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A patient with a diagnosis of gastric cancer has been unable to tolerate oral food and fluid intake and her tumor location precludes the use of enteral feeding. What intervention should the nurse identify as best meeting this patients nutritional needs?
- A. Administration of parenteral feeds via a peripheral IV
- B. TPN administered via a peripherally inserted central catheter
- C. Insertion of an NG tube for administration of feeds
- D. Maintaining NPO status and IV hydration until treatment completion
Correct Answer: B
Rationale: The correct answer is B: TPN administered via a peripherally inserted central catheter. TPN provides comprehensive nutrition intravenously, bypassing the GI tract, which is important for patients unable to tolerate oral intake. A peripherally inserted central catheter allows for long-term TPN administration.
A: Administration of parenteral feeds via a peripheral IV is not ideal for long-term nutrition as it may not provide complete nutrition.
C: Insertion of an NG tube may not be feasible due to the tumor location and the patient's inability to tolerate oral intake.
D: Maintaining NPO status and IV hydration alone may lead to malnutrition over time as it does not provide adequate nutrition.
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The nurse is caring for a patient withClostridiumdifficile. Which nursing actions will have thegreatest impact in preventing the spread of the bacteria?
- A. Appropriate disposal of contaminated items in biohazard bags
- B. Monthly in-services about contact precautions
- C. Mandatory cultures on all patients
- D. Proper hand hygiene techniques
Correct Answer: D
Rationale: Correct Answer: D - Proper hand hygiene techniques
Rationale:
1. Clostridium difficile is mainly spread through contact with contaminated surfaces.
2. Proper hand hygiene is the most effective way to prevent the spread of bacteria.
3. Hand hygiene removes bacteria from hands, reducing the risk of transmission.
4. Appropriate disposal (A) is important but doesn't directly prevent spread. Monthly in-services (B) and mandatory cultures (C) are not as effective as hand hygiene in preventing transmission.
A patient is postoperative day 6 following tympanoplasty and mastoidectomy. The patient has phoned the surgical unit and states that she is experiencing occasional sharp, shooting pains in her affected ear. How should the nurse best interpret this patients complaint?
- A. These pains are an expected finding during the first few weeks of recovery.
- B. The patients complaints are suggestive of a postoperative infection.
- C. The patient may have experienced a spontaneous rupture of the tympanic membrane.
- D. The patients surgery may have been unsuccessful.
Correct Answer: A
Rationale: The correct answer is A. Postoperative day 6 following tympanoplasty and mastoidectomy is still within the early phase of recovery, where occasional sharp, shooting pains in the affected ear can be expected due to the healing process. Here's a step-by-step rationale:
1. Timing: It is only day 6 post-surgery, so it is normal to experience some pain as part of the healing process.
2. Nature of pain: Sharp, shooting pains are common post-surgery due to tissue healing and nerve regeneration.
3. Lack of other symptoms: The patient did not report any other concerning symptoms like fever or discharge, which would be more indicative of an infection.
4. Unlikely complications: Spontaneous rupture of the tympanic membrane or unsuccessful surgery would typically present with more severe and consistent symptoms.
Summary:
- B: Unlikely as there are no other signs of infection.
- C: Unlikely as the pain is described as occasional and sharp.
- D:
A patient has presented for her annual mammogram. The patient voices concerns related to exposure to radiation. What should the nurse teach the patient about a mammogram?
- A. It does not use radiation.
- B. Radiation levels are safe as long as mammograms are performed only once per year.
- C. The negative effects of radiation do not accumulate until late in life.
- D. Radiation from a mammogram is equivalent to an hour of sunlight.
Correct Answer: A
Rationale: Step 1: Mammograms use low-dose X-rays to create images of the breast tissue.
Step 2: The radiation exposure in a mammogram is minimal and considered safe.
Step 3: Choice A is correct as it states that mammograms do not use radiation, which is accurate.
Step 4: Other choices are incorrect because B wrongly implies that annual mammograms are safe due to low radiation levels, C is incorrect as radiation effects can accumulate over time, and D is incorrect as the amount of radiation in a mammogram is much lower than an hour of sunlight.
As the American population ages, nurses expect see more patients admitted to long-term care facilities in need of palliative care. Regulations now in place that govern how the care in these facilities is both organized and reimbursed emphasize what aspect of care?
- A. Ongoing acute care
- B. Restorative measures
- C. Mobility and socialization
- D. Incentives to palliative care
Correct Answer: D
Rationale: The correct answer is D: Incentives to palliative care. Palliative care focuses on improving the quality of life for patients with serious illnesses by addressing their physical, emotional, and spiritual needs. As the American population ages, the emphasis on palliative care in long-term care facilities is crucial. Regulations emphasizing incentives for palliative care ensure that patients receive appropriate symptom management, comfort care, and support to enhance their overall well-being.
Choice A: Ongoing acute care is not the correct answer because palliative care is different from acute care, which focuses on treating the underlying medical condition.
Choice B: Restorative measures are not the correct answer as palliative care aims to improve quality of life rather than focusing on restoring physical function.
Choice C: Mobility and socialization are important aspects of care in long-term facilities, but palliative care goes beyond these aspects to provide holistic support for patients facing serious illnesses.
A nurse is teaching the staff about informatics.Which information from the staff indicates the nurse needs to follow up?
- A. To be proficient in informatics, a nurse should be able to discover, retrieve, and use information in practice.
- B. A nurse needs to know how to find, evaluate, and use information effectively.
- C. If a nurse has computer competency, the nurse is competent in informatics
- D. Nursing informatics is a recognized specialty area of nursing practice.
Correct Answer: C
Rationale: The correct answer is C. Computer competency does not equate to informatics competency. Informatics involves more than just basic computer skills; it encompasses the ability to use technology to manage and analyze data for improved healthcare outcomes.
A: This is a correct statement about informatics proficiency.
B: This is also a correct statement about the skills needed for informatics.
D: This is a true statement about nursing informatics being a recognized specialty, but it does not indicate a need for follow-up.
In summary, choice C is incorrect as it oversimplifies the concept of informatics, while choices A, B, and D provide accurate information related to informatics.