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A medical nurse is providing end-of-life care for a patient with metastatic bone cancer. The nurse notes that the patient has been receiving oral analgesics for her pain with adequate effect, but is now having difficulty swallowing the medication. What should the nurse do?
- A. Request the physician to order analgesics by an alternative route.
- B. Crush the medication in order to aid swallowing and absorption.
- C. Administer the patients medication with the meal tray.
- D. Administer the medication rectally.
Correct Answer: A
Rationale: Correct Answer: A
Rationale:
1. Requesting the physician to order analgesics by an alternative route is the correct choice as the patient is having difficulty swallowing the medication.
2. Alternative routes could include subcutaneous, intravenous, transdermal, or rectal routes to ensure the patient receives adequate pain relief.
3. Crushing the medication (choice B) may alter the absorption rate and effectiveness of the medication.
4. Administering the medication with the meal tray (choice C) may not address the swallowing issue and could lead to inadequate pain relief.
5. Administering the medication rectally (choice D) is not ideal as it may not be the most appropriate route for analgesics in this situation.
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A woman calls the clinic and tells the nurse she has had bloody drainage from her right nipple. The nurse makes an appointment for this patient, expecting the physician or practitioner to order what diagnostic test on this patient?
- A. Breast ultrasound
- B. Radiography
- C. Positron emission testing (PET)
- D. Galactography Chapter 59: Male Reproductive: Terminologies PLISSIT Model, Prostate Cancer, Testicular cancer, BPH & Erectile dysfunction (ED)
Correct Answer: A
Rationale: The correct answer is A: Breast ultrasound. Bloody drainage from the nipple can be indicative of various conditions such as breast cancer. A breast ultrasound is a non-invasive imaging test that can help visualize any abnormalities in the breast tissue, including masses or tumors. It is commonly used to evaluate breast symptoms like nipple discharge. Radiography (B) is not typically used for evaluating breast conditions. Positron emission testing (PET) (C) is more commonly used in cancer staging and may not be the first-line test for this symptom. Galactography (D) is a specific imaging test used to evaluate the ducts of the breast and may not be the initial test for bloody nipple discharge.
A nurse is aware of the need to assess patients risks for anaphylaxis. What health care procedure constitutes the highest risk for anaphylaxis?
- A. Administration of the measles-mumps-rubella (MMR) vaccine
- B. Rapid administration of intravenous fluids
- C. Computed tomography with contrast solution
- D. Administration of nebulized bronchodilators
Correct Answer: C
Rationale: The correct answer is C: Computed tomography with contrast solution. This procedure involves the use of contrast agents that can trigger anaphylaxis due to the patient's allergic reaction to the contrast solution. Contrast solutions contain substances like iodine, which can cause severe allergic reactions in some individuals. Anaphylaxis is a life-threatening allergic reaction that can occur rapidly and requires immediate intervention. Assessing the risk for anaphylaxis during this procedure is crucial to prevent any potential harm to the patient.
Incorrect choices:
A: Administration of the measles-mumps-rubella (MMR) vaccine - While allergic reactions can occur with vaccines, the risk of anaphylaxis with MMR vaccine is lower compared to the contrast solution used in CT scans.
B: Rapid administration of intravenous fluids - Rapid IV fluid administration can cause fluid overload or electrolyte imbalances, but it is not typically associated with triggering anaphylaxis.
D: Administration of nebulized bronchodil
The nurse is discharging a patient home after mastoid surgery. What should the nurse include in discharge teaching?
- A. Try to induce a sneeze every 4 hours to equalize pressure.
- B. Be sure to exercise to reduce fatigue.
- C. Avoid sleeping in a side-lying position.
- D. Dont blow your nose for 2 to 3 weeks.
Correct Answer: D
Rationale: The correct answer is D: "Don't blow your nose for 2 to 3 weeks." After mastoid surgery, blowing the nose can increase pressure in the surgical area and disrupt healing. Here's the rationale:
1. Blowing the nose can increase pressure in the surgical area and lead to complications.
2. Avoiding blowing the nose helps prevent infection and reduces the risk of damaging the surgical site.
3. It is essential to follow this instruction to promote proper healing and reduce the chances of postoperative complications.
In summary, the other choices are incorrect because inducing a sneeze, exercising, and avoiding side-lying position do not directly relate to the specific care needs after mastoid surgery.
A patient requests the nurse’s help to the bedside commode and becomes frustrated when unable to void in front of the nurse. How should the nurse interpret the patient’s inability to void?
- A. The patient can be anxious, making it difficult for abdominal and perineal muscles to relax enough to void.
- B. The patient does not recognize the physiological signals that indicate a need to void.
- C. The patient is lonely, and calling the nurse in under false pretenses is a way to get attention.
- D. The patient is not drinking enough fluids to produce adequate urine output.
Correct Answer: A
Rationale: The correct answer is A: The patient can be anxious, making it difficult for abdominal and perineal muscles to relax enough to void.
Rationale: Anxiety can lead to tension in the abdominal and perineal muscles, inhibiting the ability to relax and urinate. The sympathetic nervous system response to anxiety can cause urinary retention. So, the patient's frustration in voiding in front of the nurse may be due to anxiety hindering muscle relaxation.
Summary of other choices:
B: The patient not recognizing physiological signals is less likely as the patient requested assistance to void, indicating awareness of the need to urinate.
C: The patient being lonely and seeking attention is not relevant to the inability to void in front of the nurse.
D: Inadequate fluid intake may contribute to decreased urine output but is not directly related to the inability to void in front of the nurse.
A nurse who provides care on an acute medical unit has observed that physicians are frequently reluctant to refer patients to hospice care. What are contributing factors that are known to underlie this tendency? Select all that apply.
- A. Financial pressures on health care providers
- B. Patient reluctance to accept this type of care
- C. Strong association of hospice care with prolonging death
- D. Advances in curative treatment in late-stage illness E) Ease of making a terminal diagnosis
Correct Answer: A
Rationale: The correct answer is A: Financial pressures on health care providers. Physicians may be reluctant to refer patients to hospice care due to financial pressures. This could be because hospice care may be seen as less profitable compared to other treatments or services. Other choices are incorrect because: B: Patient reluctance is not a contributing factor from the physician's perspective. C: Hospice care is actually focused on comfort and quality of life, not prolonging death. D: Advances in curative treatment may not be directly related to physician reluctance to refer to hospice. E: Ease of making a terminal diagnosis is not a significant factor influencing physician reluctance.