Nokea
A patient arrives to the clinic 2 hours late for her prenatal appointment. This is the third time she has been late. What is the nurse’s best action in response to this patient’s tardiness?
- A. Ask the patient if she has a way to tell the time.
- B. Ask the patient if she is deliberately being late for her appointments.
- C. Determine if the patient wants this baby and if this is her way of acting out.
- D. Determine if the patient arrives after the start time for other types of appointments.
Correct Answer: C
Rationale: The nurse's best action in response to the patient's tardiness is to determine if the patient wants this baby and if this is her way of acting out. Tardiness to prenatal appointments can sometimes indicate underlying issues such as ambivalence towards the pregnancy or emotional distress. By addressing the patient's motivation for being consistently late, the nurse can better understand and support her needs. This approach allows for a more patient-centered and compassionate response, aiming to address any possible concerns or challenges the patient may be facing.
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A nurse is admitting a patient to the labor and birth unit in early labor that was sent to the facility following a checkup with her health care provider in the office. The patient is a gravida 1, para 0, and is at term. No health issues are discerned from the initial assessment, and the nurse prepares to initiate physician orders based on standard procedures. Which action by the nurse manager is warranted in this situation?
- A. No action is indicated because the nurse is acting within the scope of practice.
- B. The nurse manager should intervene and ask the nurse to clarify admission orders directly with the physician.
- C. The nurse manager should review standard procedures with the nurse to validate that orders are being carried out accurately.
- D. The nurse manger should review the admission procedure with the nurse.
Correct Answer: B
Rationale: In this scenario, the nurse is admitting a patient based on orders initiated by the physician during an office visit. Given that the patient is in early labor and has no discernible health issues, the nurse manager should intervene and ask the nurse to clarify the admission orders directly with the physician. It is important to ensure clarity and accuracy when carrying out physician orders, especially in situations where there may be ambiguity or room for misinterpretation. By verifying the orders with the physician, the nurse can help prevent any potential errors or miscommunications that may impact the patient's care.
A 48-year-old female patient presents to the OB/GYN clinic for her annual examination. She states that she has had the following symptoms: mood swings, irregular menstrual cycles, forgetfulness, food cravings, and a decrease in libido. Which of the following does the nurse suspect the patient is experiencing?
- A. Menopause
- B. Perimenopause
- C. Postmenopause
- D. Pregnancy
Correct Answer: B
Rationale: Perimenopause is the transitional period leading to menopause that usually begins in a woman's 40s but can start earlier. During this phase, women may experience symptoms such as mood swings, irregular menstrual cycles, forgetfulness, food cravings, and a decrease in libido, as described by the patient in this case. These symptoms are caused by hormonal fluctuations as the ovaries start to produce less estrogen in preparation for menopause. Menopause occurs when a woman has not had a menstrual period for 12 consecutive months. Postmenopause, on the other hand, refers to the stage after menopause, where menopausal symptoms have generally subsided. The symptoms described by the patient are more indicative of the perimenopausal stage rather than pregnancy, as they are typical signs of hormonal changes associated with the menopausal transition.
The telephone triage nurse receives a call from a patient who is 5 days postoperative total
abdominal hysterectomy. The patient states that her pain is not relieved with the medications and
that she has noticed blood in her urine. The nurse instructs the patient to report immediately to the
emergency department. What does the nurse suspect as the surgical complication?
- A. Possible complication related to the anesthesia
- B. Possible injury to the ureters or bladder
- C. Possible hemorrhage from the internal incision
- D. Possible peritoneal venous thromboembolism
Correct Answer: D
Rationale: In this situation where the patient is 5 days postoperative total abdominal hysterectomy and experiencing pain that is not relieved with medications, the nurse should suspect a possible hemorrhage from the internal incision. Although some pain is expected postoperatively, severe or worsening pain that is not relieved with medications can indicate a complication such as internal bleeding. Immediate medical attention is needed to assess and manage any potential hemorrhage to prevent further complications or adverse outcomes. Other signs of internal bleeding may include symptoms such as increasing abdominal distention, tachycardia, hypotension, and signs of shock.
A nurse is admitting a patient to the labor and birth unit in early labor that was sent to the facility following a checkup with her health care provider in the office. The patient is a gravida 1, para 0, and is at term. No health issues are discerned from the initial assessment, and the nurse prepares to initiate physician orders based on standard procedures. Which action by the nurse manager is warranted in this situation?
- A. No action is indicated because the nurse is acting within the scope of practice.
- B. The nurse manager should intervene and ask the nurse to clarify admission orders directly with the physician.
- C. The nurse manager should review standard procedures with the nurse to validate that orders are being carried out accurately.
- D. The nurse manger should review the admission procedure with the nurse.
Correct Answer: B
Rationale: In this scenario, the nurse is admitting a patient based on orders initiated by the physician during an office visit. Given that the patient is in early labor and has no discernible health issues, the nurse manager should intervene and ask the nurse to clarify the admission orders directly with the physician. It is important to ensure clarity and accuracy when carrying out physician orders, especially in situations where there may be ambiguity or room for misinterpretation. By verifying the orders with the physician, the nurse can help prevent any potential errors or miscommunications that may impact the patient's care.
Which of the following statements highlights the nurse’s role as a researcher?
- A. Reading peer-reviewed journal articles
- B. Working as a member of the interdisciplinary team to provide patient care
- C. Helping patient to obtain home care postdischarge from the hospital
- D. Delegating tasks to unlicensed personnel to allow for more teaching time with patients
Correct Answer: A
Rationale: Reading peer-reviewed journal articles highlights the nurse's role as a researcher because it involves staying current with the latest evidence-based practices, advancements in healthcare, and research findings. Nurses who engage in reading such articles are able to enhance their knowledge, critical thinking skills, and decision-making abilities, which are crucial aspects of conducting research and applying research findings to patient care. By continuously educating themselves through reviewing peer-reviewed literature, nurses contribute to the advancement of nursing practice and further research in the field.