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A nurse administers an antimuscarinic to a patient.Which findings indicate the patient is having therapeutic effects from this medication? (Select all that apply.)
- A. Decrease in dysuria
- B. Decrease in urgency
- C. Decrease in frequency
- D. Decrease in prostate size
Correct Answer: A
Rationale: The correct answer is A: Decrease in dysuria. Antimuscarinic medications target muscarinic receptors, which are involved in the contraction of smooth muscle in the bladder. Dysuria, or painful urination, is a common symptom of overactive bladder or bladder spasms, which can be relieved by antimuscarinics. Choices B, C, and D are related to other urinary symptoms such as urgency, frequency, and prostate size, respectively, which are not directly targeted by antimuscarinics. Therefore, only a decrease in dysuria indicates therapeutic effects of the medication.
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The nurse is preparing to check the gastric aspirate for pH. Which equipment will the nurse obtain?
- A. 10-mL Luer-Lok syringe
- B. Asepto syringe
- C. Sterile gloves
- D. Double gloves
Correct Answer: A
Rationale: The correct answer is A: 10-mL Luer-Lok syringe. The nurse should use this syringe to obtain a gastric aspirate for pH testing because it allows for accurate measurement of the aspirate volume. Asepto syringe (B) is not suitable for this purpose as it is not designed for accurate measurement. Sterile gloves (C) and double gloves (D) are not equipment used specifically for obtaining gastric aspirate for pH testing. Sterile gloves are used for infection control, and double gloves are used for additional protection during procedures.
During a recent visit to the clinic a woman presents with erythema of the nipple and areola on the right breast. She states this started several weeks ago and she was fearful of what would be found. The nurse should promptly refer the patient to her primary care provider because the patients signs and symptoms are suggestive of what health problem?
- A. Peau dorange
- B. Nipple inversion
- C. Pagets disease
- D. Acute mastitis
Correct Answer: C
Rationale: Rationale:
1. Erythema of nipple/areola in one breast can be a sign of Paget's disease, a rare form of breast cancer.
2. Paget's disease may also present with itching, tingling, or a burning sensation in the affected area.
3. Referring the patient promptly is crucial for early detection and appropriate management.
4. Peau d'orange (A) is a sign of advanced breast cancer, not typically presenting with erythema alone.
5. Nipple inversion (B) may be benign or related to other conditions, not typically presenting with erythema.
6. Acute mastitis (D) presents with breast pain, warmth, swelling, and fever, but not typically with isolated erythema of the nipple/areola.
A 35-year-old mother of three young children has been diagnosed with stage II breast cancer. After discussing treatment options with her physician, the woman goes home to talk to her husband, later calling the nurse for clarification of some points. The patient tells the nurse that the physician has recommended breast conservation surgery followed by radiation. The patients husband has done some online research and is asking why his wife does not have a modified radical mastectomy to be sure all the cancer is gone. What would be the nurses best response?
- A. Modified radical mastectomies are very hard on a patient, both physically and emotionally and they really arent necessary anymore.
- B. According to current guidelines, having a modified radical mastectomy is no longer seen as beneficial.
- C. Modified radical mastectomies have a poor survival rate because of the risk of cancer recurrence.
- D. According to current guidelines, breast conservation combined with radiation is as effective as a modified radical mastectomy.
Correct Answer: D
Rationale: The correct answer is D: According to current guidelines, breast conservation combined with radiation is as effective as a modified radical mastectomy.
1. Breast conservation surgery followed by radiation is a standard treatment option for early-stage breast cancer.
2. Studies have shown that breast conservation surgery combined with radiation therapy is equally effective in terms of long-term survival rates compared to mastectomy.
3. Current guidelines recommend considering breast conservation surgery as a viable option for patients with early-stage breast cancer.
4. Modified radical mastectomy is not necessarily needed to ensure complete removal of cancer, as breast conservation surgery followed by radiation can achieve the same goal.
5. Therefore, the nurse should reassure the patient's husband that the recommended treatment plan is based on current guidelines and is as effective as a modified radical mastectomy.
The nurse is providing health education to a patient newly diagnosed with glaucoma. The nurse teaches the patient that this disease has a familial tendency. The nurse should encourage the patients immediate family members to undergo clinical examinations how often?
- A. At least monthly
- B. At least once every 2 years
- C. At least once every 5 years
- D. At least once every 10 years
Correct Answer: B
Rationale: The correct answer is B: At least once every 2 years. Glaucoma has a familial tendency, meaning it can run in families. Regular eye exams are crucial for early detection and treatment. Having family members undergo clinical examinations every 2 years allows for timely identification of any potential signs of glaucoma. Monthly exams (A) would be too frequent and unnecessary. Exams every 5 years (C) or 10 years (D) are too infrequent and may miss early signs of the disease. Regular biennial exams strike a balance between early detection and practicality.
A pediatric nurse is emotionally distraught by the death of a 9-year-old girl who received care on the unit over the course of many admissions spanning several years. What action is the most appropriate response to the nurses own grief?
- A. Take time off from work to mourn the death.
- B. Post mementos of the patient on the unit.
- C. Solicit emotional support from the patients family.
- D. Attend the patients memorial service.
Correct Answer: A
Rationale: The correct answer is A because taking time off from work to mourn allows the nurse to process their emotions and prevent burnout. This self-care step promotes mental well-being and helps prevent the nurse from being overwhelmed by their grief.
Choice B is incorrect as it may prolong the grieving process and create a constant reminder of the loss. Choice C could potentially burden the patient's family with the nurse's grief, making it an inappropriate action. Choice D, attending the memorial service, may be emotionally challenging and may not provide the nurse with the necessary space to cope with their grief effectively.