Nokea
A patient is learning about his new diagnosis of asthma with the asthma nurse. What medication has the ability to prevent the onset of acute asthma exacerbations?
- A. Diphenhydramine (Benadryl)
- B. Montelukast (Singulair)
- C. Albuterol sulfate (Ventolin)
- D. Epinephrine
Correct Answer: B
Rationale: The correct answer is B: Montelukast (Singulair). Montelukast is a leukotriene receptor antagonist that helps prevent asthma exacerbations by reducing inflammation in the airways. It is used as a maintenance medication to control and prevent asthma symptoms. Diphenhydramine (A) is an antihistamine used for allergies, not asthma prevention. Albuterol sulfate (C) is a rescue inhaler used for acute asthma symptoms, not prevention. Epinephrine (D) is used for severe allergic reactions (anaphylaxis), not asthma prevention.
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The patient has just been started on an enteral feeding and has developed diarrhea after being on the feeding for 2 hours. What does the nurse suspect is themostlikely cause of the diarrhea?
- A. Antibiotic therapy
- B. Clostridium difficile
- C. Formula intolerance
- D. Bacterial contamination
Correct Answer: C
Rationale: The correct answer is C: Formula intolerance. When a patient develops diarrhea shortly after starting enteral feeding, formula intolerance is the most likely cause. This can occur due to the patient's inability to tolerate certain ingredients in the formula, leading to gastrointestinal upset. Antibiotics (choice A) and Clostridium difficile (choice B) typically take longer to cause diarrhea. Bacterial contamination (choice D) would usually result in more severe symptoms beyond just diarrhea. In this scenario, formula intolerance is the most logical explanation for the immediate onset of diarrhea after starting enteral feeding.
A medical nurse is providing end-of-life care for a patient with metastatic bone cancer. The nurse notes that the patient has been receiving oral analgesics for her pain with adequate effect, but is now having difficulty swallowing the medication. What should the nurse do?
- A. Request the physician to order analgesics by an alternative route.
- B. Crush the medication in order to aid swallowing and absorption.
- C. Administer the patients medication with the meal tray.
- D. Administer the medication rectally.
Correct Answer: A
Rationale: Correct Answer: A
Rationale:
1. Requesting the physician to order analgesics by an alternative route is the correct choice as the patient is having difficulty swallowing the medication.
2. Alternative routes could include subcutaneous, intravenous, transdermal, or rectal routes to ensure the patient receives adequate pain relief.
3. Crushing the medication (choice B) may alter the absorption rate and effectiveness of the medication.
4. Administering the medication with the meal tray (choice C) may not address the swallowing issue and could lead to inadequate pain relief.
5. Administering the medication rectally (choice D) is not ideal as it may not be the most appropriate route for analgesics in this situation.
An adult oncology patient has a diagnosis of bladder cancer with metastasis and the patient has asked the nurse about the possibility of hospice care. Which principle is central to a hospice setting?
- A. The patient and family should be viewed as a single unit of care.
- B. Persistent symptoms of terminal illness should not be treated.
- C. Each member of the interdisciplinary team should develop an individual plan of care.
- D. Terminally ill patients should die in the hospital whenever possible.
Correct Answer: A
Rationale: The correct answer is A: The patient and family should be viewed as a single unit of care. In hospice care, the focus is on providing holistic care not only to the patient but also to their family members. This approach recognizes that the patient's well-being is interconnected with that of their loved ones. By viewing the patient and family as a single unit of care, hospice providers can address not just the physical symptoms but also the emotional, social, and spiritual needs of both the patient and their family. This principle emphasizes the importance of supporting the patient and their family through the end-of-life journey.
Summary:
- Choice B is incorrect as hospice care aims to manage symptoms effectively to improve quality of life.
- Choice C is incorrect as hospice care typically involves a collaborative interdisciplinary team working towards common goals.
- Choice D is incorrect as hospice care often prioritizes providing end-of-life care in a comfortable setting preferred by the patient.
A patient at high risk for breast cancer is scheduled for an incisional biopsy in the outpatient surgery department. When the nurse is providing preoperative education, the patient asks why an incisional biopsy is being done instead of just removing the mass. What would be the nurses best response?
- A. An incisional biopsy is performed because its known to be less painful and more accurate than other forms of testing.
- B. An incisional biopsy is performed to confirm a diagnosis and so that special studies can be done that will help determine the best treatment.
- C. An incisional biopsy is performed to assess the potential for recovery from a mastectomy.
- D. An incisional biopsy is performed on patients who are younger than the age of 40 and who are otherwise healthy.
Correct Answer: B
Rationale: The correct answer is B because an incisional biopsy is typically performed to confirm a diagnosis by obtaining a sample of the tissue in question. This allows for further analysis through special studies to determine the best course of treatment. The other choices are incorrect because:
A: The reason for performing an incisional biopsy is not primarily based on pain or accuracy comparisons with other testing methods.
C: An incisional biopsy is not done to assess potential recovery from a mastectomy but rather to diagnose the nature of the mass.
D: Age and general health status are not sole criteria for determining the need for an incisional biopsy.
In the past three to four decades, nursing has moved into the forefront in providing care for the dying. Which phenomenon has most contributed to this increased focus of care of the dying?
- A. Increased incidence of infections and acute illnesses
- B. Increased focus of health care providers on disease prevention
- C. Larger numbers of people dying in hospital settings
- D. Demographic changes in the population
Correct Answer: D
Rationale: The correct answer is D: Demographic changes in the population. This is because as the population ages, there is a higher prevalence of chronic illnesses and an increased number of people facing end-of-life care needs. This has led to a greater demand for palliative and hospice care services, shifting the focus of nursing towards providing care for the dying.
A: Increased incidence of infections and acute illnesses is not the primary factor contributing to the increased focus on care for the dying. While these conditions do require nursing care, they do not directly explain the shift in focus.
B: Increased focus of health care providers on disease prevention is important but does not directly explain the increased attention on care for the dying. Disease prevention aims to reduce the incidence of illnesses, not necessarily address end-of-life care needs.
C: Larger numbers of people dying in hospital settings may be a consequence of the increased focus on care for the dying, but it is not the underlying phenomenon driving the shift in nursing care towards end-of