A patient with a deep partial thickness burn has been receiving hydromorphone through patient-controlled analgesia (PCA) for 1 week. The nurse caring for the patient during the previous shift reports that the patient wakes up frequently during the night reporting pain. What action by the nurse is appropriate?

Teach the patient to push the button every 10 minutes for an hour before going to sleep, even if the pain is minimal.

Request that the health care provider order a bolus dose of morphine to be given when the patient awakens with pain.

Consult with the health care provider about using a different treatment protocol to control the patient's pain.

Administer a dose of morphine every 1 to 2 hours from the PCA machine while the patient is sleeping.

Answer and Explanation

The Correct Answer is C

C. This option is appropriate as the current treatment protocol is not effectively managing the patient's pain. The nurse can collaborate with the healthcare provider to reassess the patient's pain management needs and explore alternative strategies or adjustments to the PCA regimen.

A. This approach may lead to overmedication and increase the risk of adverse effects such as respiratory depression or sedation.

B. Requesting a bolus dose when the patient awakens with pain could be a part of the solution, but it should be carefully evaluated within the context of the overall pain management plan.

D. Administering scheduled doses of morphine from the PCA machine without the patient's input or based solely on time intervals is not recommended.

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Correct Answer is C

Explanation

C. This information is important to communicate to the surgical and anesthesia team as it indicates a potential family history of adverse reactions to anesthesia. Family history of anesthesia-related complications, especially in close relatives, can influence the anesthetic plan and help mitigate potential risks during surgery.

A. Clear fluids, such as apple juice, are typically allowed up to 2 hours before surgery, but the specific fasting instructions may vary depending on the institution's protocol and the type of surgery planned.

B. This information provides insight into the patient's caffeine consumption habits but it is not typically considered a critical factor to communicate to the surgical and anesthesia team before surgery.

D. Knowing the duration of aspirin cessation allows the anesthesia team to assess the patient's coagulation status and adjust the perioperative management accordingly. However, it does not present immediate risks as significant as a family history of anesthetic complications.

A. Begin full weight bearing. B. Apply heat to the affected knee. C. Start range of motion (ROM) exercises. D. Perform quadriceps setting exercises.

Correct Answer is D

Explanation

D. Quadriceps setting exercises help strengthen the quadriceps muscles, which play a crucial role in knee stability and function. These exercises can be initiated early in the postoperative period and are typically part of the rehabilitation program following a partial meniscectomy.

A. Full weight bearing may place excessive stress on the knee joint and hinder the healing process.

B. Heat therapy is generally not recommended immediately after a partial meniscectomy. Heat can increase blood flow and swelling, which may exacerbate pain and inflammation in the early postoperative period.

C. Range of motion (ROM) exercises help prevent stiffness and promote flexibility in the knee joint after surgery. However, these exercises should not be initiated immediately.

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Naxlex Comprehensive Predictor Exams

The nurse interviews a patient scheduled to undergo general anesthesia for a bilateral hernia repair. Which information is most important to communicate to the surgeon and anesthesiologist before surgery?

Correct Answer is C

Explanation

A nurse in a one-day surgery center is providing discharge teaching for a client who is postoperative following a partial meniscectomy. Which of the following instructions should the nurse include?

Correct Answer is D

Explanation

A nurse is teaching a client who has a new prescription for cyclosporine oral solution to treat rheumatoid arthritis. Which of the following information should the nurse include in the teaching?

A nurse is providing discharge teaching to a client who has a fracture of the right tibia and a fiberglass cast. Which of the following instructions should the nurse include in the teaching?

The nurse assesses a patient who had a total abdominal hysterectomy 2 days ago. Which information about the patient is most important to communicate to the health care provider?

A nurse is caring for an adolescent client who has a newly applied fiberglass cast for a fractured tibia. Which of the following is the priority action for the nurse to take?

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A nurse is providing care for four clients on a medical-surgical unit, Which of the following clients should the nurse identify as being at risk for the development of pressure ulcers? (Select all that apply.)

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