Nokea
A patient has just acknowledged that she is 20 weeks pregnant and confides to the nurse that she has a daily heroin habit. The nurse discusses treatment options for the patient. Which patient statement requires follow-up?
- A. "My plan is to visit the outpatient clinic daily for treatment."
- B. "will see my health care provider at least every 2 weeks."
- C. "My baby will not have to go through withdrawal when I take methadone."
- D. "With oral methadone, my baby and I are at decreased risk of infection."
Correct Answer: B
Rationale: The correct answer is B because seeing the healthcare provider every 2 weeks may not be frequent enough for monitoring a pregnant patient with a heroin habit. Regular monitoring is crucial for the well-being of both the mother and the baby. Option A shows a proactive approach for daily treatment, Option C is incorrect as methadone does not eliminate the risk of withdrawal in newborns, and Option D is incorrect as methadone does not reduce the risk of infection. Regular and close monitoring is essential in such cases to ensure the safety and health of both the mother and the baby.
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The nurse is educating a prenatal client about weight dysphoric disorder. Which statement by the client gain during pregnancy. Which statement by the would require immediate follow-up? client indicates effective understanding?
- A. I have been crying the week of my period.
- B. I should gain 2 to 4 pounds in the first trimester
- C. I am experiencing suicidal thoughts. and half a pound per week in the last two
- D. My menstrual cycle is 1 week late. trimesters.
Correct Answer: C
Rationale: Correct Answer: C. "I am experiencing suicidal thoughts."
Rationale: This statement indicates a serious mental health concern that requires immediate follow-up. Suicidal thoughts during pregnancy can be a sign of depression or other mental health issues that need to be addressed promptly to ensure the safety and well-being of the client and the baby.
Summary of Other Choices:
A: "I have been crying the week of my period." - This statement suggests premenstrual symptoms which are common and not necessarily alarming during pregnancy.
B: "I should gain 2 to 4 pounds in the first trimester and half a pound per week in the last two trimesters." - This statement reflects a correct understanding of weight gain recommendations during pregnancy and does not raise immediate concerns.
D: "My menstrual cycle is 1 week late." - This statement is not concerning during pregnancy as menstrual cycles typically stop during pregnancy.
What statement by a health-care provider is an example of shared decision making between a health-care provider and a patient?
- A. I'm going to start this medication because it is best for your baby.
- B. Can you agree with me because I am your health-care provider?â€
- C. I understand how the hospital works, and it will be easier for you to just do what is easy for the nurses.â€
- D. Do you feel ready to make a decision after we talked about this medication?â€
Correct Answer: D
Rationale: The correct answer is D because it involves the patient in the decision-making process by asking for their readiness to make a decision after discussing the medication. This approach respects the patient's autonomy and encourages them to actively participate in their healthcare choices.
A is incorrect as it does not involve the patient in the decision-making process but rather imposes the provider's choice. B is incorrect as it uses authority to influence the patient's decision, which is not in line with shared decision making. C is incorrect as it focuses on convenience rather than involving the patient in the decision-making process.
What question during a family assessment could the nurse ask to determine if the family has necessary resources?
- A. Do you enjoy spending time with your family?
- B. Do you have a group of friends, neighbors, or a church that helps you when you are ill?
- C. How often do you go to the store by yourself?
- D. Do your family members get along well?
Correct Answer: B
Rationale: The correct answer is B: "Do you have a group of friends, neighbors, or a church that helps you when you are ill?" This question assesses the family's support network and resources in times of need. It helps determine if the family has a social support system that can provide assistance during challenging situations. Options A, C, and D are incorrect as they do not directly address the availability of external resources for the family's well-being. Option A focuses on emotional aspects, C on independence, and D on family dynamics, which are not directly related to assessing resources.
The nurse is educating a client about gestational diabetes. What is the most important teaching point?
- A. Avoid all carbohydrates.
- B. Check your blood sugar only when symptomatic.
- C. Monitor blood sugar regularly as prescribed.
- D. Increase your physical activity significantly.
Correct Answer: C
Rationale: The correct answer is C: Monitor blood sugar regularly as prescribed. This is crucial in managing gestational diabetes to ensure blood sugar levels are within target range, preventing complications for both mother and baby. Regular monitoring helps track the effectiveness of treatment and dietary adjustments. Avoiding all carbohydrates (A) is not recommended as some are necessary for energy. Checking blood sugar only when symptomatic (B) is insufficient as it may miss important fluctuations. Increasing physical activity significantly (D) is beneficial but not the most important teaching point compared to consistent blood sugar monitoring.
Developing a plan to achieve patient outcomes is included in which step of the CJMM?
- A. prioritizing hypotheses
- B. generating solutions
- C. taking action
- D. evaluating outcomes
Correct Answer: B
Rationale: The correct answer is B: generating solutions. In the CJMM (Clinical Judgment Model in Nursing), developing a plan to achieve patient outcomes falls under the step of generating solutions. This step involves identifying and implementing interventions to address the patient's needs and achieve the desired outcomes. Prioritizing hypotheses (A) is about identifying potential issues, not developing a plan. Taking action (C) is about implementing the plan, not developing it. Evaluating outcomes (D) is the final step where the effectiveness of the plan is assessed, not where the plan is developed. Therefore, B is the correct choice as it specifically focuses on the process of creating a plan to achieve patient outcomes within the CJMM.