A nurse is caring for a client who is receiving morphine intravenously. Which of the following findings indicates the client is experiencing morphine toxicity?

Hyperactive deep tendon reflexes

Fluid retention

Prolonged QT interval

Bradypnea

Answer and Explanation

The Correct Answer is D

Choice A reason: Hyperactive deep tendon reflexes are not linked to morphine toxicity. Morphine, an opioid, depresses the central nervous system, reducing reflexes. Hyperactive reflexes suggest neurological or stimulant effects, not opioid overdose, which primarily causes respiratory and consciousness depression in affected clients.
Choice B reason: Fluid retention is not a primary sign of morphine toxicity. Morphine may cause urinary retention via sphincter tone increase, but fluid overload is unrelated. Toxicity manifests as respiratory depression or sedation, driven by mu-opioid receptor overstimulation, not fluid balance alterations.
Choice C reason: Prolonged QT interval is associated with medications like antiarrhythmics, not morphine. Morphine toxicity primarily causes respiratory depression and sedation via central nervous system effects. Cardiac effects are rare, and QT prolongation is not a hallmark of opioid overdose in clinical settings.
Choice D reason: Bradypnea indicates morphine toxicity, as opioids depress the brainstem’s respiratory center via mu-receptor overstimulation. This slows breathing, risking hypoxia and respiratory arrest, a life-threatening complication requiring immediate intervention like naloxone to reverse opioid effects and restore normal respiratory function.

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Correct Answer is A

Explanation

Choice A reason: Suggesting a support group helps the client address emotional resistance to the colostomy through peer support. This fosters psychological adjustment, reduces stigma, and promotes self-management by sharing experiences, aligning with evidence-based strategies to improve coping and adaptation in clients with new ostomies.
Choice B reason: Encouraging avoidance of negative feelings dismisses the client’s emotional response, hindering psychological adaptation. Accepting a colostomy requires processing grief and fear. Suppressing emotions delays coping, as psychological adjustment involves acknowledging feelings to integrate the stoma into the client’s self-image effectively.
Choice C reason: Instructing the partner to assume colostomy care undermines the client’s autonomy and delays self-management. Independence in stoma care is critical for psychological and practical adaptation. Dependency may hinder adjustment, as clients need to develop skills to manage their condition independently.
Choice D reason: Transferring to a rehabilitation facility is premature without trying in-hospital education or support groups. Most clients learn stoma care with nursing guidance. Transfer disrupts care continuity and may increase distress, failing to address emotional resistance directly, unlike peer support interventions.

A. Sweeten foods with fructose corn syrup. B. Increase intake of foods high in gluten. C. Increase intake of milk products. D. Consume foods high in bran fiber.

Correct Answer is D

Explanation

Choice A reason: Fructose corn syrup exacerbates irritable bowel syndrome (IBS) symptoms, as fermentable carbohydrates cause gas and bloating. IBS involves altered gut motility and microbiota, and high-fructose foods trigger visceral hypersensitivity, worsening abdominal pain and discomfort, making this an inappropriate dietary recommendation.
Choice B reason: Gluten-rich foods may worsen IBS in clients with non-celiac gluten sensitivity, causing bloating and diarrhea. Gluten disrupts gut motility in susceptible individuals, exacerbating IBS symptoms. Avoiding gluten is often advised, making increased intake counterproductive to managing IBS effectively.
Choice C reason: Milk products, containing lactose, worsen IBS in lactose-intolerant clients, causing bloating and diarrhea. Fermentable carbohydrates exacerbate gut dysmotility and visceral hypersensitivity, common in IBS, making increased dairy intake inappropriate for symptom management and dietary control in affected clients.
Choice D reason: Bran fiber, a soluble fiber, regulates bowel movements in IBS by adding bulk and stabilizing colonic transit. It reduces diarrhea and constipation, supporting microbiota health and alleviating symptoms. This evidence-based recommendation aligns with dietary management to improve gut function in IBS clients.

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A nurse is caring for a client who is receiving morphine intravenously. Which of the following findings indicates the client is experiencing morphine toxicity?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has a newly created colostomy. The client’s partner tells the nurse that the client refuses to look at the stoma. Which of the following actions should the nurse take?

Correct Answer is A

Explanation

A nurse is providing dietary teaching to a client who has a new diagnosis of irritable bowel syndrome. Which of the following recommendations should the nurse include?

Correct Answer is D

Explanation

A nurse is conducting a workshop on the importance of interprofessional collaboration. Which of the following is included in the tertiary prevention phase in interprofessional care?

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