Nursing practice questions with comprehensive rationales
NurseDive Free Nursing Practice Question
A client has had emergency surgery for a ruptured appendix. Before surgery, the client was taking dexamethasone for three years. With the client's steroid use history, for which complication will the nurse monitor in the recovery phase?
A. Bradycardia
Bradycardia is not typically associated with long-term steroid use; it may be more related to factors like anesthesia or surgical stress.
B. Postoperative blood clots
Prolonged steroid use increases the risk of thrombosis, and postoperative blood clots are a concern in individuals with a history of long-term steroid use.
C. Impaired wound healing
Steroids can delay wound healing, but in this context of emergency surgery for a ruptured appendix, the primary concern is often the risk of blood clots.
D. Pre-surgical dehydration
Pre-surgical dehydration is a potential concern but is not specifically related to the client's history of steroid use.
This question is an excerpt from Nurse Dive's nursing test bank - Ramsussen Section 4 Module 11. Pharmocology For Professional Nursing Proctored Exam. Take the full exam now
Full Explanation
A) Bradycardia is not typically associated with long-term steroid use; it may be more related to factors like anesthesia or surgical stress.
B) Prolonged steroid use increases the risk of thrombosis, and postoperative blood clots are a concern in individuals with a history of long-term steroid use.
C) Steroids can delay wound healing, but in this context of emergency surgery for a ruptured appendix, the primary concern is often the risk of blood clots.
D) Pre-surgical dehydration is a potential concern but is not specifically related to the client's history of steroid use.
Similar Questions
The nurse is educating a client regarding the use of omeprazole. What statement by the client shows a proper understanding of how to take this medication?
A. A "I should chew the medication when my heartburn is bad, so it absorbs more rapidly."
Omeprazole should not be chewed; it is usually taken whole with a glass of water.
B. B "I should take this medication with an antacid to maximize its effects."
Taking omeprazole with an antacid may alter its absorption and effectiveness; they should be taken separately.
C. C "I should plan to take this medication for the rest of my life."
While long-term use may be necessary in some cases, the statement doesn't reflect proper understanding of the timing of administration.
D. D "I should take this medication on an empty stomach before I eat."
Omeprazole is most effective when taken on an empty stomach, usually 30 to 60 minutes before a meal.
Full Explanation
A) Omeprazole should not be chewed; it is usually taken whole with a glass of water.
B) Taking omeprazole with an antacid may alter its absorption and effectiveness; they should be taken separately.
C) While long-term use may be necessary in some cases, the statement doesn't reflect a proper understanding of the timing of administration.
D) Omeprazole is most effective when taken on an empty stomach, usually 30 to 60 minutes before a meal.
Which of these situations would cause the nurse to hold a dose of morphine?
A. The temperature is above 100.4 degrees Fahrenheit (38 degrees Celsius).
Elevated temperature is not a typical reason to withhold morphine unless there are other concerns, such as infection.
B. The blood pressure is above 140 mm Hg systolic.
Elevated blood pressure alone is not a reason to withhold morphine, but it should be considered in the context of the overall clinical picture.
C. Respiratory rate of 10 breaths per minute with an oxygen saturation level of 86%.
A respiratory rate of 10 breaths per minute with low oxygen saturation indicates respiratory depression, which is a significant concern and a reason to withhold morphine.
D. The heart rate is above 90 beats per minute.
An elevated heart rate alone is not a reason to withhold morphine, but it should be considered in the context of the overall clinical picture.
Full Explanation
A) Elevated temperature is not a typical reason to withhold morphine unless there are other concerns, such as infection.
B) Elevated blood pressure alone is not a reason to withhold morphine, but it should be considered in the context of the overall clinical picture.
C) A respiratory rate of 10 breaths per minute with low oxygen saturation indicates respiratory depression, which is a significant concern and a reason to withhold morphine.
D) An elevated heart rate alone is not a reason to withhold morphine, but it should be considered in the context of the overall clinical picture.
A client who has erectile dysfunction asks a nurse whether sildenafil would be a suitable medication. Which aspect of this client's history would be of most concern?
A. Taking finasteride
Sildenafil and finasteride can both lower blood pressure, and concomitant use may increase the risk of hypotension.
B. Occasional use of nitroglycerin
Nitroglycerin use is a contraindication for sildenafil due to the risk of severe hypotension.
C. Benign prostatic hypertrophy
Benign prostatic hypertrophy alone may not be a contraindication for sildenafil use.
D. Mild hypertension
Mild hypertension alone may not be a contraindication for sildenafil, but it should be considered in the overall assessment of cardiovascular health.
Full Explanation
A) Sildenafil and finasteride can both lower blood pressure, and concomitant use may increase the risk of hypotension.
B) Nitroglycerin use is a contraindication for sildenafil due to the risk of severe hypotension.
C) Benign prostatic hypertrophy alone may not be a contraindication for sildenafil use.
D) Mild hypertension alone may not be a contraindication for sildenafil, but it should be considered in the overall assessment of cardiovascular health.