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A nurse is caring for patients with dysphagia. Which patient has neurogenic dysphagia?
- A. A patient with benign peptic stricture
- B. A patient with muscular dystrophy
- C. A patient with myasthenia gravis
- D. A patient with stroke
Correct Answer: D
Rationale: The correct answer is D because neurogenic dysphagia is caused by neurological conditions affecting swallowing function, such as a stroke. In a stroke, damage to the brain can impair the coordination of swallowing muscles, leading to dysphagia.
Choice A is incorrect because benign peptic stricture is a narrowing of the esophagus due to chronic acid reflux, not a neurological issue.
Choice B is incorrect because muscular dystrophy is a genetic disorder that affects muscle strength and does not directly impact the neurological control of swallowing.
Choice C is incorrect because myasthenia gravis is an autoimmune disorder that affects neuromuscular transmission but is not typically associated with neurogenic dysphagia.
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You are caring for a patient who has just been told that her stage IV colon cancer has recurred and metastasized to the liver. The oncologist offers the patient the option of surgery to treat the progression of this disease. What type of surgery does the oncologist offer?
- A. Palliative
- B. Reconstructive
- C. Salvage
- D. Prophylactic
Correct Answer: A
Rationale: The correct answer is A: Palliative surgery. In this scenario, the patient's colon cancer has already progressed to stage IV with metastasis to the liver, indicating an advanced and incurable condition. Palliative surgery aims to alleviate symptoms, improve quality of life, and prolong survival without aiming for a cure. Reconstructive surgery (B) is typically done to restore form or function, which is not the primary goal in this case. Salvage surgery (C) is usually performed to rescue a situation where initial treatment has failed, which is not the case here. Prophylactic surgery (D) is preventive and is not appropriate in a situation where cancer is already present and advanced.
A patient with HIV infection has begun experiencing severe diarrhea. What is the most appropriate nursing intervention to help alleviate the diarrhea?
- A. Administer antidiarrheal medications on a scheduled basis, as ordered.
- B. Encourage the patient to eat three balanced meals and a snack at bedtime.
- C. Increase the patients oral fluid intake.
- D. Encourage the patient to increase his or her activity level.
Correct Answer: C
Rationale: The correct answer is C: Increase the patient's oral fluid intake. This is because severe diarrhea can lead to dehydration, which can be dangerous for patients with HIV infection. By increasing oral fluid intake, the patient can stay hydrated and prevent further complications. Administering antidiarrheal medications on a scheduled basis (Choice A) may provide temporary relief but does not address the underlying issue of dehydration. Encouraging the patient to eat balanced meals (Choice B) and increase activity level (Choice D) may be important for overall health but do not directly address the immediate concern of dehydration caused by severe diarrhea.
A nurse is a member of an interdisciplinary teamthat uses critical pathways. According to the critical pathway, on day 2 of the hospital stay, the patient should be sitting in the chair. It is day 3, and the patient cannot sit in the chair. What should the nurse do?
- A. Add this data to the problem list.
- B. Focus chart using the DAR format.
- C. Document the variance in the patient’s record.
- D. Report a positive variance in the next interdisciplinary team meeting.
Correct Answer: C
Rationale: The correct answer is C: Document the variance in the patient’s record. By documenting the variance in the patient's record, the nurse can provide a clear record of the deviation from the critical pathway. This documentation is essential for tracking the patient's progress accurately and identifying potential issues that may require intervention. It allows for proper communication among the interdisciplinary team and ensures that everyone is aware of the deviation.
Choice A is incorrect because adding data to the problem list may not provide a comprehensive record of the variance. Choice B is incorrect because focusing on charting using the DAR format does not address the deviation from the critical pathway. Choice D is incorrect because reporting a positive variance in the next team meeting may not accurately reflect the patient's actual progress and may lead to miscommunication within the team.
A patient with a sudden onset of hearing loss tells the nurse that he would like to begin using hearing aids. The nurse understands that the health professional dispensing hearing aids would have what responsibility?
- A. Test the patients hearing promptly.
- B. Perform an otoscopy.
- C. Measure the width of the patients ear canal.
- D. Refer the patient to his primary care physician.
Correct Answer: A
Rationale: The correct answer is A: Test the patient's hearing promptly. This is because before dispensing hearing aids, it is crucial to accurately assess the patient's hearing ability. Testing the patient's hearing promptly allows the healthcare professional to determine the type and degree of hearing loss, which is essential for selecting the appropriate hearing aids. Performing an otoscopy (choice B) may be part of the assessment but does not provide information on hearing ability. Measuring the width of the patient's ear canal (choice C) is not necessary for dispensing hearing aids. Referring the patient to his primary care physician (choice D) may delay the process of obtaining hearing aids and is not directly related to the responsibility of the health professional dispensing hearing aids.
A patient is being discharged home from the ambulatory surgery center after an incisional biopsy of a mass in her left breast. What are the criteria for discharging this patient home? Select all that apply.
- A. Patient must understand when she can begin ambulating
- B. Patient must have someone to accompany her home
- C. Patient must understand activity restrictions
- D. Patient must understand care of the biopsy site E) Patient must understand when she can safely remove her urinary catheter
Correct Answer: A
Rationale: Step-by-step rationale for why answer A is correct:
1. Ambulating is a crucial postoperative activity to prevent complications like blood clots.
2. Understanding when to ambulate ensures the patient follows proper recovery guidelines.
3. Proper ambulation aids in preventing postoperative complications and promotes healing.
Summary of why other choices are incorrect:
B. Having someone accompany the patient is important for support but not a strict criteria for discharge.
C. While understanding activity restrictions is important, it is not a specific criteria for immediate discharge.
D. Understanding care for the biopsy site is essential but not a strict criteria for immediate discharge.
E. Removal of a urinary catheter is not typically related to discharge criteria for a breast biopsy.