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A nurse is providing teaching to a patient who has stable angina and a new prescription for nitroglycerin oral, sustained-release capsules. Which of the following instructions should the nurse give? What instructions should the nurse give for nitroglycerin capsules?
- A. Take one capsule at the onset of anginal pain.
- B. Take the medication with meals.
- C. Stop taking the medication if side effects are troublesome.
- D. Swallow the capsules whole.
Correct Answer: D
Rationale: The correct answer is D: Swallow the capsules whole. Nitroglycerin oral, sustained-release capsules should be swallowed whole without crushing or chewing to ensure the medication is released slowly over time. If the capsules are broken or chewed, the full dose may be released at once, leading to a rapid drop in blood pressure. Choice A is incorrect because nitroglycerin capsules are not meant to be taken at the onset of pain, but as a preventive measure. Choice B is incorrect as there is no specific instruction to take the medication with meals. Choice C is incorrect as stopping medication abruptly can be dangerous, and patients should consult their healthcare provider before making any changes.
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A nurse in the emergency department is caring for a patient who was injured in a motor-vehicle crash. The patient reports dyspnea and severe pain. The nurse notes that the patient's chest moves inward during inspiration and bulges out during expiration. The nurse should identify this finding as which of the following? What condition is indicated by paradoxical chest movement?
- A. Flail chest
- B. Hemothorax
- C. Atelectasis
- D. Pneumothorax
Correct Answer: A
Rationale: The correct answer is A: Flail chest. Flail chest is characterized by a segment of the rib cage that moves independently due to multiple rib fractures. The paradoxical chest movement, where the chest moves inward during inspiration and bulges out during expiration, is a classic sign of flail chest. This occurs due to the loss of stability in the rib cage, leading to ineffective breathing mechanics.
Incorrect answers:
B: Hemothorax - This is the accumulation of blood in the pleural cavity, which would not cause paradoxical chest movement.
C: Atelectasis - Atelectasis is the collapse of lung tissue, which would not result in paradoxical chest movement.
D: Pneumothorax - Pneumothorax is the presence of air in the pleural space, which typically causes chest pain and shortness of breath but does not result in paradoxical chest movement.
A nurse is caring for a patient who is receiving IV fluids. The nurse notes that the IV site is red, warm, and painful. Which of the following actions should the nurse take first? What should the nurse do first for IV site issues?
- A. Slow the infusion rate.
- B. Apply a warm compress.
- C. Discontinue the IV line.
- D. Notify the provider.
Correct Answer: C
Rationale: The correct action for the nurse to take first is to discontinue the IV line (choice C). This is essential to prevent further complications such as infection or infiltration. Discontinuing the IV line will stop the source of the redness, warmth, and pain at the IV site. Slowing the infusion rate (choice A) would not address the underlying issue and could potentially worsen the situation. Applying a warm compress (choice B) could also exacerbate the symptoms if there is an infection. Notifying the provider (choice D) is important but should come after the immediate action of discontinuing the IV line to address the IV site issues promptly.
A nurse is performing tracheostomy care for a patient and plans to remove copious secretions. What actions should the nurse take? What action should the nurse take for tracheostomy suctioning?
- A. Lubricate the suction catheter tip with sterile saline
- B. Hyperventilate the patient on 100% oxygen prior to suctioning
- C. Perform chest physiotherapy prior to suctioning
- D. Suction two to three times with a 60-second pause between passes
Correct Answer: D
Rationale: The correct answer is D: Suction two to three times with a 60-second pause between passes. This is the correct action for tracheostomy suctioning to prevent hypoxia and tissue damage. Suctioning should be limited to 10-15 seconds to minimize the risk of hypoxia. Pausing between passes allows the patient to recover oxygen saturation levels. Choice A is incorrect because lubricating the suction catheter tip with sterile saline is not necessary for tracheostomy suctioning. Choice B is incorrect as hyperventilating the patient on 100% oxygen prior to suctioning can lead to respiratory alkalosis. Choice C is incorrect as performing chest physiotherapy prior to suctioning is not indicated in tracheostomy care.
A nurse is formulating a care plan for a patient recovering from severe burns. Which of the following strategies should the nurse incorporate to provide emotional support? Which strategy provides emotional support for burn recovery?
- A. Engage in conversation with the patient during wound care.
- B. Ensure the patient's room is kept tidy by support staff.
- C. Keep the patient's family informed about his condition.
- D. Rotate the nursing staff to provide the patient with varied interactions.
Correct Answer: A
Rationale: The correct answer is A: Engage in conversation with the patient during wound care. This strategy provides emotional support by offering the patient a distraction and a sense of connection during a potentially painful and distressing procedure. It allows the patient to express their feelings and concerns, fostering a therapeutic relationship.
Choice B: Ensuring the patient's room is tidy is important for the patient's physical comfort but does not directly address emotional support.
Choice C: Keeping the patient's family informed is crucial for communication but may not directly provide emotional support to the patient.
Choice D: Rotating nursing staff may offer varied interactions, but consistency and building rapport with the same caregiver can be more beneficial for emotional support in this context.
A nurse is caring for a patient who has a new prescription for fluconazole. Which of the following instructions should the nurse include? What instructions should the nurse include for fluconazole?
- A. Take the medication with food.
- B. Report any abdominal pain.
- C. Avoid driving for 24 hours.
- D. Take the medication at bedtime.
Correct Answer: B
Rationale: The correct answer is B: Report any abdominal pain. This is important because fluconazole can cause gastrointestinal side effects such as abdominal pain, nausea, and diarrhea. Prompt reporting of abdominal pain can help monitor for potential complications like liver toxicity. Choice A is incorrect as fluconazole can be taken with or without food. Choice C is incorrect as fluconazole does not typically impair driving ability. Choice D is incorrect as fluconazole can be taken at any time of the day.