A nurse is caring for an oldest patient.
For each potential provider’s prescription, click to specify if the potential prescription is anticipated or contraindicated for the client.
Ice packs to affected area 15 minutes on, 15 minutes off
Intravenous fluids (IVF) at maintenance rate
Ketorolac IV for pain
Ambulate in hallway with supervision
Meperidine IV for pain
The Correct Answer is {"A":{"answers":"B"},"B":{"answers":"A"},"C":{"answers":"A"},"D":{"answers":"B"},"E":{"answers":"B"}}
Choice A: Ice packs to affected area 15 minutes on, 15 minutes off
Reason: Ice packs are generally contraindicated for patients with sickle cell disease (SCD). The use of ice packs can cause vasoconstriction, which narrows blood vessels and reduces blood flow. This can exacerbate the pain and potentially trigger a vaso-occlusive crisis (VOC) by further restricting blood flow to the already compromised areas. Studies have shown that cold exposure can worsen pain in SCD patients, making ice packs an unsuitable option.
Choice B: Intravenous fluids (IVF) at maintenance rate
Reason: Intravenous fluids are anticipated for patients with SCD, especially during a pain crisis. Hydration is crucial as it helps to reduce the viscosity of the blood, thereby improving blood flow and reducing the likelihood of sickling. Adequate hydration can help to alleviate pain and prevent further complications. The administration of IV fluids is a standard practice in managing acute pain episodes in SCD patients.
Choice C: Ketorolac IV for pain
Reason: Ketorolac, a nonsteroidal anti-inflammatory drug (NSAID), is anticipated for managing pain in SCD patients. It provides effective pain relief without the risks associated with opioids, such as respiratory depression and dependence. Ketorolac works by inhibiting the production of prostaglandins, which are involved in the inflammatory process and pain signaling. It is particularly useful for acute pain management in SCD patients.
Choice D: Ambulate in hallway with supervision
Reason: Ambulation during a pain crisis is generally contraindicated for SCD patients. Movement can increase pain and stress on the affected areas, potentially worsening the condition. During a VOC, patients are often advised to rest and avoid activities that could exacerbate the pain. While physical activity is important for overall health, it should be carefully managed and avoided during acute pain episodes.
Choice E: Meperidine IV for pain
Reason: Meperidine is contraindicated for pain management in SCD patients due to its potential for serious side effects. Meperidine can accumulate in the body and produce a toxic metabolite called normeperidine, which can cause seizures and other adverse effects. Additionally, meperidine is less effective than other opioids and has a higher risk of causing dependency and other complications. Therefore, it is not recommended for managing pain in SCD patients.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["B","D","E"]
Explanation
Choice A: Wash raw carrots before cooking
Reason: Washing raw vegetables, including carrots, before cooking is essential to remove dirt, bacteria, and pesticide residues. However, this option is not specific to preventing foodborne illnesses. Washing vegetables is a general hygiene practice, but it does not address the broader aspects of food safety, such as preventing cross-contamination or ensuring proper cooking temperatures. Therefore, while important, it is not the most critical instruction for preventing foodborne illnesses in this context.
Choice B: Separate raw foods from ready-to-eat foods
Reason: Separating raw foods from ready-to-eat foods is crucial to prevent cross-contamination. Raw foods, especially meats, poultry, and seafood, can harbor harmful bacteria that can transfer to ready-to-eat foods if not kept separate. This separation should be maintained during storage, preparation, and cooking. For example, raw meat should be stored on the bottom shelf of the refrigerator to prevent juices from dripping onto other foods. Using separate cutting boards and utensils for raw and ready-to-eat foods further minimizes the risk of cross-contamination.
Choice C: Wash utensils with warm water
Reason: While washing utensils with warm water is a good practice, it is not sufficient on its own to ensure food safety. Utensils that have come into contact with raw meat, poultry, or seafood should be washed with hot, soapy water and sanitized to kill any harmful bacteria. Simply using warm water may not effectively remove or kill bacteria, making this option less critical compared to others that directly address foodborne illness prevention.
Choice D: Practice good hand washing after handling raw eggs, meat, or poultry
Reason: Practicing good hand washing after handling raw eggs, meat, or poultry is one of the most effective ways to prevent foodborne illnesses. Hands can easily transfer bacteria from raw foods to other surfaces, utensils, and foods. Proper hand washing involves scrubbing hands with soap and water for at least 20 seconds, ensuring all parts of the hands are cleaned. This practice helps to eliminate harmful bacteria and reduce the risk of cross-contamination.
Choice E: Ensure all food is cooked to 165°F. Promptly refrigerate foods when finished eating
Reason: Cooking food to the proper internal temperature is essential to kill harmful bacteria that can cause foodborne illnesses. For most foods, an internal temperature of 165°F (73.9°C) is recommended to ensure safety. Using a food thermometer to check the temperature is the best way to ensure food is cooked thoroughly. Additionally, promptly refrigerating foods after eating helps to prevent bacterial growth. Bacteria can multiply rapidly at room temperature, so refrigerating leftovers within two hours (or one hour if the temperature is above 90°F) is crucial for food safety.
Correct Answer is ["0.8"]
Explanation
Step 1: Determine the dosage required. Required dosage = 30 mg
Step 2: Determine the concentration of the available solution. Available concentration = 40 mg/mL
Step 3: Calculate the volume to be administered. Volume to be administered = Required dosage ÷ Available concentration Volume to be administered = 30 mg ÷ 40 mg/mL
Step 4: Perform the division. 30 ÷ 40 = 0.75
Step 5: Round the answer to the nearest tenth. Rounded volume = 0.8 mL
The nurse should administer 0.8 mL.
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