Foundations and Adult Health Nursing Test Bank

Correct Answer: D

Rationale: Demerol (meperidine hydrochloride) is an opioid analgesic commonly used as a preoperative medication to decrease intra-operative anesthetic requirements and provide analgesia. Opioids like Demerol act on the central nervous system to reduce pain sensations, making it an effective choice for preoperative pain management. This can help decrease the amount of anesthesia needed during surgery, leading to better pain control and overall patient comfort during and after the procedure. Celebrex, acetaminophen, and ibuprofen are also used for pain management, but they do not have the same potency and mechanism of action as opioids like Demerol for reducing intra-operative anesthetic requirements.

Correct Answer: B

Rationale: Identifying the patient's stage of change is crucial when someone expresses a desire to be "detoxified" from a substance like marijuana. The Transtheoretical Model (Stages of Change) outlines different stages individuals go through when making behavior changes. By identifying which stage the patient is in (precontemplation, contemplation, preparation, action, maintenance, or relapse), the nurse can tailor interventions and support accordingly. This approach helps ensure that interventions are effective and appropriate for the individual's readiness for change. It is important to meet the patient where they are in their journey towards detoxification and offer support and guidance accordingly.

Correct Answer: A

Rationale: Troponin is the most specific cardiac biomarker for myocardial injury. Troponin I and Troponin T are proteins released into the bloodstream when there is damage to the heart muscle, making them highly indicative of myocardial infarction. Troponin levels rise within a few hours of cardiac injury, peak within 24-48 hours, and can remain elevated for up to 2 weeks. Troponin is considered the gold standard biomarker for the diagnosis of acute myocardial infarction due to its high specificity and sensitivity for cardiac injury. In contrast, Creatine kinase-MB (CK-MB) and myoglobin are also used in diagnosing myocardial infarction but are less specific than troponin. Brain natriuretic peptide (BNP) is primarily used in heart failure diagnosis and management, and its levels are not specific to myocardial injury.

Correct Answer: D

Rationale: Advocacy is the ethical principle that the nurse is responsible for providing all patients with caring attention and information, despite the reaction of the patient. Advocacy involves supporting and speaking up for the patient's best interests, ensuring they receive the care and information they need to make informed decisions about their health and well-being. Providing caring attention and information is essential in advocating for the patient's autonomy and well-being, even if the patient may not initially appreciate or react positively to these efforts.

Correct Answer: C

Rationale: Hypokalemia (low levels of potassium) increases the risk of digoxin toxicity. This is because digoxin competes with potassium for binding sites on the sodium-potassium ATPase pump in the cell membrane. When potassium levels are low, there is an increased binding of digoxin to these pumps, leading to enhanced entry of calcium into the cells. This can result in an increased intracellular calcium concentration, leading to digoxin toxicity and potential cardiac arrhythmias. Therefore, monitoring and correcting potassium levels is crucial in patients prescribed digoxin to reduce the risk of toxicity.