Nokea
A patient has undergone diagnostic testing and has been diagnosed with otosclerosis? What ear structure is primarily affected by this diagnosis?
- A. Malleus
- B. Stapes
- C. Incus
- D. Tympanic membrane
Correct Answer: B
Rationale: The correct answer is B: Stapes. Otosclerosis is a condition characterized by abnormal bone growth in the middle ear, causing the stapes bone to become fixed in place. This results in hearing loss due to the inability of the stapes to transmit sound vibrations to the inner ear. The malleus (choice A), incus (choice C), and tympanic membrane (choice D) are not primarily affected by otosclerosis. The malleus and incus are located in the middle ear but are not typically affected by otosclerosis. The tympanic membrane is part of the outer ear and is not directly involved in otosclerosis.
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The nurse is planning care for a group of patients. Which task will the nurse assign to the nursing assistive personnel?
- A. Measuring capillary blood glucose level
- B. Measuring nasoenteric tube for insertion
- C. Measuring pH in gastrointestinal aspirate
- D. Measuring the patient’s risk for aspiration
Correct Answer: A
Rationale: The correct answer is A because measuring capillary blood glucose level is a task that can be safely delegated to nursing assistive personnel. This task is within their scope of practice and does not require specialized nursing knowledge. Nursing assistive personnel can perform this task accurately with proper training and supervision.
Incorrect choices:
B: Measuring nasoenteric tube for insertion requires specialized training and assessment skills that nursing assistive personnel may not possess.
C: Measuring pH in gastrointestinal aspirate involves interpretation and clinical judgment that should be done by a licensed nurse.
D: Measuring the patient's risk for aspiration involves critical thinking and assessment skills that are beyond the scope of nursing assistive personnel.
A clinic nurse is providing preprocedure education for a man who will undergo a vasectomy. Which of the following measures will enhance healing and comfort? Select all that apply.
- A. Abstaining from sexual intercourse for at least 14 days postprocedure
- B. Wearing a scrotal support garment
- C. Using sitz baths
- D. Applying a heating pad intermittently E) Staying on bed rest for 48 to 72 hours postprocedure
Correct Answer: A
Rationale: The correct answer is A: Abstaining from sexual intercourse for at least 14 days postprocedure. This is important to allow the surgical site to heal properly and reduce the risk of complications. Choice B, wearing a scrotal support garment, can provide comfort but does not directly enhance healing. Choice C, using sitz baths, may help with discomfort but may not specifically promote healing. Choice D, applying a heating pad intermittently, could potentially increase the risk of infection. Choice E, staying on bed rest for 48 to 72 hours postprocedure, is unnecessary and could lead to complications such as blood clots.
A 42-year-old man has come to the clinic for an annual physical. The nurse notes in the patients history that his father was treated for breast cancer. What should the nurse provide to the patient before he leaves the clinic?
- A. A referral for a mammogram
- B. Instructions about breast self-examination (BSE)
- C. A referral to a surgeon
- D. A referral to a support group
Correct Answer: A
Rationale: The correct answer is A: A referral for a mammogram. Given the family history of breast cancer in the patient's father, the nurse should recommend a mammogram as a preventive measure due to increased risk. Mammograms are effective in detecting breast cancer early, especially in individuals with a family history. This can help in early diagnosis and timely intervention if needed.
B: Instructions about breast self-examination (BSE) can be helpful, but in this case, a mammogram is a more definitive screening tool for high-risk individuals.
C: A referral to a surgeon is not necessary at this point as the patient does not exhibit any symptoms of breast cancer.
D: Referral to a support group may be beneficial for emotional support, but the priority should be on proactive screening measures like a mammogram.
The nurse is teaching a health class about thegastrointestinal tract. The nurse will explain that which portion of the digestive tract absorbs most of the nutrients?
- A. Ileum
- B. Cecum
- C. Stomach
- D. Duodenum
Correct Answer: D
Rationale: The correct answer is D: Duodenum. The duodenum is the first part of the small intestine where most of the digestion and absorption of nutrients occurs. It receives partially digested food from the stomach and mixes it with bile and pancreatic enzymes to break down nutrients. The villi in the duodenum increase the surface area for absorption. The other choices (A: Ileum, B: Cecum, C: Stomach) are incorrect because the ileum and cecum are parts of the small intestine where some absorption occurs but not as much as in the duodenum. The stomach primarily digests food and does not absorb many nutrients.
A nurse is providing care to a culturally diversepopulation. Which action indicates the nurse is successful in the role of providing culturally congruent care?
- A. Provides care that fits the patient’s valued life patterns and set of meanings
- B. Provides care that is based on meanings generated by predetermined criteria
- C. Provides care that makes the nurse the leader in determining what is needed
- D. Provides care that is the same as the values of the professional health care system
Correct Answer: A
Rationale: The correct answer is A because providing care that fits the patient's valued life patterns and set of meanings demonstrates cultural congruence. This approach acknowledges and respects the patient's cultural background, beliefs, and preferences. It promotes patient-centered care and enhances communication and trust between the nurse and the patient.
Choice B is incorrect because care based on predetermined criteria may not align with the patient's individual cultural needs. Choice C is incorrect as it does not prioritize the patient's values and preferences. Choice D is incorrect because providing care based solely on the values of the professional health care system may not consider the cultural diversity of the patient population.