Nokea
A nurse who provides care on an acute medical unit has observed that physicians are frequently reluctant to refer patients to hospice care. What are contributing factors that are known to underlie this tendency? Select all that apply.
- A. Financial pressures on health care providers
- B. Patient reluctance to accept this type of care
- C. Strong association of hospice care with prolonging death
- D. Advances in curative treatment in late-stage illness E) Ease of making a terminal diagnosis
Correct Answer: A
Rationale: The correct answer is A: Financial pressures on health care providers. Physicians may be reluctant to refer patients to hospice care due to financial pressures. This could be because hospice care may be seen as less profitable compared to other treatments or services. Other choices are incorrect because: B: Patient reluctance is not a contributing factor from the physician's perspective. C: Hospice care is actually focused on comfort and quality of life, not prolonging death. D: Advances in curative treatment may not be directly related to physician reluctance to refer to hospice. E: Ease of making a terminal diagnosis is not a significant factor influencing physician reluctance.
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When planning discharge teaching with a patient who has undergone a total mastectomy with axillary dissection, the nurse knows to instruct the patient that she should report what sign or symptom to the physician immediately?
- A. Fatigue
- B. Temperature greater than 98.5F
- C. Sudden cessation of output from the drainage device
- D. Gradual decline in output from the drain
Correct Answer: C
Rationale: The correct answer is C: Sudden cessation of output from the drainage device. This is crucial because it can indicate a potential complication like a blocked drain or infection, requiring immediate medical attention to prevent further issues. Other choices like fatigue (A) are common after surgery but not urgent. Temperature elevation (B) may indicate infection but is not as critical as sudden cessation of drainage. Gradual decline in output (D) is expected as the drainage decreases over time, so it doesn't require immediate reporting.
After providing care, a nurse charts in the patient’srecord. Which entry will the nurse document?
- A. Appears restless when sitting in the chair
- B. Drank adequate amounts of water
- C. Apparently is asleep with eyes closed
- D. Skin pale and cool
Correct Answer: D
Rationale: The correct answer is D because documenting the skin condition is an objective assessment that provides vital information about the patient's health status. Pale and cool skin may indicate poor perfusion or circulation issues. This observation is crucial for monitoring the patient's condition and identifying any potential concerns. Choices A, B, and C are subjective and do not provide specific or relevant information related to the patient's overall health status or response to care. Without objective data like skin appearance, it would be challenging to assess the patient's condition accurately.
A nurse is teaching preventative measures for otitis externa to a group of older adults. What action should the nurse encourage?
- A. Rinsing the ears with normal saline after swimming
- B. Avoiding loud environmental noises
- C. Instilling antibiotic ointments on a regular basis
- D. Avoiding the use of cotton swabs
Correct Answer: A
Rationale: The correct answer is A: Rinsing the ears with normal saline after swimming. This is because rinsing with normal saline helps to remove excess moisture and debris, preventing bacterial growth that can lead to otitis externa. Avoiding loud noises (B) is important for overall ear health but does not specifically prevent otitis externa. Instilling antibiotic ointments regularly (C) is not recommended as it can disrupt the ear's natural flora. Avoiding cotton swabs (D) is important to prevent injury but does not directly prevent otitis externa.
A nurse is planning the postoperative care of a patient who is scheduled for radical prostatectomy. What intraoperative position will place the patient at particular risk for the development of deep vein thrombosis postoperatively?
- A. Fowlers position
- B. Prone position
- C. Supine position
- D. Lithotomy position
Correct Answer: D
Rationale: The correct answer is D: Lithotomy position. In lithotomy position, the patient's legs are elevated and positioned higher than the heart, which can lead to venous stasis and increase the risk of deep vein thrombosis (DVT). This position compresses the femoral veins, hindering blood flow and predisposing the patient to DVT formation.
Summary:
A: Fowlers position - Not typically associated with increased DVT risk.
B: Prone position - Not typically associated with increased DVT risk.
C: Supine position - Generally considered a safe position regarding DVT risk.
A 35-year-old father of three tells the nurse that he wants information on a vasectomy. What would the nurse tell him about ejaculate after a vasectomy?
- A. There will be no ejaculate after a vasectomy, though the patients potential for orgasm is unaffected.
- B. There is no noticeable decrease in the amount of ejaculate even though it contains no sperm.
- C. There is a marked decrease in the amount of ejaculate after vasectomy, though this does not affect sexual satisfaction.
- D. There is no change in the quantity of ejaculate after vasectomy, but the viscosity is somewhat increased.
Correct Answer: B
Rationale: The correct answer is B: There is no noticeable decrease in the amount of ejaculate even though it contains no sperm. After a vasectomy, the vas deferens, the tube that carries sperm from the testicles, is cut or blocked. This prevents sperm from being ejaculated, but the seminal fluid produced by the prostate and other glands still makes up the majority of the ejaculate volume. Therefore, although the ejaculate does not contain sperm after a vasectomy, there is no significant change in the amount of fluid ejaculated.
Choice A is incorrect because the absence of sperm does not impact the volume of ejaculate. Choice C is incorrect as there is no marked decrease in ejaculate volume. Choice D is incorrect as there is no evidence to suggest that the viscosity of ejaculate changes post-vasectomy.