoacidosis (DKA). Therefore, blood glucose levels should be monitored at least hourly.

H. Monitoring urine output is important in clients with diabetes and dehydration. Therefore, inserting an indwelling urinary catheter is important in this scenario.

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A nurse is caring for a client who has a herniated disc and is scheduled for a peripheral nerve block. The client tells the nurse. "I am afraid to have this procedure." Which of the following responses should the nurse make?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is asking a preoperative client about food allergies. Which of the following food allergies indicates a potential reaction to propofol?

Correct Answer is B

Explanation

A nurse is caring for a client in the emergency department. Exhibits Which of the following 3 provider prescriptions does the nurse anticipate?

Correct Answer is ["D","E","H"]

Explanation

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