Pharmacology and the Nursing Process 9th Edition Test Bank

Correct Answer: C

Rationale: The correct answer is C: Assess apical heart before administering digitalis. This is important because digitalis can slow down the heart rate, so it is crucial to monitor the client's heart rate before giving the medication to prevent further decrease in cardiac output. Encouraging activities that engage the Valsalva maneuver (A) is contraindicated in clients with congestive heart failure as it can lead to increased intra-thoracic pressure and decreased venous return, worsening cardiac output. Encouraging the client to perform exercises (B) may also increase cardiac workload and exacerbate symptoms. Offering small frequent feedings (D) is generally beneficial for clients with congestive heart failure to prevent overeating and promote easier digestion, but it does not directly address the decreased cardiac output concern in this scenario.

Correct Answer: A

Rationale: The correct answer is A: Use parallel bars or a walker. Before a client with impaired physical mobility gets up, the nurse should provide assistive devices like parallel bars or a walker to ensure safe and supported ambulation. This helps prevent falls and promotes independence. Using incontinence pads (B) is not directly related to mobility. Applying an abdominal binder (C) is not necessary before the client gets up. Using a footboard (D) is more relevant for positioning in bed, not for assisting with ambulation.

Correct Answer: A

Rationale: The correct answer is A: Hypocalcemia. Chvostek's sign and Trousseau's sign are both indicators of hypocalcemia, which is a common complication following thyroidectomy surgery due to potential damage to the parathyroid glands. Chvostek's sign is elicited by tapping the facial nerve and observing facial muscle twitching, while Trousseau's sign involves carpal spasm induced by inflating a blood pressure cuff above systolic pressure. Both signs are sensitive indicators of hypocalcemia due to their association with neuromuscular irritability. Hypercalcemia (option C) and hyperkalemia (option D) are not typically associated with thyroidectomy surgery and would not present with these specific signs. Hypokalemia (option B) is not related to Chvostek's sign and Trousseau's sign.

Correct Answer: B

Rationale: Rationale: Answer B is correct because a hemoglobin level of 11mg/dl and hematocrit level of 32% in a 78-year-old client are indicative of anemia. Conducting a thorough nutritional assessment is essential to identify potential causes of anemia such as iron deficiency or vitamin deficiencies. This assessment will help determine appropriate interventions to manage the anemia. Summary: A: Incorrect. These levels are indicative of anemia, not normal findings. C: Incorrect. Advising to repeat the test in three months may delay necessary interventions for the anemia. D: Incorrect. While anemia can be related to bone marrow degeneration, a nutritional assessment is needed to identify the specific cause in this case.

Correct Answer: A

Rationale: The correct answer is A: Oxygen saturation above 90%. This is a discharge criterion because adequate oxygen saturation indicates the patient is breathing well and there is no immediate respiratory compromise. Oxygen saturation below 90% (choice C) would indicate hypoxemia and would not be safe for discharge. IV narcotics given less than 15 minutes ago (choice B) can still be in effect and may impair the patient's ability to function post-surgery. IV narcotics given less than 30 minutes ago (choice D) is a longer timeframe but still not ideal for discharge as the effects of the narcotics may not have fully worn off.