Nokea
A patient tells his nurse that he has delayed having TURP because he is afraid it will affect his sexual function. Which response by the nurse is most appropriate?
- A. "Don't worry about sterility; sperm production is not affected by this surgery."
- B. "Would you like some information about implants used for impotence?"
- C. "This type of surgery rarely affects the ability to have an erection or ejaculation."
- D. "There are many methods of sexual expression that are alternatives to sexual intercourse."
Correct Answer: C
Rationale: The most appropriate response by the nurse is option C, "This type of surgery rarely affects the ability to have an erection or ejaculation." This response is accurate and provides reassurance to the patient while acknowledging his concerns. Transurethral resection of the prostate (TURP) is a common procedure for managing benign prostatic hyperplasia (BPH), and it typically does not have a significant impact on sexual function. By providing this information, the nurse can help alleviate the patient's fears and encourage him to proceed with the necessary treatment.
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The LPN is caring for a patient in the preoperative period who, even after verbalizing concerns and having questions answered, states, "I know I am not going to wake up after surgery." Which of the following actions should the nurse take?
- A. Reassure patient everything will be all right
- B. Explain national surgery death rate
- C. Inform the registered nurse
- D. Ask family to comfort the patient
Correct Answer: C
Rationale: The correct action for the LPN to take in this situation is to inform the registered nurse. The patient's statement indicates a high level of fear and anxiety about the surgery and their potential outcome. It is important to involve the registered nurse, who can provide further assessment, support, and interventions to address the patient's concerns appropriately. Simply reassuring the patient or providing statistics about national surgery death rates may not address the underlying fear and may require additional support and intervention. Asking the family to comfort the patient may not be the most appropriate immediate action as the patient's concerns are specific and may require professional support. Bringing the registered nurse into the situation allows for a comprehensive approach to addressing the patient's emotional needs before the surgery.
Which of the following is the most critical intervention needed for a client with myxedema coma?
- A. Administering an oral dose of levothyroxine (Synthroid)
- B. Warming the client with a warming blanket
- C. Measuring and recording accurate intake and output
- D. Maintaining a patent airway
Correct Answer: A
Rationale: Myxedema coma is a severe form of hypothyroidism that can lead to life-threatening complications, including decreased level of consciousness, hypothermia, respiratory depression, and cardiovascular collapse. Rapid administration of thyroid hormone replacement therapy, such as levothyroxine, is crucial in the management of myxedema coma to reverse the underlying hypothyroid state and improve clinical outcomes. Therefore, administering an oral dose of levothyroxine is the most critical intervention needed for a client with myxedema coma. While warming the client with a warming blanket, measuring intake and output, and maintaining a patent airway are important aspects of care, they are not as directly related to the reversal of the underlying hypothyroid state in myxedema coma as administering levothyroxine.
The nurse is caring for a newborn who was born 24 hours ago to a mother who received no prenatal care. The newborn is a poor feeder but sucks avidly on his hands. Clinical manifestations also include loose stools, tachycardia, fever, projectile vomiting, sneezing, and generalized sweating. Which should the nurse suspect?
- A. Seizure disorder
- B. Narcotic withdrawal
- C. Placental insufficiency
- D. Meconium aspiration syndrome
Correct Answer: B
Rationale: The clinical manifestations described in the scenario are classic signs of neonatal abstinence syndrome (NAS), which occurs in newborns who were exposed to drugs, particularly narcotics, in utero. The newborn's symptoms of poor feeding, sucking on his hands, tachycardia, fever, projectile vomiting, loose stools, sneezing, and generalized sweating are consistent with NAS. These symptoms occur as the newborn experiences withdrawal from the drugs to which they were exposed during pregnancy. In this case, the lack of prenatal care suggests that the mother may have used narcotics during pregnancy, leading to NAS in the newborn. It is essential for healthcare providers to recognize these signs and provide appropriate care and support for infants experiencing NAS.
Airborne isolation is required for a child who is hospitalized with:
- A. mumps.
- B. chickenpox.
- C. exanthema subitum (roseola).
- D. erythema infectiosum (fifth disease).
Correct Answer: B
Rationale: Airborne isolation is needed for a child hospitalized with chickenpox (varicella) because the virus causing chickenpox spreads easily through the air when an infected person coughs or sneezes. The virus can also be transmitted through direct contact with the rash or fluid from the blisters. By implementing airborne precautions, healthcare providers aim to prevent the spread of the virus to other patients, staff, and visitors in the healthcare setting. In contrast, mumps, exanthema subitum (roseola), and erythema infectiosum (fifth disease) are generally not transmitted through airborne routes; therefore, they do not require airborne isolation in a hospital setting.
A nurse is teaching high school students about transmission of the human immunodeficiency virus (HIV). Which comment by a student warrants clarification by the nurse?
- A. "A man should wear a latex condom during intimate sexual contact."
- B. "I've heard about people who got AIDS from blood transfusions."
- C. "I won't donate blood because I don't want to get AIDS."
- D. "IV drug users can get HIV from sharing needles."
Correct Answer: C
Rationale: It is important for the nurse to clarify to the student that donating blood does not put them at risk for getting AIDS. Blood donation centers follow strict protocols to ensure that donated blood is safe for transfusion, including screening for infectious diseases like HIV. It is admirable to donate blood as it can save lives without putting the donor at risk for acquiring HIV. It is crucial to dispel any misconceptions or fears surrounding blood donation to encourage people to participate in this important act of altruism.