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A patient receiving palliative care for end-stage amyotrophic lateral sclerosis (ALS) experiences difficulty swallowing and expresses concerns about choking. What intervention should the palliative nurse prioritize to address the patient's concerns?
- A. Encourage the patient to avoid eating solid foods to prevent choking.
- B. Refer the patient to a speech therapist for swallowing exercises and techniques.
- C. Administer sedative medications to reduce anxiety related to choking fears.
- D. Recommend inserting a feeding tube for nutritional support.
Correct Answer: B
Rationale: The most appropriate intervention for a patient with difficulty swallowing due to end-stage ALS and concerns about choking is to refer the patient to a speech therapist for swallowing exercises and techniques (Choice B). Speech therapists are trained to assess and manage swallowing difficulties in patients, especially those with neurodegenerative diseases like ALS. They can provide specific exercises and strategies to help the patient swallow safely and reduce the risk of choking. This intervention focuses on addressing the underlying issue causing the difficulty swallowing and aims to improve the patient's quality of life by enhancing their ability to eat and drink. The other options are not as effective or appropriate in addressing the patient's concerns.
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Which of the following is not a characteristic of quality improvement that the medical director is interested in?
- A. The leader is the empowerer
- B. Problem-solving is by everyone
- C. The employees are treated as customers
- D. Reacts to correct or bad situation
Correct Answer: D
Rationale: Quality improvement focuses on proactive measures rather than reactive responses. The medical director would be more interested in establishing processes and systems that prevent issues from occurring in the first place, rather than just reacting to problems as they arise. Continuous improvement involves identifying problems, analyzing root causes, and implementing long-term solutions to prevent the issues from recurring. Therefore, reacting to correct or bad situations is not a characteristic of quality improvement that the medical director would prioritize.
Which of the following is NOT included among the factors that should be considered by the nurse or the pregnant woman in interpreting results of pregnancy test?
- A. Last menstrual period
- B. Type of pregnancy test
- C. Previous pregnancy
- D. Menstrual cycle length
Correct Answer: B
Rationale: The type of pregnancy test is not a factor that should be considered by the nurse or the pregnant woman in interpreting the results of a pregnancy test. Factors such as the last menstrual period, previous pregnancy history, and menstrual cycle length play a crucial role in determining the reliability and accuracy of the pregnancy test results.
If Nurse Tarly and her core group decide to formulate a directional hypothesis it will be ________.
- A. There is an increase relationship between the caring staff nurses and degree of satisfaction of ostomized patients.
- B. The caring behaviors of the staff nurses is related to increased satisfaction of ostomized patients.
- C. The staff nurses' behaviors have an effect on the patient's satisfaction with osomized patients.
- D. A significant relationship exists between the caring behaviors of the staff-nurses and degree of satisfaction of ostomized patients.
Correct Answer: D
Rationale: A directional hypothesis predicts the direction of the relationship between variables. In this case, the statement "A significant relationship exists between the caring behaviors of the staff-nurses and degree of satisfaction of ostomized patients" clearly indicates the direction of the expected relationship. This hypothesis suggests that there will be a positive or negative relationship between the caring behaviors of staff nurses and the satisfaction of ostomized patients. The terms "significant relationship" and "degree of satisfaction" indicate that the hypothesis is specific and measurable, making it suitable for testing through research methods.
A patient with suspected acute exacerbation of asthma presents with severe dyspnea, accessory muscle use, and inability to speak in full sentences. Which of the following interventions is most appropriate for assessing the severity of the patient's asthma exacerbation and guiding management decisions?
- A. Peak expiratory flow rate (PEFR) measurement
- B. Arterial blood gas (ABG) analysis
- C. Chest X-ray
- D. Clinical assessment using standardized severity scores
Correct Answer: D
Rationale: In the scenario described, the patient is presenting with severe symptoms of acute exacerbation of asthma, including severe dyspnea, accessory muscle use, and inability to speak in full sentences. In such cases, the most appropriate intervention for assessing the severity of the asthma exacerbation and guiding management decisions is a clinical assessment using standardized severity scores.
A nurse is caring for a patient who expresses concerns about the potential side effects of a prescribed medication. What action should the nurse take to address the patient's concerns?
- A. Disregard the patient's concerns and reassure them about the medication's safety
- B. Provide accurate information about the medication, including potential side effects
- C. Encourage the patient to stop taking the medication if they are worried about side effects
- D. Minimize the importance of the patient's concerns and focus on other aspects of care
Correct Answer: B
Rationale: The nurse should provide accurate information about the medication, including potential side effects, to address the patient's concerns. It is important for the nurse to listen to the patient's worries and provide them with the knowledge they need to make an informed decision about their treatment. By educating the patient about the medication and its potential side effects, the nurse empowers the patient to be actively involved in their care and promotes shared decision-making. Disregarding the patient's concerns, encouraging them to stop taking the medication, or minimizing the importance of their worries are not appropriate responses and may negatively impact the patient-nurse relationship and the patient's adherence to the prescribed treatment.