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A 52-year-old woman has just been told she has breast cancer and is scheduled for a modified mastectomy the following week. The nurse caring for this patient knows that she is anxious and fearful about the upcoming procedure and the newly diagnosed malignancy. How can the nurse most likely alleviate this patients fears?
- A. Provide written material on the procedure that has been scheduled for the patient.
- B. Provide the patient with relevant information about expected recovery.
- C. Give the patient current information on breast cancer survival rates.
- D. Offer the patient alternative treatment options.
Correct Answer: B
Rationale: The correct answer is B: Provide the patient with relevant information about expected recovery. This option addresses the patient's anxiety by providing her with concrete information about what to expect after the procedure. By knowing the expected recovery process, the patient can feel more in control and prepared, which can help alleviate fears.
Summary:
A: Providing written material on the procedure does not directly address the patient's fears about the upcoming surgery and cancer diagnosis.
C: Giving the patient current information on breast cancer survival rates may increase anxiety rather than alleviate it, as it focuses on statistics rather than the individual patient's concerns.
D: Offering alternative treatment options may not be appropriate at this stage when the patient is already scheduled for a modified mastectomy. It may add confusion and further anxiety.
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When teaching patients about the risk factors of cervical cancer, what would the nurse identify as the most important risk factor?
- A. Late childbearing
- B. Human papillomavirus (HPV)
- C. Postmenopausal bleeding
- D. Tobacco use
Correct Answer: B
Rationale: The correct answer is B: Human papillomavirus (HPV). HPV is the most important risk factor for cervical cancer as it is responsible for almost all cases. Step 1: HPV infection can lead to changes in cervical cells, increasing the risk of cancer. Step 2: Early detection and vaccination against HPV can prevent cervical cancer. Step 3: Other factors like late childbearing, postmenopausal bleeding, and tobacco use may be associated with increased risk but are not as directly linked to cervical cancer development.
The nurse is providing discharge education to an adult patient who will begin a regimen of ocular medications for the treatment of glaucoma. How can the nurse best determine if the patient is able to self-administer these medications safely and effectively?
- A. Assess the patient for any previous inability to self-manage medications.
- B. Ask the patient to demonstrate the instillation of her medications.
- C. Determine whether the patient can accurately describe the appropriate method of administering her medications.
- D. Assess the patients functional status.
Correct Answer: B
Rationale: The correct answer is B. By asking the patient to demonstrate the instillation of medications, the nurse can directly assess the patient's ability to self-administer the medications safely and effectively. This method allows for a practical demonstration of skills, which is more reliable than relying solely on verbal descriptions or past experiences. Choices A, C, and D are incorrect because assessing for previous inability, describing the method, or evaluating functional status may not directly demonstrate the patient's competency in self-administering ocular medications.
A patient has been prescribed sildenafil. What should the nurse teach the patient about this medication?
- A. Sexual stimulation is not needed to obtain an erection.
- B. The drug should be taken 1 hour prior to intercourse.
- C. Facial flushing or headache should be reported to the physician immediately.
- D. The drug has the potential to cause permanent visual changes.
Correct Answer: A
Rationale: The correct answer is A because sildenafil works by enhancing the effects of nitric oxide, which is released during sexual stimulation to relax the muscles in the penis and increase blood flow for an erection. Therefore, sexual stimulation is necessary for the medication to be effective.
Explanation of other choices:
B: While sildenafil is typically taken 30 minutes to 4 hours before sexual activity, it does not need to be exactly 1 hour prior.
C: Facial flushing and headache are common side effects of sildenafil but do not require immediate reporting unless severe or persistent.
D: Sildenafil may cause temporary visual disturbances like changes in color vision, but permanent visual changes are rare.
A patient with a diagnosis of gastric cancer has been unable to tolerate oral food and fluid intake and her tumor location precludes the use of enteral feeding. What intervention should the nurse identify as best meeting this patients nutritional needs?
- A. Administration of parenteral feeds via a peripheral IV
- B. TPN administered via a peripherally inserted central catheter
- C. Insertion of an NG tube for administration of feeds
- D. Maintaining NPO status and IV hydration until treatment completion
Correct Answer: B
Rationale: The correct answer is B: TPN administered via a peripherally inserted central catheter. TPN provides comprehensive nutrition intravenously, bypassing the GI tract, which is important for patients unable to tolerate oral intake. A peripherally inserted central catheter allows for long-term TPN administration.
A: Administration of parenteral feeds via a peripheral IV is not ideal for long-term nutrition as it may not provide complete nutrition.
C: Insertion of an NG tube may not be feasible due to the tumor location and the patient's inability to tolerate oral intake.
D: Maintaining NPO status and IV hydration alone may lead to malnutrition over time as it does not provide adequate nutrition.
A patient was prescribed an oral antibiotic for the treatment of sinusitis. The patient has now stopped, stating she developed a rash shortly after taking the first dose of the drug. What is the nurses most appropriate response?
- A. Encourage the woman to continue with the medication while monitoring her skin condition closely.
- B. Refer the woman to her primary care provider to have the medication changed.
- C. Arrange for the woman to go to the nearest emergency department.
- D. Encourage the woman to take an OTC antihistamine with each dose of the antibiotic.
Correct Answer: B
Rationale: The correct answer is B: Refer the woman to her primary care provider to have the medication changed.
Rationale:
1. Rash after taking the first dose of an antibiotic suggests a possible allergic reaction.
2. Allergic reactions can range from mild to severe, including anaphylaxis.
3. It is crucial to discontinue the suspected medication to prevent worsening of the reaction.
4. Referring the patient to their primary care provider ensures proper evaluation and management.
5. Changing the medication is necessary to avoid potential harm from continued exposure.
Summary:
A: Continuing the medication can worsen the allergic reaction and is not recommended.
C: Going to the emergency department may be excessive at this point for a mild rash.
D: Taking an antihistamine does not address the underlying issue of an allergic reaction.