Nokea
A patient who is scheduled for a skin test informs the nurse that he has been taking corticesteroids to help control his allergy symptoms. What nursing intervention should the nurse implement?
- A. The patient should take his corticosteroids regularly prior to testing.
- B. The patient should only be tested for grass, mold, and dust initially.
- C. The nurse should have an emergency cart available in case of anaphylaxis during the test.
- D. The patients test should be cancelled until he is off his corticosteroids.
Correct Answer: A
Rationale: The patient should continue taking his corticosteroids regularly prior to testing. Corticosteroids can suppress the body's immune response and affect the results of skin tests by potentially causing a false-negative result. Instructing the patient to maintain his regular corticosteroid regimen will help ensure accurate testing results. It is essential to consult with the healthcare provider to determine the appropriate timing for testing in relation to corticosteroid use.
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The priority nursing intervention when admitting a pregnant patient who has experienced a bleeding episode in late pregnancy is to
- A. monitor uterine contractions.
- B. assess fetal heart rate and maternal vital signs.
- C. place clean disposable pads to collect any drainage.
- D. perform a venipuncture for hemoglobin and hematocrit levels.
Correct Answer: B
Rationale: When admitting a pregnant patient who has experienced a bleeding episode in late pregnancy, the top priority nursing intervention is to assess fetal heart rate (FHR) and maternal vital signs. This assessment will help the nurse determine the extent of the blood loss and its impact on both the mother and the fetus. Monitoring uterine contractions is important as well, but not the priority in this situation. Placing clean disposable pads to collect any drainage is important for ongoing assessment and management but can be done after assessing the FHR and vital signs. Performing a venipuncture for hemoglobin and hematocrit levels is necessary for further evaluation but can be done after the initial assessment of FHR and vital signs. Checking the patient and fetal well-being is crucial in situations of bleeding in late pregnancy to ensure timely and appropriate intervention.
For the patient who delivered at 6:30 AM on January 10, Rho(D) immune globulin (RhoGAM) must be administered prior to
- A. 6:30 AM on January 13
- B. 6:30 PM on January 13
- C. 6:30 PM on January 14
- D. 6:30 AM on January 15
Correct Answer: A
Rationale: Rho(D) immune globulin (RhoGAM) needs to be administered within 72 hours postpartum to Rh-negative patients who have given birth to Rh-positive infants to prevent Rh sensitization. The patient delivered at 6:30 AM on January 10, so the RhoGAM should be administered prior to that time on January 13, which is 72 hours postpartum. Therefore, the correct choice is A. 6:30 AM on January 10.
The nurse is caring for a patient with an advanced stage of breast cancer and the patient has recently learned that her cancer has metastasized. The nurse enters the room and finds the patient struggling to breath and the nurses rapid assessment reveals that the patients jugular veins are distended. The nurse should suspect the development of what oncologic emergency?
- A. Increased intracranial pressure
- B. Superior vena cava syndrome (SVCS)
- C. Spinal cord compression
- D. Metastatic tumor of the neck
Correct Answer: B
Rationale: Superior vena cava syndrome (SVCS) is a medical emergency that can occur in patients with advanced cancer, such as breast cancer with metastasis. SVCS is caused by the obstruction or compression of the superior vena cava, a large vein that carries blood from the upper body back to the heart. When the superior vena cava is obstructed or compressed, it can lead to symptoms such as difficulty breathing (dyspnea) and distended jugular veins.
A nurse is beginning to use patient-centered careand cultural competence to improve nursing care. Which step should the nurse takefirst?
- A. Assessing own biases and attitude
- B. Learning about the world view of others
- C. Understanding organizational forces
- D. Developing cultural skills
Correct Answer: A
Rationale: Assessing own biases and attitudes is the first step a nurse should take when beginning to use patient-centered care and cultural competence to improve nursing care. By becoming more aware of one's biases and attitudes about human behavior, the nurse can enhance self-awareness and self-reflection. This self-awareness is vital in understanding one's own perspectives, beliefs, and values that may influence interactions with patients from different cultural backgrounds. It also allows the nurse to identify areas that may require improvement or further education. Understanding and addressing personal biases is fundamental to providing patient-centered care and avoiding potential cultural misunderstandings that may arise in the healthcare setting.
An uncircumcised 78-year-old male has presented at the clinic complaining that he cannot retract his foreskin over his glans. On examination, it is noted that the foreskin is very constricted. The nurse should recognize the presence of what health problem?
- A. Bowens disease
- B. Peyronies disease
- C. Phimosis
- D. Priapism
Correct Answer: C
Rationale: Phimosis is a condition in which the foreskin of the penis is tight and cannot be retracted over the glans. It can occur in uncircumcised males, like the 78-year-old male in this scenario. Phimosis may lead to difficulty with hygiene, pain during sexual activity, and an increased risk of infections. Treatment may involve conservative measures such as topical corticosteroids or, in severe cases, surgical intervention like circumcision to alleviate the tightness of the foreskin.