Nokea
The nurse sees that Mr. B (bladder cancer) has received docusate for the past 2 days. Which question is the nurse most likely to ask to evaluate the effectiveness of the docusate?
- A. "Are you experiencing any burning with urination?"
- B. "Did you have a bowel movement today or yesterday?"
- C. "Has the medication helped to relieve the nausea?"
- D. "Were you able to sleep soundly the last couple of nights?"
Correct Answer: B
Rationale: The correct answer is B. Docusate is a stool softener commonly used to prevent constipation, which is a common side effect of opioid pain medications. By asking if the patient had a bowel movement today or yesterday, the nurse can evaluate the effectiveness of docusate in facilitating bowel movements. This question directly assesses the expected outcome of the medication.
A: "Are you experiencing any burning with urination?" - This question is more relevant to urinary tract infections, not related to docusate use for constipation.
C: "Has the medication helped to relieve the nausea?" - Docusate is not typically used to relieve nausea, so this question is not relevant to evaluating its effectiveness.
D: "Were you able to sleep soundly the last couple of nights?" - This question is not directly related to the expected outcome of docusate in treating constipation.
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The nurse provides care to a client from Nigeria who is visiting the United States. Which should the nurse use to communicate with this client?
- A. Review the predominant health beliefs of the Nigerian population.
- B. Appraise the client's health beliefs and behaviors with a cultural assessment.
- C. Consult with other nurses who have taken care of clients from other countries.
- D. Use standard communication techniques to establish a helping relationship.
Correct Answer: B
Rationale: The correct answer is B because conducting a cultural assessment allows the nurse to understand the client's individual health beliefs and behaviors. This approach promotes culturally competent care by tailoring interventions to the client's specific needs. Option A is incorrect as it assumes all Nigerians have the same health beliefs. Option C is not necessary as the nurse can directly assess the client. Option D does not consider the importance of cultural competence in communication. Conducting a cultural assessment ensures effective communication and respectful care.
The nurse is reviewing Mr. N's (non-Hodgkin lymphoma) medication administration record and sees that the combination therapy aprepitant, dexamethasone, and ondansetron was administered during the last shift. What is the nurse most likely to ask to determine efficacy of the therapy?
- A. "On a scale of 1 to 10, with 1 being the least and 10 being the worst, what number is your pain? Where is the pain located?"
- B. "Have the medications improved your appetite? Are there special foods that you would prefer?"
- C. "Are you having any feelings of nausea right now? When was the last time you vomited?"
- D. "After taking the medications, have you experienced any improvement in your energy level? Do you feel fatigued?"
Correct Answer: C
Rationale: The correct answer is C. The nurse would ask about feelings of nausea and vomiting to determine the efficacy of the antiemetic therapy. Nausea and vomiting are common side effects of chemotherapy, which Mr. N would receive for non-Hodgkin lymphoma. Improvement in these symptoms indicates the effectiveness of the antiemetic regimen. Choices A, B, and D are not directly related to the medications administered and would not provide valuable information on the efficacy of the therapy for managing chemotherapy-induced nausea and vomiting. Option A focuses on pain assessment, B on appetite and food preferences, and D on energy levels and fatigue, which are not the primary outcomes to evaluate in this context.
A patient asks the nurse to make a decision for her about whether or not to continue taking hormone replacement therapy (estrogen). Which response by the nurse is most appropriate?
- A. "You should check with a doctor; I cannot give you advice about drugs."
- B. "My friend has taken estrogen for more than 5 years without any problems."
- C. "I can answer any questions you have but it is up to you to make this decision."
- D. "Herbal supplements were much better for me than prescription-strength estrogen."
Correct Answer: C
Rationale: The correct answer is C because it emphasizes patient autonomy and informed decision-making, aligning with ethical principles. The nurse should not make decisions for the patient but should provide information and support. Choice A deflects responsibility and does not empower the patient. Choice B is anecdotal and not a reliable source of information. Choice D is not relevant to the patient's question and could potentially lead to misinformation. Ultimately, choice C encourages the patient to take an active role in their healthcare decisions, which promotes patient-centered care.
The nurse discusses smoking cessation with a client. Which action, if taken by the nurse, would most likely result in a behavior change?
- A. The nurse should advise the client to contact the national telephone quitline.
- B. The nurse should recommend nicotine replacement and behavioral interventions.
- C. The nurse should collaborate with the client to develop an individualized plan of action.
- D. The nurse should implement a strategy that has been validated by research.
Correct Answer: C
Rationale: The correct answer is C: The nurse should collaborate with the client to develop an individualized plan of action. This is the most likely action to result in a behavior change because it involves actively involving the client in the process, taking into account their unique needs, preferences, and circumstances. By collaborating with the client, the nurse can tailor the smoking cessation plan to be more personalized and therefore more effective.
Choice A (contact the national telephone quitline) may be helpful but lacks individualization. Choice B (recommend nicotine replacement and behavioral interventions) is a good approach but may not address the client's specific needs. Choice D (implement a strategy validated by research) is important but may not be as effective if it does not consider the client's individual factors. Overall, choice C is the best option as it promotes client engagement and customization for a higher chance of successful behavior change.
A patient states, "I'm so worried that I might have cancer." The nurse responds, "It is time for you to eat breakfast." The nurse's response is an example of:
- A. using clichés.
- B. judgmental response.
- C. changing the subject.
- D. giving false reassurance. Changing the subject is a block to effective communication in which the patient is deprived of the chance to verbalize concerns.
Correct Answer: C
Rationale: The correct answer is C: changing the subject. The nurse's response shifts the conversation away from the patient's expression of worry about having cancer to a completely unrelated topic - eating breakfast. This technique blocks effective communication as it disregards the patient's concerns and prevents further exploration of the underlying issue. By redirecting the conversation, the nurse fails to address the patient's emotional needs and misses an opportunity to provide support and reassurance. Choices A, B, and D are incorrect as they do not accurately reflect the nurse's response in this scenario.