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A nurse involves well-being in her definition of health. What will the primary concern or focus of the nurse when she provides care to a family confronting the imminent death of a family member?
- A. Reinforcing the need for the whole family to adapt to the impending death.
- B. Sharing the nurse's knowledge on the client's symptoms of grief
- C. Discussing the perceived meaning of life with the family
- D. Administering pain medication so that the client can be kept comfortable
Correct Answer: A
Rationale: When a nurse involves well-being in her definition of health, it indicates a holistic approach that considers not only physical health but also emotional, mental, and social aspects of well-being. In the context of a family confronting the imminent death of a family member, the primary concern of the nurse would be to focus on reinforcing the need for the whole family to adapt to the impending death. This involves providing emotional support, facilitating communication, addressing coping mechanisms, and assisting the family in coming to terms with the situation. By emphasizing the importance of the whole family adapting to the imminent death, the nurse can help promote holistic well-being for the family during this challenging time.
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A patient presents with fever, malaise, and a maculopapular rash that started on the face and spread to the trunk and extremities. Laboratory tests reveal leukopenia and thrombocytopenia. Which of the following is the most likely causative agent?
- A. Borrelia burgdorferi
- B. Plasmodium falciparum
- C. Rickettsia rickettsii
- D. Leishmania donovani
Correct Answer: C
Rationale: The clinical presentation of fever, malaise, maculopapular rash starting on the face and spreading to the trunk and extremities, along with leukopenia and thrombocytopenia, is highly suggestive of Rocky Mountain spotted fever (RMSF) caused by Rickettsia rickettsii. RMSF is a tick-borne illness transmitted by the American dog tick, Rocky Mountain wood tick, and brown dog tick. The constellation of symptoms described aligns well with the typical presentation of RMSF. Borrelia burgdorferi causes Lyme disease, which presents with erythema migrans but does not typically cause leukopenia or thrombocytopenia. Plasmodium falciparum is the causative agent of severe malaria and would present with symptoms such as cyclic fevers, anemia, and jaundice but not the described rash distribution.
In her capacity to teach, the nurse describes the changes of the uterus after childbirth to return to a nonpregnant state as _____
- A. catabolism
- B. subinvolution
- C. contraction of muscle fibers
- D. Involution
Correct Answer: D
Rationale: Involution refers to the process of the uterus returning to its nonpregnant state after childbirth. During pregnancy, the uterus undergoes significant changes and enlarges to accommodate the growing fetus. After childbirth, the uterus begins to contract, leading to a decrease in its size and a return to its pre-pregnant state. This process involves the shedding of the excess endometrial tissue and the reduction of the size of the uterine muscle fibers. It is a normal and essential process for postpartum recovery. Failure of the uterus to undergo proper involution is known as subinvolution, which can lead to complications such as postpartum hemorrhage.
Nurse Edna admits a patient from the ER to the medical unit. The patient is very restless with IV lines and a urinary catheter. She was put to bed and the nurse applied a body restraint without the doctor's order. Nurse Edna's action can be liable for _____.
- A. invasion of privacy
- B. battery
- C. assault
- D. neglect
Correct Answer: B
Rationale: Battery in the context of healthcare refers to the intentional and unauthorized touching of a patient. By applying a body restraint without a doctor's order, Nurse Edna has potentially committed battery against the patient. It is important for healthcare providers to obtain proper authorization before implementing any physical restraints on a patient to avoid legal liabilities such as battery.
Which nursing diagnosis is NOT RELEVANT to sexual health?
- A. Anxiety-related inability to conceive after six months .
- B. Health-seeking behaviors related to reproductive functioning
- C. Sexual dysfunction related to an unknown cause.
- D. Risk for infection related to high-risk. sexual behaviors.
Correct Answer: B
Rationale: In the given situation, the nursing diagnosis that is NOT RELEVANT to sexual health is option B, Health-seeking behaviors related to reproductive functioning. This diagnosis focuses on the patient's proactive approach to seeking healthcare services related to reproductive health matters. However, in the situation presented of a pregnant patient with sickle cell anemia experiencing fever, painful swelling, and in labor pain, the immediate priority lies in addressing the health issues related to sickle cell disease and the current pregnancy. Sexual health is not the primary concern in this scenario compared to managing the complications of sickle cell anemia during pregnancy. Therefore, the diagnosis related to health-seeking behaviors related to reproductive functioning is not as pertinent in this specific case.
The patient refuses to take the medication because it causes diarrhea. Nurse Parker explains the action of the drug but the patient vehemently refuses the medication. What should be the INITIAL action of the nurse?
- A. Discuss with a family member the need for the patient to take the medication.
- B. Document the patient 's refusa l to take the medication.
- C. Notify the physician of the patient 's refusal to take the medication.
- D. Explain again to the patient the consequences of refusing to take the medication.
Correct Answer: C
Rationale: The initial action the nurse should take when faced with a situation where a patient refuses to take medication after education and explanation is to notify the physician. The physician may need to be informed so they can reassess the medication and potentially explore alternative options or make adjustments based on the patient's concerns and preferences. It is important for medical decisions to be made in collaboration with the healthcare team to ensure the best care for the patient. Consulting the physician also helps in avoiding any potential negative outcomes resulting from the patient's refusal to take the prescribed medication. Once the physician is aware, further actions can be discussed and implemented to address the patient's concerns.