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A nurse is implementing nursing care measuresfor patients with challenging communication issues. Which types of patients will need these nursing care measures? (Selectall that apply.)
- A. A child who is developmentally delayed
- B. An older-adult patient who is demanding
- C. A female patient who is outgoing and flirty
- D. A male patient who is cooperative with treatments
Correct Answer: A
Rationale: Challenging communication situations in nursing care typically involve patients who exhibit behaviors that make communication difficult or complex. In the given options, a child who is developmentally delayed (Option A) and an older-adult patient who is demanding (Option B) are examples of patients who may have challenging communication issues.
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Which routine nursing assessment is contraindicated for a patient admitted with suspected placenta previa?
- A. Determining cervical dilation and effacement
- B. Monitoring FHR and maternal vital signs
- C. Observing vaginal bleeding or leakage of amniotic fluid
- D. Determining frequency, duration, and intensity of contractions
Correct Answer: A
Rationale: Vaginal examination of the cervix may result in perforation of the placenta and subsequent hemorrhage in a patient admitted with suspected placenta previa. It is important to avoid any unnecessary manipulation of the cervix to prevent complications. Assessing cervical dilation and effacement should be avoided until placenta previa is ruled out to prevent harm to the patient.
An uncircumcised 78-year-old male has presented at the clinic complaining that he cannot retract his foreskin over his glans. On examination, it is noted that the foreskin is very constricted. The nurse should recognize the presence of what health problem?
- A. Bowens disease
- B. Peyronies disease
- C. Phimosis
- D. Priapism
Correct Answer: C
Rationale: Phimosis is a condition in which the foreskin of the penis is tight and cannot be retracted over the glans. It can occur in uncircumcised males, like the 78-year-old male in this scenario. Phimosis may lead to difficulty with hygiene, pain during sexual activity, and an increased risk of infections. Treatment may involve conservative measures such as topical corticosteroids or, in severe cases, surgical intervention like circumcision to alleviate the tightness of the foreskin.
A patient has been discharged home after a total mastectomy without reconstruction. The patient lives alone and has a home health referral. When the home care nurse performs the first scheduled visit this patient, what should the nurse assess? Select all that apply.
- A. Adherence to the exercise plan
- B. Overall psychological functioning
- C. Integrity of surgical drains
- D. Understanding of cancer E) Use of the breast prosthesis
Correct Answer: B
Rationale: B. Overall psychological functioning: It is crucial for the home care nurse to assess the patient's overall psychological functioning after a total mastectomy without reconstruction. The patient may be experiencing emotional distress, body image disturbances, anxiety, or depression related to the surgery and changes in physical appearance. The nurse should evaluate the patient's coping mechanisms, emotional well-being, and any signs of psychological implications to provide appropriate support and referral for mental health services if needed.
A patient has presented at the clinic with symptoms of benign prostatic hyperplasia. What diagnostic findings would suggest that this patient has chronic urinary retention?
- A. Hypertension
- B. Peripheral edema
- C. Tachycardia and other dysrhythmias
- D. Increased blood urea nitrogen (BUN)
Correct Answer: D
Rationale: Chronic urinary retention can lead to an elevated blood urea nitrogen (BUN) level due to impaired kidney function. When urine is not effectively eliminated from the body, waste products, including urea, accumulate in the bloodstream. This can result in an increase in BUN levels, indicating potential kidney dysfunction in the setting of chronic urinary retention. Hypertension (Choice A), peripheral edema (Choice B), and tachycardia and other dysrhythmias (Choice C) are not specifically associated with chronic urinary retention but may be related to other conditions or comorbidities.
A nurse is discussing the advantages of a nursingclinical information system. Which advantage should the nurse describe?
- A. Varied clinical databases
- B. Reduced errors of omission
- C. Increased hospital costs
- D. More time to read charts
Correct Answer: B
Rationale: One of the key advantages associated with a nursing clinical information system is the reduction of errors of omission. By using an electronic system that prompts for required data entry and ensures completeness of documentation, nurses are less likely to miss important information, leading to improved patient care and safety. This advantage helps in promoting efficient communication among healthcare providers and contributes to better decision-making processes.