Nokea
A patient comes to the clinic complaining of a tender, inflamed vulva. Testing does not reveal the presence of any known causative microorganism. What aspect of this patients current health status may account for the patients symptoms of vulvitis?
- A. The patient is morbidly obese.
- B. The patient has type 1 diabetes.
- C. The patient has chronic kidney disease.
- D. The patient has numerous allergies.
Correct Answer: A
Rationale: Morbid obesity is a risk factor for developing a condition known as intertrigo, which is inflammation of the skin folds. In this case, the skin folds of the vulva are affected, leading to vulvitis. The warm and moist environment between the skin folds in obese individuals can promote the growth of microorganisms and the development of inflammation. This can result in symptoms such as tenderness and redness in the vulva. Since testing did not reveal the presence of any known causative microorganism, the patient's morbid obesity may be the underlying factor contributing to the symptoms of vulvitis. Treating the intertrigo and addressing the underlying obesity may help alleviate the symptoms.
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A 60-year-old patient with a diagnosis of prostate cancer is scheduled to have an interstitial implant for high-dose radiation (HDR). What safety measure should the nurse include in this patients subsequent plan of care?
- A. Limit the time that visitors spend at the patients bedside.
- B. Teach the patient to perform all aspects of basic care independently.
- C. Assign male nurses to the patients care whenever possible.
- D. Situate the patient in a shared room with other patients receiving brachytherapy.
Correct Answer: A
Rationale: The patient undergoing interstitial implant for high-dose radiation (HDR) for prostate cancer will emit radiation that poses a risk to others. Limiting the time that visitors spend at the patient's bedside is essential to minimize their exposure to radiation. It is important to follow safety measures to protect both the patient and others from potential harm. Other options such as teaching the patient to perform basic care independently, assigning male nurses, or situating the patient in a shared room with other brachytherapy patients do not directly address the safety concern of radiation exposure to visitors.
A 50-year-old man diagnosed with leukemia will begin chemotherapy. What would the nurse do to combat the most common adverse effects of chemotherapy?
- A. Administer an antiemetic.
- B. Administer an antimetabolite.
- C. Administer a tumor antibiotic.
- D. Administer an anticoagulant.
Correct Answer: A
Rationale: Nausea and vomiting are common adverse effects of chemotherapy. Administering an antiemetic helps to prevent or reduce these symptoms in patients undergoing chemotherapy. By managing nausea and vomiting, the patient's overall well-being and quality of life during treatment can be improved. Therefore, providing an antiemetic medication is essential in combating these adverse effects and promoting patient comfort and compliance with treatment.
A patient who has AIDS is being treated in the hospital and admits to having periods of extreme anxiety. What would be the most appropriate nursing intervention?
- A. Teach the patient guided imagery.
- B. Give the patient more control of her antiretroviral regimen.
- C. Increase the patients activity level.
- D. Collaborate with the patients physician to obtain an order for hydromorphone.
Correct Answer: A
Rationale: The most appropriate nursing intervention for a patient with AIDS experiencing extreme anxiety is to teach the patient guided imagery. Guided imagery is a relaxation technique that can help the patient reduce anxiety levels, promote a sense of calm, and improve overall well-being. By teaching the patient how to use guided imagery, the nurse empowers the patient to manage her anxiety in a non-pharmacological way. This intervention promotes self-care and allows the patient to have a tool to use independently beyond the hospital setting. Giving the patient more control of her antiretroviral regimen may be beneficial for adherence but does not directly address the anxiety symptoms. Increasing the patient's activity level may be helpful for overall well-being but may not specifically target the extreme anxiety. Collaborating with the patient's physician to obtain an order for hydromorphone, a potent opioid medication, is not appropriate unless it is indicated for severe pain management, not anxiety.
A patient with no prenatal care delivers a healthy male infant via the vaginal route, with minimal blood loss. During the labor period, vital signs were normal. At birth, significant maternal hypertension is noted. When the patient is questioned, she relates that there is history of heart disease in her family; but, that she has never been treated for hypertension. Blood pressure is treated in the hospital setting and the patient is discharged. The patient returns at her scheduled 6-week checkup and is found to be hypertensive. Which type of hypertension is the patient is exhibiting?
- A. Pregnancy-induced hypertension (PIH)
- B. Gestational hypertension
- C. Preeclampsia superimposed on chronic hypertension
- D. Undiagnosed chronic hypertension
Correct Answer: D
Rationale: The patient in this scenario exhibits signs of chronic hypertension, particularly due to the history of heart disease in her family, the postpartum persistence of elevated blood pressure, and the diagnosis of hypertension at the 6-week checkup. While pregnancy-induced hypertension (PIH), gestational hypertension, and preeclampsia can occur during pregnancy, they typically resolve within a few weeks after delivery. The fact that the patient's hypertension persists beyond the postpartum period suggests that she likely had preexisting, undiagnosed chronic hypertension. Therefore, option D is the most appropriate choice in this case.
The nurse responds to the call light of a patient who has had a cervical diskectomy earlier in the day. Thecpatient states that she is having severe pain that had a sudden onset. What is the nurses most appropriate action?
- A. Palpate the surgical site.
- B. Remove the dressing to assess the surgical site.
- C. Call the surgeon to report the patients pain.
- D. Administer a dose of an NSAID.
Correct Answer: C
Rationale: In this scenario, the patient who has had a cervical diskectomy is experiencing severe pain with a sudden onset, which can be indicative of a complication such as bleeding, infection, or nerve impingement. The nurse's most appropriate action is to call the surgeon immediately to report the patient's pain. The surgeon needs to be informed promptly so that a further assessment can be made and appropriate interventions can be initiated to address the cause of the sudden pain. Palpating the surgical site or removing the dressing without consulting the surgeon first may worsen the situation or increase the risk of complications. Administering an NSAID is not appropriate in this situation without further evaluation and guidance from the surgeon. It is essential to prioritize patient safety and ensure that the patient receives timely and appropriate care by involving the surgeon in the decision-making process.