14. Which of these findings indicate that a pump delivering a basal rate of 10 ml per hour, plus PRN for pain breakthrough for a morphine drip, is not working?

A. The client complains of discomfort at the IV insertion site.
B. The client states, "I just can't get relief from my pain."
C. The drug level is 100 ml at 8 AM and 80 ml at noon.
D. The drug level is 100 ml at 8 AM and 50 ml at noon.

15. The nurse is speaking at a community meeting about personal responsibility for health promotion. A participant asks about chiropractic treatment for illnesses. What should be the focus of the nurse's response?

A. Electrical energy fields
B. Spinal column manipulation
C. Mind-body balance
D. Exercise of joints

16. The nurse is performing a neurological assessment on a client post-right CVA. Which finding, if observed by the nurse, would warrant immediate attention?

A. Decrease in level of consciousness
B. Loss of bladder control
C. Altered sensation to stimuli
D. Emotional lability

17. A child recently diagnosed with cystic fibrosis is in a pediatric clinic where a nurse is performing an assessment. Which later finding of this disease would the nurse not expect to see at this time?

A. Positive sweat test
B. Bulky greasy stools
C. Moist, productive cough
D. Meconium ileus

18. The home health nurse visits a male client to provide wound care and finds the client lethargic and confused. His wife states he fell down the stairs 2 hours ago. The nurse should:

A. Place a call to the client's health care provider for instructions.
B. Send him to the emergency room for evaluation.

When analyzing the function of a pump delivering morphine, we aim to identify any signs that might indicate malfunction. Morphine pumps are designed to deliver a continuous (basal) dose of medication and additional doses as needed (PRN) for breakthrough pain. In this context:

A. The client complains of discomfort at the IV insertion site: This likely indicates a local issue with the IV site, such as infiltration, rather than a malfunction in the pump itself.
B. The client states "I just can't get relief from my pain.": This suggests that the pump might not be delivering the correct amount of medication, as the intended relief is not being achieved. This indicates a potential malfunction of the pump.
C. The level of drug is 100 ml at 8 AM and is 80 ml at noon: This shows that the pump is dispensing 20 ml over four hours, equivalent to 5 ml per hour, which is below the intended 10 ml per hour basal rate.
D. The level of the drug is 100 ml at 8 AM and is 50 ml at noon: This indicates the pump is dispensing 50 ml over four hours, or 12.5 ml per hour, which is slightly higher than the 10 ml per hour basal rate but also suggests over-delivery.

The correct option indicating the pump is not working as intended is B. The client states "I just can't get relief from my pain."

Response about chiropractic treatment

Chiropractic care primarily involves the manipulation of the spinal column to alleviate musculoskeletal issues. It aims to relieve pain, improve function, and support the body's natural ability to heal itself. In this context:

The correct focus of response should be B. Spinal column manipulation.

Post right CVA neurological assessment

CVA, or cerebrovascular accident, commonly known as a stroke, can cause a variety of symptoms. Immediate attention is required for life-threatening or significantly deteriorating conditions. In this context:

A. Decrease in level of consciousness: This warrants immediate attention, as it may indicate worsening of the condition or other complications.

Therefore, the finding that warrants immediate attention is A. Decrease in level of consciousness.

Cystic fibrosis assessment

Cystic fibrosis is a genetic disorder affecting the lungs and digestive system. Common initial symptoms include:

A. Positive sweat test
B. Bulky greasy stools
C. Moist, productive cough
D. Meconium ileus: This is a sign of cystic fibrosis that usually presents shortly after birth. If the child is being diagnosed now and did not present with this condition, this symptom would not be expected at this time.

Therefore, the finding not expected now is D. Meconium ileus.

Client with head injury

After a fall or head injury, symptoms like lethargy and confusion can indicate serious issues requiring urgent medical evaluation.

The appropriate action is B. Send him to the emergency room for evaluation, as these symptoms could indicate a possible concussion or other complications from the fall.