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Which patient scenario of a surgical patient in pain is most indicative of critical thinking?

Explaining to the patient that self-reporting of severe pain is not consistent with the minor procedure that was performed.

Asking the patient what pain-relief methods, pharmacological and nonpharmacological approach have worked best in the past?

Administering pain-relief medication according to what was given last shift.

Offering pain-relief medications based on the providers orders.

Answer and Explanation

The Correct Answer is B

A. Explaining to the patient that self-reporting of severe pain is not consistent with the minor procedure that was performed. Pain is subjective and should always be believed and assessed rather than dismissed based on procedure type. This does not demonstrate critical thinking.

B. Asking the patient what pain-relief methods, pharmacological and nonpharmacological, have worked best in the past. This approach assesses the patient’s individual experience and applies personalized care, which is a hallmark of critical thinking.

C. Administering pain-relief medication according to what was given last shift. Pain levels fluctuate, and medication effectiveness must be reassessed each time. Simply repeating the previous shift’s orders does not involve critical thinking.

D. Offering pain-relief medications based on the provider’s orders. While following orders is necessary, critical thinking involves assessing the patient’s pain level and determining the most appropriate intervention rather than blindly administering medication.

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Correct Answer is A

Explanation

A. Report by patient that something has given way: A patient reporting a "giving way" sensation is a classic early sign of dehiscence, indicating that the wound edges are separating.

B. Drainage that is odorous and purulent: Purulent (pus-like) and foul-smelling drainage suggests infection, not necessarily dehiscence. Infection can contribute to dehiscence, but it is not the defining feature.

C. Protrusion of visceral organs through a wound opening: Evisceration occurs when internal organs protrude through the incision. Dehiscence is partial or complete separation of the wound edges without organ protrusion.

D. Chronic drainage of fluid through the incision site: Persistent drainage suggests a fistula (abnormal connection between tissues), infection, or poor wound healing, rather than wound dehiscence.

A. Nonproductive cough B. Drowsiness C. Urinary retention D. Dry mouth E. Skin rash

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

Explanation

A. Nonproductive cough: Diphenhydramine is an antihistamine, not a cough suppressant. It does not cause a nonproductive cough as a side effect.

B. Drowsiness: First-generation antihistamines (like diphenhydramine) cause CNS depression, leading to drowsiness.

C. Urinary retention: Diphenhydramine has anticholinergic effects, which can lead to urinary retention, especially in older adults or those with prostate issues.

D. Dry mouth: Diphenhydramine blocks muscarinic receptors, reducing saliva production and causing dry mouth.

E. Skin rash: Skin rash is not a common adverse effect of diphenhydramine but can be a sign of an allergic reaction.

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Which patient scenario of a surgical patient in pain is most indicative of critical thinking?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which finding will alert the nurse to a potential wound dehiscence?

Correct Answer is A

Explanation

A nurse is teaching a client who has a new prescription for diphenhydramine for allergic rhinitis. The nurse should instruct the client to monitor for which of the following manifestations as an adverse effect of this medication? (Select all that apply.)

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

Explanation

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Which patient scenario of a surgical patient in pain is most indicative of critical thinking?

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