Nokea
A nurse is caring for an 87-year-old Mexican-American female patient who is in end-stage renal disease. The physician has just been in to see the patient and her family to tell them that nothing more can be done for the patient and that death is not far. The physician offers to discharge the patient home to hospice care, but the patient and family refuse. After the physician leaves, the patients daughter approaches you and asks what hospice care is. What would this lack of knowledge about hospice care be perceived as?
- A. Lack of an American education of the patient and her family
- B. A language barrier to hospice care for this patient
- C. A barrier to hospice care for this patient
- D. Inability to grasp American concepts of health care
Correct Answer: C
Rationale: The correct answer is C: A barrier to hospice care for this patient. The lack of knowledge about hospice care can be perceived as a barrier to accessing this type of care for the patient and her family. Understanding hospice care is crucial in making informed decisions about end-of-life care options. This lack of knowledge does not necessarily indicate lack of education (choice A), language barrier (choice B), or inability to grasp American concepts of health care (choice D), as hospice care is a universal concept that transcends cultural and educational backgrounds.
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After the completion of testing, a childs allergies have been attributed to her familys cat. When introducing the family to the principles of avoidance therapy, the nurse should promote what action?
- A. Removing the cat from the familys home
- B. Administering OTC antihistamines to the child regularly
- C. Keeping the cat restricted from the childs bedroom
- D. Maximizing airflow in the house
Correct Answer: A
Rationale: The correct answer is A: Removing the cat from the family's home. This is the most effective way to prevent allergic reactions in the child. By removing the source of allergens (cat), the child will be exposed to fewer allergens, leading to a reduction in symptoms.
B: Administering OTC antihistamines treats symptoms but does not address the underlying cause of the allergy.
C: Keeping the cat restricted from the child's bedroom helps reduce exposure, but allergens can still spread throughout the house.
D: Maximizing airflow may help reduce allergens in the air but does not eliminate the source of the allergy.
Which of the following nursing interventions would most likely facilitate effective communication with a hearing-impaired patient?
- A. Ask the patient to repeat what was said in order to evaluate understanding.
- B. Stand directly in front of the patient to facilitate lip reading.
- C. Reduce environmental noise and distractions before communicating.
- D. Raise the voice to project sound at a higher frequency.
Correct Answer: C
Rationale: The correct answer is C: Reduce environmental noise and distractions before communicating. This intervention is most likely to facilitate effective communication with a hearing-impaired patient because it creates an optimal environment for the patient to better focus on the communication. By reducing noise and distractions, the patient can more easily concentrate on the conversation and lip reading, if needed. This approach demonstrates sensitivity to the patient's needs and enhances the chances of successful communication.
The other choices are incorrect because:
A: Asking the patient to repeat what was said may cause frustration and does not address the environmental factors that can hinder communication.
B: Standing directly in front of the patient to facilitate lip reading may help, but it does not address the impact of environmental noise and distractions on communication.
D: Raising the voice to project sound at a higher frequency is not effective as it can distort speech and may not necessarily improve understanding for a hearing-impaired patient.
The nurse is administering eye drops to a patient with glaucoma. After instilling the patients first medication, how long should the nurse wait before instilling the patients second medication into the same eye?
- A. 30 seconds
- B. 1 minute
- C. 3 minutes
- D. 5 minutes
Correct Answer: C
Rationale: The correct answer is C: 3 minutes. After administering the first eye drop, waiting for 3 minutes before instilling the second medication allows for proper absorption and effectiveness of each medication. This interval prevents dilution or interaction between the medications. Option A (30 seconds) is too short, not allowing sufficient time for absorption. Option B (1 minute) is also inadequate for proper absorption. Option D (5 minutes) is unnecessarily long and may lead to patient discomfort or inconvenience.
A nurse who works in the specialty of palliative care frequently encounters issues and situations that constitute ethical dilemmas. What issue has most often presented challenging ethical issues, especially in the context of palliative care?
- A. The increase in cultural diversity in the United States
- B. Staffing shortages in health care and questions concerning quality of care
- C. Increased costs of health care coupled with inequalities in access
- D. Ability of technology to prolong life beyond meaningful quality of life
Correct Answer: D
Rationale: The correct answer is D: Ability of technology to prolong life beyond meaningful quality of life. In palliative care, the focus is on improving the quality of life for patients with serious illnesses. The use of technology to prolong life can sometimes conflict with this goal, leading to ethical dilemmas. Technology may extend life without considering the patient's comfort or dignity, raising questions about the meaningfulness of prolonging life in such situations. This issue is particularly challenging in palliative care as it requires balancing the benefits of technology with the patient's quality of life.
Other choices are incorrect:
A: The increase in cultural diversity in the United States - While cultural diversity can present challenges in palliative care, it is not the most often presented challenging ethical issue.
B: Staffing shortages in health care and questions concerning quality of care - Staffing shortages are important issues in healthcare, but they do not directly relate to the ethical dilemmas specific to palliative care.
C: Increased costs of health care coupled with
The nurse is caring for patients with ostomies.In which ostomy location will the nurse expect very liquid stool to be present?
- A. Sigmoid
- B. Transverse
- C. Ascending
- D. Descending
Correct Answer: C
Rationale: The correct answer is C: Ascending. Stool consistency varies based on the location of the ostomy. The ascending colon is responsible for absorbing water from stool, so an ostomy in this location will have very liquid stool. Sigmoid, transverse, and descending colons are responsible for further solidifying stool, so ostomies in those locations would not typically have very liquid stool.