Nokea
A patient is prescribed a beta-blocker for the management of migraine headaches. Which adverse effect should the nurse monitor closely in the patient?
- A. Hypertension
- B. Bradycardia
- C. Hyperglycemia
- D. Constipation
Correct Answer: B
Rationale: Beta-blockers work by blocking the effects of adrenaline on beta receptors in the body. One common adverse effect of beta-blockers is bradycardia, or a slowed heart rate. Since the patient is being prescribed a beta-blocker for migraine headaches, it is important for the nurse to monitor closely for signs and symptoms of bradycardia such as dizziness, fatigue, and fainting. Monitoring the heart rate regularly and reporting any significant decrease to the healthcare provider is essential to prevent complications associated with bradycardia. Compared to the other options, bradycardia is the most relevant adverse effect to monitor in a patient prescribed a beta-blocker.
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A rape victim tells the emergency nurse, I feel so dirty. Help me take a shower before I get examined. The nurse should:
- A. arrange for the victim to shower.
- B. give the victim a basin of water and towels.
- C. offer the victim a shower after evidence is collected .
- D. explain that bathing facilities are not available in the emergency department.
Correct Answer: C
Rationale: The correct response for the nurse in this situation would be to offer the victim a shower after evidence is collected. It is essential to preserve any physical evidence that may be present from the assault during the forensic examination. Allowing the victim to shower before evidence is collected could potentially compromise the evidence and hinder the investigation. The nurse should provide support to the victim during this difficult time and assure them that they will have the opportunity to shower once the necessary evidence is obtained. It is also crucial for the nurse to offer empathy and understanding while explaining the importance of preserving any evidence related to the assault.
A patient becomes emotional while discussing their recent diagnosis. What is the nurse's most appropriate response?
- A. Ignore the patient's emotions and continue with the conversation.
- B. Acknowledge the patient's emotions and offer empathy and support.
- C. Tell the patient to stop being emotional and focus on the facts.
- D. Change the subject to avoid further emotional distress.
Correct Answer: B
Rationale: Acknowledging the patient's emotions and offering empathy and support is the most appropriate response in this situation. It is important for the nurse to show understanding and compassion towards the patient, especially when they are feeling emotional about a recent diagnosis. By acknowledging the patient's emotions, the nurse can create a supportive environment that facilitates open communication and helps the patient feel heard and valued. This approach can also help build trust between the patient and the nurse, leading to better outcomes in terms of patient care and overall well-being. Ignoring the patient's emotions, telling them to stop being emotional, or changing the subject may make the patient feel dismissed or isolated, which could negatively impact their mental and emotional state. Thus, offering empathy and support is key in helping the patient cope with their emotions and navigate through their diagnosis.
During the active phase of labor, the nurse observes that the cervix is dilated to 6 cm and the contractions are regular, lasting 60 seconds each, occurring every 3 minutes. What action should the nurse take?
- A. Encourage the mother to push.
- B. Administer oxytocin to augment labor.
- C. Prepare for delivery.
- D. Continue to monitor the progress of labor.
Correct Answer: D
Rationale: During the active phase of labor, a cervical dilation of 6 cm and regular contractions lasting 60 seconds each, occurring every 3 minutes indicate good progress in labor. The nurse should continue to monitor the progress closely by assessing the mother's vital signs, fetal heart rate, and the pattern of contractions. It is important to provide support and encouragement to the mother, continue with comfort measures, and be prepared to assist with the delivery when the cervix is fully dilated. This stage of labor is focused on active dilation and effacement of the cervix, and it is not yet time for the mother to push or for the nurse to administer oxytocin to augment labor.
Which of the following laboratory findings is characteristic of a patient with a diagnosis of gestational diabetes mellitus (GDM)?
- A. Fasting blood glucose ≥126 mg/dL
- B. Random plasma glucose ≥200 mg/dL
- C. Hemoglobin A1c (HbA1c) ≥6.5%
- D. Oral glucose tolerance test (OGTT) 2-hour plasma glucose ≥140 mg/dL
Correct Answer: D
Rationale: The diagnosis of gestational diabetes mellitus (GDM) is typically confirmed through an oral glucose tolerance test (OGTT) during pregnancy. In GDM, the 2-hour plasma glucose level during the OGTT is equal to or greater than 140 mg/dL. This finding is characteristic of GDM and distinguishes it from other types of diabetes. Fasting blood glucose ≥126 mg/dL is diagnostic of diabetes mellitus outside of pregnancy, not specifically GDM. Random plasma glucose ≥200 mg/dL is indicative of uncontrolled diabetes in general. Hemoglobin A1c (HbA1c) ≥6.5% is used for diagnosing diabetes outside of pregnancy and is not specific to GDM.
The nurse asks the patient, "What do you fear MOST about your surgery tomorrow?" This is an example of which communication technique?
- A. Providing general leads
- B. Seeking clarification
- C. Summarizing
- D. Presenting reality
Correct Answer: B
Rationale: In this scenario, the nurse is asking the patient to elaborate on their feelings and thoughts related to the upcoming surgery. By asking, "What do you fear MOST about your surgery tomorrow?" the nurse is seeking clarification to better understand the patient's concerns and enable effective communication. Seeking clarification involves asking open-ended questions that encourage the patient to express themselves more fully, allowing the healthcare provider to address their specific worries or needs more effectively.