Nokea
What is the appropriate nursing response when a patient refuses blood transfusion due to religious beliefs?
- A. Respect the patient's decision and notify the provider
- B. Attempt to persuade the patient to accept the transfusion
- C. Document the refusal and notify the healthcare provider
- D. Provide education on the benefits of blood transfusion
Correct Answer: A
Rationale: The correct answer is A: "Respect the patient's decision and notify the provider." When a patient refuses a blood transfusion due to religious beliefs, it is essential to respect their autonomy and religious beliefs. Attempting to persuade the patient (Choice B) goes against the principle of respect for autonomy and can lead to ethical dilemmas. Documenting the refusal and notifying the healthcare provider (Choice C) is important for legal and ethical purposes but should be preceded by respecting the patient's decision. Providing education on the benefits of blood transfusion (Choice D) may be appropriate in other situations but is not indicated when a patient refuses based on religious beliefs.
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When should healthcare professionals perform hand hygiene?
- A. Before and after patient contact
- B. Before and after performing procedures
- C. After using the restroom
- D. After touching contaminated surfaces
Correct Answer: A
Rationale: Healthcare professionals should perform hand hygiene before and after patient contact to prevent the spread of infections. While choices B, C, and D are also important times to practice hand hygiene, they are not as crucial as before and after patient contact because patient contact poses a higher risk of transmitting infections.
A client is receiving opioid analgesics for pain management. Which of the following assessments is the priority?
- A. Monitor the client's blood pressure.
- B. Check the client's urinary output.
- C. Monitor the client's respiratory rate.
- D. Assess the client's pain level.
Correct Answer: C
Rationale: The correct answer is C: Monitor the client's respiratory rate. When a client is receiving opioid analgesics, the priority assessment is monitoring respiratory rate. Opioids can cause respiratory depression, so it is crucial to assess the client's breathing to detect any signs of respiratory distress promptly. Checking the client's blood pressure (Choice A) and urinary output (Choice B) are important assessments too, but they are not the priority when compared to ensuring adequate respiratory function. Assessing the client's pain level (Choice D) is essential for overall care but is not the priority assessment when the client is on opioids, as respiratory status takes precedence.
A nurse is assessing a client who has chronic obstructive pulmonary disease (COPD). Which of the following findings should the nurse report to the provider?
- A. Oxygen saturation of 91%
- B. Use of pursed-lip breathing
- C. Productive cough with green sputum
- D. Decreased breath sounds in the right lower lobe
Correct Answer: D
Rationale: The correct finding the nurse should report to the provider is decreased breath sounds in the right lower lobe. This can indicate a respiratory infection or atelectasis in clients with COPD, requiring further evaluation and intervention.
Choice A, an oxygen saturation of 91%, although slightly lower than normal, does not necessarily require immediate reporting unless the client's baseline is significantly higher. Choice B, the use of pursed-lip breathing, is actually a beneficial technique for clients with COPD to improve oxygenation and reduce shortness of breath, so it does not need reporting. Choice C, a productive cough with green sputum, can be common in clients with COPD and may indicate an infection, but it is not as concerning as decreased breath sounds in a specific lung lobe which may signify a more acute issue.
A client with schizophrenia is beginning therapy with clozapine. Which statement indicates a need for further teaching?
- A. I will need to have my blood work checked regularly while taking clozapine.
- B. I understand that clozapine may cause me to gain weight.
- C. I should report any signs of a fever while taking clozapine.
- D. I should discontinue clozapine once my symptoms improve.
Correct Answer: D
Rationale: The correct answer is D because clients should continue taking clozapine even if their symptoms improve. Abruptly discontinuing the medication can lead to relapse. Choices A, B, and C are all correct statements regarding clozapine therapy. Regular blood work monitoring is necessary due to potential side effects, weight gain is a common side effect of clozapine, and reporting signs of fever is important as it can indicate a serious side effect of clozapine.
A client is receiving discharge teaching for a new prescription of warfarin. Which statement by the client indicates an understanding of the teaching?
- A. I will need to increase my intake of leafy green vegetables.
- B. I will avoid drinking grapefruit juice while taking warfarin.
- C. I will have my INR checked regularly.
- D. I will take my medication at the same time each day.
Correct Answer: C
Rationale: The correct answer is C. Clients on warfarin therapy need to have their International Normalized Ratio (INR) checked regularly to monitor the medication's effectiveness and prevent complications like clotting or bleeding. Option A is incorrect because increasing leafy green vegetables can affect INR levels due to their vitamin K content. Option B is incorrect as grapefruit juice is not a significant concern with warfarin. Option D is important for medication adherence but does not specifically address the monitoring aspect required for warfarin therapy.