Nokea
A patient diagnosed with arthritis has been taking aspirin and now reports experiencing tinnitus and hearing loss. What should the nurse teach this patient?
- A. The hearing loss will likely resolve with time after the drug is discontinued.
- B. The patients hearing loss and tinnitus are irreversible at this point.
- C. The patients tinnitus is likely multifactorial, and not directly related to aspirin use.
- D. The patients tinnitus will abate as tolerance to aspirin develops.
Correct Answer: B
Rationale: The correct answer is B because hearing loss and tinnitus caused by aspirin are typically irreversible. Aspirin is known to cause ototoxicity, which can lead to permanent damage to the auditory system. The nurse should inform the patient that the hearing loss and tinnitus may not improve even after discontinuing aspirin.
Choice A is incorrect because hearing loss caused by aspirin is usually permanent. Choice C is incorrect because aspirin is a known cause of tinnitus and hearing loss. Choice D is incorrect because tolerance to aspirin does not prevent or reverse ototoxic effects like tinnitus and hearing loss.
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A 14-year-old is brought to the clinic by her mother. The mother explains to the nurse that her daughter has just started using tampons, but is not yet sexually active. The mother states I am very concerned because my daughter is having a lot of stabbing pain and burning. What might the nurse suspect is theproblem with the 14-year-old?
- A. Vulvitis
- B. Vulvodynia
- C. Vaginitis
- D. Bartholins cyst
Correct Answer: B
Rationale: The correct answer is B: Vulvodynia. Vulvodynia is characterized by chronic vulvar pain or discomfort, including stabbing pain and burning, without an identifiable cause. In this case, the young girl is experiencing these symptoms despite not being sexually active, ruling out other conditions like vulvitis (inflammation of the vulva), vaginitis (inflammation of the vagina), and Bartholin's cyst (fluid-filled swelling near the vaginal opening). The absence of sexual activity suggests that the pain is not related to an infection or trauma, further supporting the diagnosis of vulvodynia.
A nurse is preparing to lavage a patient in theemergency department for an overdose. Which tube should the nurse obtain?
- A. Ewald
- B. Dobhoff
- C. Miller-Abbott
- D. Sengstaken-Blakemore
Correct Answer: A
Rationale: The correct answer is A: Ewald tube. This tube is used for gastric lavage due to its large diameter and open end which allows for effective suction of gastric contents. The Ewald tube is specifically designed for gastric lavage and is ideal for removing toxins from the stomach.
Summary of why the other choices are incorrect:
B: Dobhoff tube is a small-bore feeding tube, not suitable for gastric lavage.
C: Miller-Abbott tube is used for intestinal decompression, not gastric lavage.
D: Sengstaken-Blakemore tube is used for esophageal varices, not gastric lavage.
A nurse has asked the nurse educator if there is any way to predict the severity of a patients anaphylactic reaction. What would be the nurses best response?
- A. The faster the onset of symptoms, the more severe the reaction.
- B. The reaction will be about one-third more severe than the patients last reaction to the same antigen.
- C. There is no way to gauge the severity of a patients anaphylaxis, even if it has occurred repeatedly in the past.
- D. The reaction will generally be slightly less severe than the last reaction to the same antigen.
Correct Answer: C
Rationale: The correct answer is C because the severity of an anaphylactic reaction can vary greatly from one episode to another in the same patient. Anaphylactic reactions are unpredictable and can be influenced by various factors such as the amount of allergen exposure, individual immune response, underlying health conditions, and concurrent medications. Therefore, it is not possible to reliably gauge the severity of a patient's anaphylactic reaction even if it has occurred repeatedly in the past.
Choice A is incorrect because the onset of symptoms alone is not a reliable predictor of the severity of the reaction. Choice B is incorrect as well because there is no set formula to predict that the reaction will be one-third more severe than the patient's last reaction. Choice D is incorrect because stating that the reaction will generally be slightly less severe than the last reaction is also not accurate or supported by evidence.
A patient with severe environmental allergies is scheduled for an immunotherapy injection. What should be included in teaching the patient about this treatment?
- A. The patient will be given a low dose of epinephrine before the treatment.
- B. The patient will remain in the clinic to be monitored for 30 minutes following the injection.
- C. Therapeutic failure occurs if the symptoms to the allergen do not decrease after 3 months.
- D. The allergen will be administered by the peripheral intravenous route. .
Correct Answer: B
Rationale: Step 1: Immunotherapy injections can cause allergic reactions.
Step 2: Monitoring post-injection is crucial to detect and manage any potential adverse reactions promptly.
Step 3: Staying in the clinic for 30 minutes allows for immediate intervention if needed.
Step 4: This ensures patient safety and reduces the risk of severe reactions.
Summary:
A: Epinephrine is not typically given before immunotherapy injections.
C: Therapeutic response may take longer than 3 months to show.
D: Immunotherapy is usually given via subcutaneous route, not intravenous.
A nursing student is learning how to perform sexual assessments using the PLISSIT model. According to this model, the student should begin an assessment by doing which of the following?
- A. Briefly teaching the patient about normal sexual physiology
- B. Assuring the patient that what he says will be confidential
- C. Asking the patient if he is willing to discuss sexual functioning
- D. Ensuring patient privacy
Correct Answer: D
Rationale: The correct answer is D: Ensuring patient privacy. In the PLISSIT model, ensuring patient privacy is crucial as it creates a safe and confidential environment for discussing sensitive topics like sexual health. This step helps build trust and allows the patient to feel comfortable sharing intimate details. Briefly teaching about normal sexual physiology (A) may come later in the assessment process. Assuring confidentiality (B) is important but doesn't address the immediate need for privacy. Asking if the patient is willing to discuss sexual functioning (C) assumes patient readiness without first establishing a private setting.