The nurse is providing a gentle massage on a painful area of a client's hip. What is the goal of the nurse in providing this intervention?

Release of endorphins and enkephalins

Interrupts pain perception

Keep the pain at a manageable level

Floods the brain with alternative stimuli closes the spinal gate

Answer and Explanation

The Correct Answer is A

A. Release of endorphins and enkephalins: Massage stimulates the release of natural opioids such as endorphins and enkephalins. These neurotransmitters bind to opioid receptors in the brain and spinal cord, helping to reduce pain perception and promote a sense of well-being.
B. Interrupts pain perception: While massage may contribute to distraction, the primary mechanism involves biochemical modulation rather than directly interrupting the perception pathway. Pain perception is complex and multifactorial.
C. Keep the pain at a manageable level: This is a general goal of pain management but not a specific physiological mechanism of massage. It describes the outcome rather than the process by which massage works.
D. Floods the brain with alternative stimuli closes the spinal gate: This describes the gate control theory of pain, which applies more directly to techniques like transcutaneous electrical nerve stimulation (TENS) than to massage. Massage can influence gate control but primarily works through neurochemical pathways.

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Correct Answer is D

Explanation

A. Increased cardiac output: Mitral stenosis typically reduces cardiac output due to impaired left ventricular filling. Increased output would be unusual but not immediately concerning compared to pressure-related complications.
B. Decreased pulmonary pressure: Pulmonary pressure often increases, not decreases, in mitral stenosis due to blood backing up from the left atrium. Decreased pressure is not a critical concern in this condition.
C. Decreased right ventricular pressure: This is not commonly associated with mitral stenosis. The right ventricle may experience increased pressure if pulmonary hypertension develops, but a decrease is less concerning.
D. Increased left atrial pressure: Mitral valve narrowing impairs blood flow into the left ventricle, leading to blood accumulation and elevated pressure in the left atrium. This can cause pulmonary congestion and is the most critical finding.

A. Dyspnea when ambulating from the bathroom B. A noted irregular pulse rate prior to Lanoxin (digoxin) administration C. Pulsus paradoxus on vital sign assessment D. Cyanosis with a pulse oximetry level of 92%

Correct Answer is C

Explanation

A. Dyspnea when ambulating from the bathroom: Mild exertional dyspnea is common in cardiac clients and may not require immediate provider notification unless it worsens or becomes unrelieved with rest.
B. A noted irregular pulse rate prior to Lanoxin (digoxin) administration: An irregular pulse may warrant holding the medication and further assessment, but it is not always an emergency unless associated with hemodynamic instability or bradycardia.
C. Pulsus paradoxus on vital sign assessment: Pulsus paradoxus, a significant drop in systolic blood pressure during inspiration, may indicate cardiac tamponade or severe pericardial effusion. It is a critical finding that requires immediate medical attention.
D. Cyanosis with a pulse oximetry level of 92%: While cyanosis is concerning, a SpO₂ of 92% may be acceptable for some cardiac or pulmonary patients. Further monitoring is needed, but it may not require urgent notification unless oxygen levels drop further.

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The nurse is providing a gentle massage on a painful area of a client's hip. What is the goal of the nurse in providing this intervention?

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Naxlex Comprehensive Predictor Exams

The nurse is caring for a client with mitral stenosis. Which assessment finding would cause the greatest concern in providing nursing care to this client?

Correct Answer is D

Explanation

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Correct Answer is C

Explanation

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