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A Hispanic patient is visited by several family members and the nurse witnessed one visitor who pinches a piece of skin at the waist. The nurse asks the purpose and learns the "provider" is listening for a snap from the abdominal region, which is then repeated several times. The patient most likely suffers from:
- A. mal ojo.
- B. susto.
- C. bilis.
- D. empacho.
Correct Answer: D
Rationale: The correct answer is D: empacho. Empacho is a traditional Hispanic folk illness characterized by a blockage in the digestive system. In this scenario, the behavior of pinching the skin and listening for a snap in the abdominal region aligns with the common practice associated with empacho diagnosis. The family member is likely trying to detect an abnormal sound, indicating a blockage in the intestines. The other choices (A: mal ojo, B: susto, C: bilis) do not fit the description of the observed behavior and symptoms. Mal ojo refers to the evil eye, susto is a fright-related illness, and bilis pertains to an imbalance of bodily fluids, none of which involve the specific diagnostic behavior described in the scenario.
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The nurse is demonstrating active listening when:
- A. while assessing the patient's vital signs, the nurse records the data and states, "You are improving, your vital signs are normal."
- B. eye contact is maintained while focusing on the patient as the patient describes the current pain level and location.
- C. he or she states, "I know how you feel, I recently lost my father and I am still hurting."
- D. cultural values are in opposition to the patient but shares that "I agree with your decision to use herbs rather than the prescribed medications."
Correct Answer: B
Rationale: The correct answer is B because maintaining eye contact while focusing on the patient's description of pain level and location demonstrates active listening. This non-verbal communication shows empathy and attentiveness to the patient's concerns. Choice A focuses on providing information rather than actively listening. Choice C involves personalizing the situation rather than focusing on the patient's needs. Choice D involves agreeing with the patient's decision rather than actively listening to understand their perspective.
The nurse prepares to apply sterile gloves needed for a procedure. After introducing self and verifying patient information, the nurse performs hand hygiene. The nurse should open the outer package and then perform steps in which order. Put a comma and space between each answer choice (e.g., a, b, c, d).
- A. Open inner package, taking care not to touch inner surface.
- B. Put the glove on the nondominant hand using the sterile gloved hand.
- C. Put glove on dominant hand by grasping folded cuff edge, touching only inside of cuff.
- D. Adjust each glove carefully by sliding finders under the cuff.
Correct Answer: A
Rationale: The correct order is to first open the outer package to access the inner package containing the gloves. This ensures that the gloves remain sterile until they are needed. Opening the inner package first would expose the gloves to potential contamination. Putting on the gloves should be done after opening the inner package, starting with the nondominant hand to prevent contamination. Adjusting the gloves carefully should be the final step after both gloves are on to ensure a proper fit. Therefore, choice A is correct as it establishes the correct sequence for maintaining sterility throughout the process.
A nurse caring for a patient with anemia and heart failure prepares to hang a unit of packed red blood cells and realizes her break is in 5 minutes. She decides it is not necessary to have another nurse check the blood against the patient's information since the patient's blood type is O+ which she incorrectly remembered to be the universal donor. She hangs the blood, noting the patient is "reading and vital signs normal." She leaves the floor for her break and does not report leaving or ask anyone to perform required vital signs. Upon returning she meets a family friend who is visiting and time "just flies." She returns to the patient's room after admitting a new patient. The patient is hypotensive and color is cyanotic and anxious. She reports the findings to the charge nurse, who then contacts the physician. A blood reaction occurrence is noted. The nurse providing care is charged:
- A. with comparative negligence.
- B. with a preventable adverse event.
- C. with criminal negligence.
- D. under the doctrine of res ipsa loquitur.
Correct Answer: C
Rationale: The correct answer is C: with criminal negligence. The nurse displayed a reckless disregard for the patient's safety by not verifying the blood type, leaving for an extended break without ensuring proper monitoring, and failing to report her absence. These actions were highly irresponsible and demonstrated a severe lack of care and attention to the patient's well-being. Criminal negligence involves a conscious disregard for the consequences of one's actions, which in this case resulted in a serious adverse event for the patient. Choices A and B do not fully capture the gravity of the nurse's actions, as they imply a lesser degree of fault. Choice D, under the doctrine of res ipsa loquitur, would be inappropriate in this scenario as the nurse's actions directly contributed to the adverse outcome.
Nurses and community officials are working together to ensure that churches and schools have needed supplies to provide shelter for large numbers of individuals in the event of a natural or manmade disaster. These activities represent which phase of a disaster continuum?
- A. Preparedness
- B. Relief response
- C. Recovery
- D. Crisis intervention
Correct Answer: A
Rationale: The correct answer is A: Preparedness. In this scenario, nurses and community officials are proactively planning and organizing resources to be ready for a disaster. Preparedness involves activities such as training, drills, and stockpiling supplies to ensure an effective response. Relief response (B) occurs during or immediately after a disaster to provide immediate assistance. Recovery (C) focuses on restoring community infrastructure and services post-disaster. Crisis intervention (D) is a short-term, immediate response to individuals in distress. In this case, the focus is on prevention and readiness, fitting the preparedness phase.
A public health nurse is interested in determining which educational programs are needed in the aggregates served. The researcher personally interviews individuals who are walking on the streets in the community. This type of research design is:
- A. quasi-experimental.
- B. survey.
- C. case study.
- D. ethnography.
Correct Answer: B
Rationale: The correct answer is B: survey. In this scenario, the nurse is conducting personal interviews with individuals to gather information about educational program needs. Surveys involve collecting data from a sample of individuals through questioning, making it suitable for this situation.
A: Quasi-experimental designs involve manipulation of variables and comparison of groups, which is not evident in this scenario.
C: Case studies focus on in-depth analysis of a single case or a small group, not the entire community as in this case.
D: Ethnography involves studying a group's culture and behavior over an extended period, which is not the main focus of the nurse's research.