PrepU Teaching/Learning Flashcards
A nurse teaches a client with angina pectoris 3 sublingual nitroglycerin tablets at 5-minute intervals should be taken, and ot immediately notify provider if chest pain doesn’t subside within 15 minutes. What symptoms may the client experience after taking nitroglycerin?
A. Nausea, vomiting, depression, fatigue, impotence
B. Flushing, dizziness, headache, and pedal edema
C. Sedation, nausea, vomiting, constipation, and resp. depression
D. Headache, hypotension, dizziness and flushing
D. nitroglycerin is a vasodilator. Vasodilators, beta-adrenergic blockers, and calcium channel blockers are 3 major classes of drugs used to treat angina pectoris.
-Nausea, vomiting, depression, fatigue, and impotence are adverse effects of propranolol, a beta-adrenergic blocker.
-Sedation, nausea, vomiting, constipation, and resp. depression are common adverse effects of morphine, an opioid analgesic that relieves pain associated with acute myocardial infarction.
-Flushing, dizziness, headache, and pedal edema are common adverse effects of nifedipine, a calcium channel blocker.
The nurse is administering a new medication to an elderly male client and begins instruction about the medication. The client states, “Tell my wife. She takes care of all this kind of stuff.” The nurse replies:
A. It is necessary that you learn about this medication.
B. I will print out some information for you to give to your wife.
C. When your wife comes to visit, I will return and provide the information to both of you.
C. Family members should be involved in teaching session when possible/appropriate. The client is giving permission with his statement to include his spouse.
A nurse caring for a veteran with musculoskeletal pain (MSP) is assisting the family to understand the requirements and demands placed on our military service members and veterans. Which statement acknowledges a truth about this population?
A. Ongoing physical tasks and strength bearing demands pain endurance.
B. Service members who require analgesic are discharged.
C. Military members are expected to be fit, strong, and healthy.
A. MSP is caused by injuries/disorders of the joints, muscles, tendons, or ligaments to the bones, muscles, nerves, and/or connective tissue. Combat injuries (polytrauma, blast injuries) and noncombat injuries (muscle strain, overuse) can lead to chronic MSP.
-Reviews of incidence, prevalence, and risk factors for MSP and headaches in active duty showed that inflammation and pain from overuse comprised the largest proportion of injury (82% of all nondeployed military personnel). Risk was highest among active duty, female, Army, enlisted personnel, and those with greater time in a motor vehicle. For veterans who sustained a TBI, 92% reported headaches.
-Ongoing physical tasks, activities, and strength bearing demands require service members to coalesce and serve their unit to accomplish the mission, often done under duress that cannot be avoided and mandates enduring pain.
-“Apparently” surgeries, procedures, and medications of all types are prescribed as needed and do not necessitate a medical discharge from the military because of this need. (?)
The nurse is teaching an elderly client about heart failure. What action with the nurse take to enhance learning?
A. Sit in a chair a few feet away from the client.
B. Look at notes to make sure all important information has been covered.
C. Frequently repeat the provided information
D. Cover all information in one session.
C. Effective teaching strategies for older adults includes frequent repetition of information.
-Giving small amounts of information in multiples session is most effective for learning.
-The nurse needs to look at the client rather than notes to assist the client with speech reading.
Which statement, if made y an adolescent preparing for abdominal surgery, would indicate to the nurse that the client requires additional instruction?
A. The better I eat before surgery, the more likely I will heal.
B. Eating a lot of vitamin C and Protein will help me to heal.
C. The surgery may make me feel nauseas
D. After this fasting, I am looking forward to a hamburger and fries once I wake up.
D. Progressive dietary intake is ordered after surgery depending on the client’s recovery. In most cases, this progresses from clear fluids to full fluids to diet as tolerated. For this reason, a burger and fries would be contraindicated immediately after surgery. All other statements are accurate.
When the nurse gives a client and family instructions after laryngeal surgery, which does the nurse indicate should be avoided?
A. Wearing a scarf over the stoma
B. coughing
C. Taking handheld showers
D. Swimming
D. Water should never enter the stoma because it will flow from the trachea to the lungs. The client can wear a scarf over the stoma and encourages the client to cough every 2 hours to promote effective gas exchange.
The nurse is caring for a client with Raynaud’s disease. What are important instructions for a client who is diagnosed with this disease to prevent an attack?
A. Avoid fatty foods and exercise
B. Avoid situations that contribute to ischemic episodes
C. Report any changes in pain other than the usual pain patterns
D. Take over-the-counter decongestants
B.
-Reporting changes in pain patterns and avoiding fatty foods and exercise does not help attack avoidance, rather more relative for a client with CAD. Clients with Raynaud’s disease should avoid over-the-counter decongestants.
The nurse is caring for a 7-year-old child new to insulin therapy. Which intervention(s) is appropriate to use with a 7-year-old child? SATA
A. Use concise and concrete terms when instructing
B. Allow clients to make choices in relation to care
C. Have a parent do a return demonstration of insulin administration.
D. Provide a doll for the client to give a shot with a needleless syringe
E. Encourage the client to stop extracurricular activities at school for the first few months.
All but E. Participation is encouraged so the child should be given choices as much as possible. Practicing on a doll may give the client confidence before giving themselves injections. The parent will need to supervise the child so the parent must know what to do. Keep routine as normal as possible to encourage a normal life and better adjustment.
Example of community-oriented nurse?
Nurse working a booth at a health fair performing blood pressure and glucose screenings.
-Community-oriented nursing targets improving the health status of groups of clients or individuals in the community.
-Community-based nursing is directed towards individuals and families with needs related to illness, injury or disability.
The nurse is working with a mother whose unborn child was diagnosed with Down syndrome. The nurse explains to the mother that Down syndrome occurs as a result of which genetic issue?
Chromosome nondisjunction: when a pair of chromosomes fails to separate completely (nondisjunction), the resulting sperm or oocyte contains two copies or no copy of a particular chromosome. This can result in a fertilized egg having trisomy 21, or Down syndrome.
Postoperatively, a client with a radical neck dissection should be placed in which position?
A. Side-lying
B. Fowler
C. Prone
D. Supine
B. Facilitates breathing and promotes comfort. Expands the lungs because the diaphragm is pulled downward and the abdominal viscera are pulled away from the lungs.
A client with an IUD is at increased risk of systemic infection, which would present with?
declining vital signs, high fever, chills, and weakness.
Vaginal discharge and lower abdominal tenderness suggest what disease?
pelvic inflammatory disease.
A nurse is teaching the client about the causes of fast heart rates. What client statement indicates the client requires more teaching?
A. I will take my levothyroxine daily.
B. I will drink coffee with only two of my meals.
C. Taking metoprolol will help me regulate my heart rate.
B.
Which may occur if a client experiences compartment syndrom in an upper extremity?
A. subluxation
B. callus
C. volkmann’s contracture
D. whiplash injury
C. Volkmann’s contracture, a claw-like deformity of the hand resulting from obstructed arterial blood flow to the forearm and hand.
-Whiplash injury is a cervical spine sprain.
Callus refers to healing mass that occurs with true bone formation after a fracture.
-Subluxation refers to a partial dislocation.
Donepezil hydrochloride prescribed for Alheimer’s disease should include what statement in teaching?
The drug helps to control the symptoms of the disease. It is a cholinesterase inhibitor used to control symptoms. It does not cure or slow progression.
Cognitive ability typically improves within 6-12 months of therapy, but if stopped, cognitive progression occurs. It is recommended that treatment continue at least through the moderate stage of illness. However, it is usually not prescribed as life-long therapy.
The Post Anesthesia Care Unit (PACU) for a hemorrhoidectomy. What would the nurse discuss in the discharge plan?
The client should expect pain with bowel movements and begin stool softeners in the post-operative period.
What is the key clinical manifestation of internal hemorrhoids?
bleeding.
What is a key characteristic of extern hemorrhoids?
Itching, difficult to clean rectal area
When is pain experienced after a hemorrhoidectomy?
The first bowel movement is the most difficult and painful. Pain can persist for up to 3 weeks post surgery as the area heals. Opiates may be prescribed for the first couple of days after surgery, then over-the-counter medications should suffice.
What teachings can aid the client in bowel movement ease after hemorrhoidectomy
-High fiber diet, low carbohydrate, and increase fluid intake. Laxatives and stool softeners are commonly prescribed. Incompetence may occur while healing, however, diarrhea may indicate too much laxatives than recommended.
A client reports after a back massage that his lower back pain has decreased from 8 to 3 on the pain scale. What opioid neuromodulator may be responsible for this increased level of comfort?
Release of endorphins and enkephalins- have prolonged analgesic effects and produces euphoria.
What symptom is a common symptom associated with a diagnosis of mild cognitive impairment and later, dementia, with a gradual loss or inability to use coordinated and purposeful movement to complete tasks? Tasks that have been done repeatedly throughout the client’s life such as tying shoes, getting dressed, or feeding themselves?
Apraxia
