A nurse is receiving postoperative report for a school-age child following surgery for a ruptured appendix. Which of the following prescriptions should the nurse expect?

Place the client in a supine position for the first 12 hr postoperative.

Pack the open wound with a dry gauze dressing.

Administer naproxen orally for pain 30 min prior to ambulation.

Maintain an NG tube on low intermittent suction until bowel sounds return.

Answer and Explanation

The Correct Answer is D

A) Place the client in a supine position for the first 12 hr postoperative: Following surgery for a ruptured appendix, placing the child in a supine position for the first 12 hours can be inappropriate. It may be more beneficial to position the child in a semi-Fowler's position to promote drainage of any remaining infection and reduce the risk of respiratory complications.

B) Pack the open wound with a dry gauze dressing: For a postoperative wound following a ruptured appendix, using a dry gauze dressing might not be the best practice. A moist dressing can promote better healing and reduce the risk of infection. Wet-to-dry or other appropriate dressings are typically recommended based on the surgeon's instructions.

C) Administer naproxen orally for pain 30 min prior to ambulation: While managing pain is important, naproxen is a nonsteroidal anti-inflammatory drug (NSAID) that is typically not the first choice for postoperative pain management in children. Additionally, oral medication might not be recommended immediately post-surgery, especially if the child has an NG tube or other contraindications for oral intake.

D) Maintain an NG tube on low intermittent suction until bowel sounds return: This is a standard postoperative practice for children who have had surgery for a ruptured appendix. The NG tube helps to decompress the stomach, preventing vomiting and aspiration, and helps manage bowel function until normal activity resumes, which is crucial for postoperative recovery.

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Correct Answer is A

Explanation

A. Administer a dose of subcutaneous epinephrine.: The swelling of the lips and tongue is indicative of angioedema, a serious adverse reaction to captopril. Epinephrine is the first-line treatment for severe allergic reactions or angioedema to quickly counteract the swelling and prevent airway obstruction.

B. Advise the client not to consume grapefruit products.: Grapefruit can interact with some medications, but it is not related to the management of angioedema. This action would be more relevant for drugs metabolized by CYP3A4, not specifically for angioedema.

C. Place warm compresses on both sides of the client's face.: Warm compresses are not appropriate for angioedema and may not address the underlying issue. This action does not manage the immediate, potentially life-threatening reaction caused by captopril.

D. Swab the client's oral mucosa with nystatin suspension.: Nystatin is used for fungal infections of the oral mucosa, not for angioedema. This action does not address the adverse reaction related to captopril.

A. "I have been taking acetaminophen when my knees start to hurt." B. "I've been sleeping on my back with a large pillow under my knees." C. "I have been exercising every day, even when I have pain." D. "I've been changing my lidocaine patches every 18 hours."

Correct Answer is A

Explanation

A) "I have been taking acetaminophen when my knees start to hurt.":
Taking acetaminophen for pain relief indicates that the client is managing the osteoarthritis symptoms appropriately. Acetaminophen is a recommended first-line treatment for mild to moderate pain associated with osteoarthritis and can help improve the client's quality of life by reducing discomfort.

B) "I've been sleeping on my back with a large pillow under my knees.":
Sleeping with a large pillow under the knees can cause the knees to remain in a flexed position for prolonged periods, potentially leading to joint stiffness and worsening pain. This practice is not typically recommended for clients with osteoarthritis as it can exacerbate symptoms.

C) "I have been exercising every day, even when I have pain.":
While regular exercise is beneficial for managing osteoarthritis, it is important to avoid exercising through significant pain. Pain during exercise may indicate overuse or joint damage. Clients should be encouraged to modify their activities to prevent further joint stress and manage symptoms effectively.

D) "I've been changing my lidocaine patches every 18 hours.":
Lidocaine patches are typically designed for 12-hour application periods, followed by a 12-hour off period. Changing the patches every 18 hours may not provide the intended relief and could lead to inconsistent pain management. Proper use of pain management techniques is essential for effective disease management.

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A nurse is receiving postoperative report for a school-age child following surgery for a ruptured appendix. Which of the following prescriptions should the nurse expect?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is monitoring a client who is taking captopril and has developed swelling of the lips and tongue. Which of the following actions should the nurse plan to take to manage this adverse medication reaction?

Correct Answer is A

Explanation

A nurse is assessing a client's adaptation to a new diagnosis of osteoarthritis. Which of the following client statements should indicate to the nurse that the client is managing the disease?

Correct Answer is A

Explanation

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