Pharmacology and the Nursing Process Test Bank

Correct Answer: C

Rationale: The correct answer is C: Check his airway. Ensuring a patent airway is the priority in trauma care to maintain oxygenation and ventilation. With the patient unconscious and bleeding profusely, airway obstruction or compromise is a critical concern. By checking the airway first, the nurse can quickly assess and address any immediate threats to the patient's breathing. Stopping the bleeding (choice A) can be addressed once the airway is secured. Taking vital signs (choice B) and finding out what happened from eyewitnesses (choice D) can be important but are secondary to ensuring the patient's airway is clear and unobstructed.

Correct Answer: A

Rationale: The correct answer is A because narcotics in high doses can depress the respiratory rate and cough reflex, which can be especially dangerous for a laryngectomy patient due to the risk of airway compromise. Low doses can provide pain relief without significant respiratory depression. Choices B and C are incorrect because narcotics typically do not increase respiratory tract secretions or cause stomal edema. Choice D is incorrect because while narcotics can potentially cause addiction, this is not the primary reason for giving low doses to laryngectomy patients.

Correct Answer: C

Rationale: The correct answer is C because data validation involves verifying the accuracy and consistency of data by comparing it with other reliable sources. This ensures that the data is correct and reliable for analysis. Choice A is incorrect because data validation typically occurs after data collection, which is followed by data interpretation. Choice B is incorrect because validation is not about professional standards but about verifying data accuracy. Choice D is incorrect because data interpretation focuses on deriving meaning and insights from data, not on professional standards. In summary, understanding the differences between data validation and interpretation is crucial for ensuring data accuracy and reliability.

Correct Answer: A

Rationale: The correct answer is A. First, the nurse should assess the chest-drainage system and tubing for any air leaks. Air leaks can cause bubbling in the water-seal chamber, indicating a potential issue with the system's integrity. By examining the entire system, the nurse can identify and correct any leaks to ensure proper functioning of the chest-drainage system. Lowering the level of suction (choice B) may not address the underlying issue of air leaks. Doing nothing (choice C) is not appropriate as vigorous bubbling indicates a problem. Asking the patient to cough forcefully (choice D) is unrelated to addressing bubbling in the water-seal chamber.

Correct Answer: C

Rationale: The correct answer is C because it focuses on the client actively engaging in reducing tension, which is essential in managing anxiety. This outcome is measurable and client-centered. A: Verbalizing feelings is important, but it does not necessarily lead to reduction in anxiety. B: Not guessing prognosis is helpful, but it does not address the active management of anxiety. D: Stopping seeking information may not be beneficial as knowledge can empower the client in coping with the diagnosis.