The nurse should question which of the written medical prescriptions for the client admitted to the emergency department with a major burn?

Administering IV Lactated Ringers @ 150ml/hour

Morphine 5 mg IV every 3 hours prn for pain

Strict intake and output

Insert an indwelling (Foley) catheter

Answer and Explanation

The Correct Answer is A

A. Administering IV Lactated Ringers @ 150ml/hour: In major burns, the fluid resuscitation rate is initially aggressive to compensate for the large fluid loss. The Parkland formula is used to determine the volume for resuscitation, which would be much more than 150 mL/hour in the first 24 hours.

B. Morphine 5 mg IV every 3 hours prn for pain: Morphine is commonly used for pain management in burn patients, as burns are extremely painful. Administering morphine every 3 hours as needed is an appropriate prescription for managing moderate pain in burn patients.

C. Strict intake and output: Monitoring strict intake and output is a critical part of managing fluid balance in burn patients. It helps ensure that the patient is receiving and excreting the correct volume of fluids, which is crucial for avoiding fluid overload or dehydration.

D. Insert an indwelling (Foley) catheter: In major burns, inserting a Foley catheter is standard practice. It allows for accurate monitoring of urinary output, which is an essential part of fluid management and kidney function monitoring.

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Correct Answer is ["A","C","D"]

Explanation

A. Hoarseness: Hoarseness is a common clinical manifestation of thyroid cancer, especially when the tumor affects the vocal cords or the recurrent laryngeal nerve. This may occur due to direct compression or invasion of the surrounding tissues in the neck, including the larynx.

B. Increased appetite: Increased appetite is associated with hyperthyroidism rather than thyroid cancer itself. Thyroid cancer often does not significantly alter thyroid hormone levels in its early stages, and therefore, an increased appetite is not a direct clinical manifestation.

C. Difficulty swallowing: Difficulty swallowing, or dysphagia, is a common symptom of thyroid cancer, particularly if the tumor enlarges and compresses the esophagus or other structures in the neck. This can interfere with the passage of food through the throat.

D. Neck swelling: Neck swelling, particularly a lump or nodule in the thyroid gland, is one of the most common clinical manifestations of thyroid cancer. The mass can be palpable and is often the first noticeable sign. It may be associated with other symptoms such as pain or difficulty swallowing.

E. Constipation: Constipation is not directly linked to thyroid cancer. While thyroid dysfunction (especially hypothyroidism) may cause constipation, this symptom is not a typical manifestation of thyroid cancer itself.

A. If fatigue occurs, stop taking beta blockers B. Limit fluid intake to 1000 mL per day C. Monitor weights daily D. Limit strenuous physical activity

Correct Answer is D

Explanation

A. If fatigue occurs, stop taking beta blockers: Fatigue can be a common side effect of beta blockers, but the nurse should not recommend stopping the medication without consulting the healthcare provider. Abruptly discontinuing beta blockers can worsen symptoms.

B. Limit fluid intake to 1000 mL per day: Limiting fluid intake to 1000 mL per day is not a standard for hypertrophic cardiomyopathy unless signs of fluid retention are present. Fluid restriction should be based on the client’s condition and any co-existing issues like heart failure.

C. Monitor weights daily: Monitoring daily weights is important for assessing fluid retention, but it is not the most crucial teaching point for hypertrophic cardiomyopathy. The primary concern is managing symptoms and avoiding strenuous activity.

D. Limit strenuous physical activity: Limiting strenuous physical activity is essential for clients with hypertrophic cardiomyopathy. Intense exercise can increase the risk of arrhythmias and sudden cardiac arrest. The client should avoid activities that strain the heart.

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The nurse should question which of the written medical prescriptions for the client admitted to the emergency department with a major burn?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which of the following are clinical manifestations for thyroid cancer? Select all that apply

Correct Answer is ["A","C","D"]

Explanation

Which information should the nurse include in the teaching plan for a client who has hypertrophic cardiomyopathy?

Correct Answer is D

Explanation

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