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13. Priority Decision: While the nurse is obtaining a health history for a patient, the patient tells the nurse that he uses a number of herbs to maintain his health. What is the most important thing the nurse can do to address the patient’s use of these products?
- A. Ask the patient what effects the various products have.
- B. Have a working knowledge of commonly used herbs and dietary supplements.
- C. Reassure the patient that the products can continue to be used with conventional therapies.
- D. Warn the patient that there is limited research on the therapeutic and harmful effects of herbal products.
Correct Answer: B
Rationale: Having a working knowledge of commonly used herbs and dietary supplements (option B) allows the nurse to provide informed guidance and identify potential interactions.
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A patient with chronic cancer-related pain has started using MS Contin for pain control and has developed common side effects of the drug. The nurse reassures the patient that tolerance will develop to most of these side effects but that continued treatment will most likely be required for what?
- A. Pruritus
- B. Constipation
- C. Dizziness
- D. Nausea and vomiting
Correct Answer: B
Rationale: The correct answer is B. Constipation is a persistent side effect of opioids.
When is role playing best used as a teaching strategy (select all that apply)?
- A. To rehearse behaviors or feelings
- B. With mature and confident participants
- C. To teach motor skills or procedures to patients
- D. To provide patients and caregivers basic information
Correct Answer: A
Rationale: The correct answers are 'To rehearse behaviors or feelings,' 'With mature and confident participants,' and 'In combination with almost any other teaching strategy.' Role-playing is most effective when used to practice behaviors or feelings and when combined with other strategies. It is less suitable for teaching motor skills or providing basic information.
Which medication is a nonamphetamine wake-promotion drug?
- A. Modafinil (Provigil)
- B. Protriptyline (Vavactil)
- C. Desipramine (Norpramin)
- D. Methylphenidate (Concerta)
Correct Answer: A
Rationale: The correct answer is A. Modafinil is a wake-promoting agent used for conditions like narcolepsy. Protriptyline (B) and Desipramine (C) are tricyclic antidepressants, while Methylphenidate (D) is a stimulant.
Which finding on assessment supports the nursing diagnosis Decreased Cardiac Output related to decreased plasma volume?
- A. Flattened neck veins when client is in supine position
- B. Full and bounding pedal and post-tibial pulses
- C. Pitting edema located in feet ankles and calves
- D. Shallow respirations with crackles on auscultation
Correct Answer: A
Rationale: Flattened neck veins in the supine position indicate reduced venous return due to decreased plasma volume, which supports the diagnosis of Decreased Cardiac Output.
Tom is diagnosed with an aortic aneurysm. He asks why this did not show up on his annual physical examination. You respond by saying
- A. It did show and your physician did not want to alarm you.
- B. You probably do not remember that your physician told you about your condition.
- C. Aortic aneurysms are asymptomatic.
- D. Aortic aneurysms are always symptomatic.
Correct Answer: C
Rationale: Aortic aneurysms often do not present symptoms until they become large or rupture.