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Question 1 of 5.

A 60-year-old female with chronic cancer pain has been receiving opiates for 4 months. She rated her pain as an 8 on a 10-point scale before starting the opioid medication. She has just had a thorough examination with no new evidence of increased disease, yet her pain is close to 8 again. The most likely explanation for her increasing pain is:

A. Development of an addiction to the opioids.

B. Tolerance to the opioid.

C. Withdrawal from the opioid.

D. Placebo effect has decreased.

Explanation: Tolerance to opioids is the most likely explanation, as the body adapts to the medication over time, reducing its effectiveness and requiring a dose adjustment.

Question 2 of 5.

If the client who was admitted for myocardial infarction (MI) develops cardiogenic shock, which characteristic sign should the nurse expect to observe?

A. Oliguria.

B. Bradycardia.

C. Elevated blood pressure.

D. Fever.

Explanation: Cardiogenic shock causes decreased cardiac output, leading to reduced renal perfusion and oliguria (low urine output). Bradycardia, elevated BP, and fever are not typical signs.

Question 3 of 5.

Contraindications to the administration of tissue plasminogen activator (t-PA) include which of the following?

A. Age greater than 60 years.

B. History of cerebral hemorrhage.

C. History of heart failure.

D. Cigarette smoking.

Explanation: A history of cerebral hemorrhage is an absolute contraindication to t-PA due to the risk of bleeding. Age, heart failure, and smoking are not contraindications.

Question 4 of 5.

A client with angina has been taking nifedipine. The nurse should teach the client to:

A. Monitor blood pressure monthly.

B. Perform daily weights.

C. Inspect gums daily.

D. Limit intake of green leafy vegetables.

Explanation: Nifedipine, a calcium channel blocker, can cause gingival hyperplasia. Daily gum inspection helps detect this side effect early.

Question 5 of 5.

A client is scheduled for a cardiac catheterization. The nurse should do which of the following preprocedure tasks? Select all that apply.

A. Administer all ordered oral medications.

B. Check for iodine sensitivity.

C. Verify that written consent has been obtained.

D. Withhold food and oral fluids before the procedure.

E. Insert a urinary drainage catheter.

Explanation: Checking iodine sensitivity (B), verifying consent (C), and withholding food/fluids (D) are standard pre-catheterization tasks to ensure safety and preparedness.

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