Which actions by the nurse are examples of independent nursing interventions for a postoperative patient? (Select all that apply).

Switching the patient’s injected pain medication to oral tablets before discharge.

Elevating the head of the patient’s bed to facilitate use of the incentive spirometer.

Administering intravenous fluids when the patient is unable to eat or drink.

Advancing a patient’s diet from clear liquids to solid foods after surgery.

Teaching patients with heart failure how to do accurate daily weights.

Answer and Explanation

Correct Answer : A,B,D,E

Choice A reason: This is a correct choice because switching the patient’s injected pain medication to oral tablets before discharge is an example of an independent nursing intervention. An independent nursing intervention is an action that the nurse can perform based on their own knowledge, skills, and judgment without a physician's order. The nurse can decide when to switch the route of administration of the pain medication based on the patient's condition, preference, and readiness for discharge.

Choice B reason: This is a correct choice because elevating the head of the patient’s bed to facilitate use of the incentive spirometer is an example of an independent nursing intervention. An independent nursing intervention is an action that the nurse can perform based on their own knowledge, skills, and judgment without a physician's order. The nurse can adjust the position of the patient's bed to promote lung expansion and prevent atelectasis, which are common postoperative complications.

Choice C reason: This is an incorrect choice because administering intravenous fluids when the patient is unable to eat or drink is an example of a dependent nursing intervention. A dependent nursing intervention is an action that the nurse can perform only with a physician's order. The nurse cannot give any intravenous fluids to the patient without a prescription.

Choice D reason: This is a correct choice because advancing a patient’s diet from clear liquids to solid foods after surgery is an example of an independent nursing intervention. An independent nursing intervention is an action that the nurse can perform based on their own knowledge, skills, and judgment without a physician's order. The nurse can progress the patient's diet based on the patient's tolerance, appetite, and bowel function.

Choice E reason: This is a correct choice because teaching patients with heart failure how to do accurate daily weights is an example of an independent nursing intervention. An independent nursing intervention is an action that the nurse can perform based on their own knowledge, skills, and judgment without a physician's order. The nurse can educate the patient about the importance of monitoring their weight and fluid status and document the teaching.

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Correct Answer is B

Explanation

Choice A reason: This is incorrect. Hydromorphone 0.5 mg IV is not the best option for providing consistent control of the patient's chronic pain. Hydromorphone is a potent opioid analgesic that can relieve severe pain, but it has a short duration of action. It is given intravenously, which means it has a rapid onset and peak, but also a rapid decline and elimination. The patient may experience fluctuations in pain relief and need frequent doses.

Choice B reason: This is correct. Fentanyl transdermal patch 25 mcg is the best option for providing consistent control of the patient's chronic pain. Fentanyl is a potent opioid analgesic that can relieve severe pain, but it has a long duration of action. It is given transdermally, which means it is absorbed through the skin and released slowly and steadily into the bloodstream. The patient may experience continuous and stable pain relief and need less frequent doses.

Choice C reason: This is incorrect. Fentanyl oral lozenge 200 mcg is not the best option for providing consistent control of the patient's chronic pain. Fentanyl is a potent opioid analgesic that can relieve severe pain, but it has a short duration of action. It is given orally, which means it has to pass through the digestive system and the liver before reaching the bloodstream. The patient may experience delayed and variable pain relief and need frequent doses.

Choice D reason: This is incorrect. Morphine sulfate liquid 10 mg is not the best option for providing consistent control of the patient's chronic pain. Morphine is a moderate opioid analgesic that can relieve moderate to severe pain, but it has a short duration of action. It is given orally, which means it has to pass through the digestive system and the liver before reaching the bloodstream. The patient may experience delayed and variable pain relief and need frequent doses.

A. The patient follows an organic, low-carbohydrate diet. B. The patient now works in Alaska with extended daylight hours. C. The patient’s job includes many hours of hard labor each day. D. The patient enjoys doing crossword puzzles and reading.

Correct Answer is B

Explanation

Choice A reason: This is an incorrect choice because the patient follows an organic, low-carbohydrate diet is not an assessment finding that indicates to the nurse why the patient is having difficulty sleeping at night. A low-carbohydrate diet may have some benefits for weight loss, blood sugar control, and cardiovascular health, but it does not have a direct impact on the sleep quality or quantity of the patient.

Choice B reason: This is the correct choice because the patient now works in Alaska with extended daylight hours is an assessment finding that indicates to the nurse why the patient is having difficulty sleeping at night. Extended daylight hours can disrupt the circadian rhythm, which is the natural cycle of sleeping and waking that follows a 24-hour pattern. The circadian rhythm is influenced by the exposure to light and dark, and it regulates the production of melatonin, a hormone that promotes sleep. When the daylight hours are longer, the melatonin levels may be lower, and the patient may have trouble falling asleep or staying asleep.

Choice C reason: This is an incorrect choice because the patient’s job includes many hours of hard labor each day is not an assessment finding that indicates to the nurse why the patient is having difficulty sleeping at night. Hard labor may have some effects on the physical and mental health of the patient, but it does not necessarily cause insomnia or poor sleep. In fact, hard labor may increase the need for sleep and rest, and the patient may sleep better after a long day of work.

Choice D reason: This is an incorrect choice because the patient enjoys doing crossword puzzles and reading is not an assessment finding that indicates to the nurse why the patient is having difficulty sleeping at night. Crossword puzzles and reading are hobbies that may stimulate the brain and enhance the cognitive function of the patient, but they do not have a negative effect on the sleep quality or quantity of the patient. However, the nurse should advise the patient to avoid doing these activities close to bedtime, especially if they involve bright screens or lights, as they may interfere with the melatonin production and the sleep onset.

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Which actions by the nurse are examples of independent nursing interventions for a postoperative patient? (Select all that apply).

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which medication order will provide the most consistent control of the patient's chronic pain?

Correct Answer is B

Explanation

Which assessment finding indicates to the nurse why the patient is having difficulty sleeping at night?

Correct Answer is B

Explanation

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