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A nurse is completing an OASIS data set on apatient. The nurse works in which area?
- A. Home health
- B. Intensive care unit
- C. Skilled nursing facility
- D. Long-term care facility
Correct Answer: A
Rationale: The correct answer is A: Home health. The Outcome and Assessment Information Set (OASIS) data set is specifically used in the home health care setting to assess the patient's condition and needs. This includes collecting data on the patient's health, functional status, and living environment to determine the appropriate care plan. In contrast, choices B, C, and D are incorrect because OASIS is not utilized in the intensive care unit, skilled nursing facility, or long-term care facility settings. These settings have their own assessment tools and documentation requirements that are different from OASIS used in home health care.
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A patient with a new diagnosis of amyotrophic lateral sclerosis (ALS) is overwhelmed by his diagnosis and the known complications of the disease. How can the patient best make known his wishes for care as his disease progresses?
- A. Prepare an advance directive.
- B. Designate a most responsible physician (MRP) early in the course of the disease.
- C. Collaborate with representatives from the Amyotrophic Lateral Sclerosis Association.
- D. Ensure that witnesses are present when he provides instruction.
Correct Answer: A
Rationale: The correct answer is A: Prepare an advance directive. This allows the patient to document their healthcare preferences in advance, ensuring their wishes are known and honored as the disease progresses. It provides clear instructions for healthcare providers and family members, reducing potential conflicts and ensuring the patient's autonomy is respected.
Choice B is incorrect as designating an MRP focuses on medical decision-making but may not capture the full range of the patient's care preferences. Choice C involves collaboration with an organization, which may not fully represent the patient's individual wishes. Choice D is incorrect as witnesses are not always necessary for providing instructions, and the presence of witnesses does not guarantee that the patient's wishes will be followed accurately.
The nurse is preparing to insert a nasogastric tube in a patient who is semiconscious. To determine the length of the tube needed to be inserted, how should the nurse measure the tube?
- A. From the tip of the nose to the earlobe
- B. From the tip of the earlobe to the xiphoid process
- C. From the tip of the earlobe to the nose to the xiphoid process
- D. From the tip of the nose to the earlobe to the xiphoid process
Correct Answer: C
Rationale: Rationale for Correct Answer (C): To determine the correct length of the nasogastric tube needed to be inserted, the nurse should measure from the tip of the earlobe to the nose and then to the xiphoid process. This method ensures that the tube reaches the stomach without coiling in the esophagus or being inserted too far down. The distance from the earlobe to the nose approximates the distance from the nose to the stomach, and measuring to the xiphoid process ensures proper placement. This technique minimizes the risk of complications such as aspiration or misplacement.
Summary of Incorrect Choices:
A: Measuring from the tip of the nose to the earlobe is incorrect because it does not take into account the distance to the stomach.
B: Measuring from the tip of the earlobe to the xiphoid process alone is incorrect because it does not consider the distance through the nasal passage.
D: Measuring from the tip of the nose to the earlobe to
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.
A woman aged 48 years comes to the clinic because she has discovered a lump in her breast. After diagnostic testing, the woman receives a diagnosis of breast cancer. The woman asks the nurse when her teenage daughters should begin mammography. What is the nurses best advice?
- A. Age 28
- B. Age 35
- C. Age 38
- D. Age 48
Correct Answer: D
Rationale: The correct answer is D: Age 48. This recommendation aligns with the current guidelines from major health organizations, such as the American Cancer Society, which suggest that women at average risk should start regular mammograms at age 45 to 54. Screening before age 45 may lead to unnecessary procedures due to false positives. Beginning at age 48 allows for early detection without subjecting the daughters to unnecessary testing at a younger age. Choices A, B, and C are incorrect as they suggest starting mammography at younger ages than recommended, which can increase the likelihood of false positives and unnecessary interventions.
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.