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A nurse is performing a cultural assessment usingthe ETHNIC mnemonic for communication. Which area will the nurse assess for the “H”?
- A. Health
- B. Healers
- C. History
- D. Homeland
Correct Answer: B
Rationale: The correct answer is B: Healers. In the ETHNIC mnemonic, "H" stands for Healers, where the nurse assesses the individual's traditional healers, healthcare practices, and preferences for seeking healthcare. This is important in understanding the individual's cultural beliefs and practices related to health and treatment. Assessing "Health" (A) may be important, but it does not specifically address traditional healers. "History" (C) focuses on the individual's cultural background rather than healthcare practices. "Homeland" (D) pertains to the individual's place of origin, which is not directly related to healthcare communication.
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A 25-year-old female patient with brain metastases is considering her life expectancy after her most recent meeting with her oncologist. Based on the fact that the patient is not receiving treatment for her brain metastases, what is the nurses most appropriate action?
- A. Promoting the patients functional status and ADLs
- B. Ensuring that the patient receives adequate palliative care
- C. Ensuring that the family does not tell the patient that her condition is terminal
- D. Promoting adherence to the prescribed medication regimen
Correct Answer: B
Rationale: The correct answer is B: Ensuring that the patient receives adequate palliative care. Palliative care focuses on improving the quality of life for patients with serious illnesses, including managing symptoms and providing emotional support. In this case, since the patient is not receiving treatment for her brain metastases, palliative care would be most appropriate to help alleviate any pain or discomfort she may be experiencing and provide holistic support for her and her family.
A: Promoting the patient's functional status and ADLs may not be the priority if the patient's prognosis is terminal and she is not receiving treatment for her brain metastases.
C: Ensuring that the family does not tell the patient her condition is terminal goes against ethical principles of honesty and transparency in healthcare.
D: Promoting adherence to the prescribed medication regimen may not be relevant if the patient is not receiving active treatment for her brain metastases.
A 58-year-old male patient has been hospitalized for a wedge resection of the left lower lung lobe after a routine chest x-ray shows carcinoma. The patient is anxious and asks if he can smoke. Which statement by the nurse would be most therapeutic?
- A. Smoking is the reason you are here.
- B. The doctor left orders for you not to smoke.
- C. You are anxious about the surgery. Do you see smoking as helping?
- D. Smoking is OK right now, but after your surgery it is contraindicated.
Correct Answer: C
Rationale: The correct answer is C: "You are anxious about the surgery. Do you see smoking as helping?" This response acknowledges the patient's anxiety and invites him to explore his reasons for wanting to smoke, opening up a dialogue and potentially uncovering underlying issues. It also avoids judgment or direct orders, fostering a therapeutic nurse-patient relationship.
Explanation of why the other choices are incorrect:
A: "Smoking is the reason you are here." - This response is blaming and may increase the patient's guilt or anxiety, hindering effective communication.
B: "The doctor left orders for you not to smoke." - This response is authoritative and may lead to resistance or defensiveness from the patient, rather than addressing his concerns.
D: "Smoking is OK right now, but after your surgery it is contraindicated." - This response is unclear and may send mixed messages to the patient, potentially leading to confusion or misunderstanding.
A blood-soaked peripad weighs 900 g. The nurse would document a blood loss of _____ mL.
- A. 1800
- B. 450
- C. 900
- D. 90
Correct Answer: C
Rationale: The correct answer is C (900 mL) because the weight of 900 g corresponds to a blood loss of the same amount in milliliters. Blood density is close to that of water, so 1 g ≈ 1 mL. Therefore, a blood-soaked peripad weighing 900 g indicates a blood loss of 900 mL. Choice A (1800 mL) is incorrect as it doubles the weight instead of converting it to milliliters. Choice B (450 mL) is incorrect as it halves the weight. Choice D (90 mL) is incorrect as it divides the weight by 10, which is too small for the blood loss indicated.
The nurse is reviewing the physicians notes from the patient who has just left the clinic. The nurse learns that the physician suspects a malignant breast tumor. On palpation, the mass most likely had what characteristic?
- A. Nontenderness
- B. A size of 5 mm
- C. Softness and a regular shape
- D. Mobility
Correct Answer: D
Rationale: The correct answer is D: Mobility. A malignant breast tumor typically lacks mobility due to its fixed attachment to surrounding tissues. This characteristic is concerning for malignancy as it suggests invasive growth.
Incorrect answers:
A: Nontenderness - Tenderness does not reliably indicate malignancy or benignancy.
B: A size of 5 mm - Tumor size alone does not determine malignancy.
C: Softness and a regular shape - Malignant tumors are often firm and irregular in shape.
A patient diagnosed with Bells palsy is being cared for on an outpatient basis. During health education, the nurse should promote which of the following actions?
- A. Applying a protective eye shield at night
- B. Chewing on the affected side to prevent unilateral neglect
- C. Avoiding the use of analgesics whenever possible
- D. Avoiding brushing the teeth
Correct Answer: A
Rationale: Rationale for Correct Answer A: Applying a protective eye shield at night is crucial for a patient with Bell's palsy to prevent corneal abrasions due to incomplete eyelid closure. This action helps protect the eye from dryness and injury, which can occur due to decreased blinking and moisture. It is essential to maintain eye health and prevent complications.
Summary of Incorrect Choices:
B: Chewing on the affected side does not prevent unilateral neglect in Bell's palsy. Instead, encouraging balanced chewing and facial exercises would be more beneficial.
C: Avoiding the use of analgesics is not necessary for Bell's palsy management unless contraindicated, as pain management may be required for associated symptoms.
D: Avoiding brushing the teeth is not recommended. Good oral hygiene is important for overall health, including maintaining oral health during Bell's palsy.