A patient with a history of myocardial infarction is prescribed atorvastatin for lipid-lowering therapy. Which parameter should the nurse monitor closely during atorvastatin therapy?
- A. Serum potassium levels
- B. Liver function tests
- C. Blood glucose levels
- D. Serum sodium levels
Correct Answer: B
Rationale: Atorvastatin is a medication commonly used for lipid-lowering therapy to reduce cholesterol levels and decrease the risk of cardiovascular events. However, one of the potential side effects of statin medications such as atorvastatin is liver injury. Therefore, monitoring liver function tests, including alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels, is crucial during atorvastatin therapy.
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Which of the following is the initial teachinggiven to the patient with ALS having problems in communication?
- A. Referring the client to a speech therapist
- B. Documenting any change in the elimination functions
- C. Use of pre-signals before the loss of speech
- D. Continue to use therapeutic communication technique
Correct Answer: C
Rationale: In ALS (Amyotrophic Lateral Sclerosis), communication difficulties may occur as the disease progresses and affects the muscles responsible for speech. It is crucial to initiate early measures to assist the patient in communicating effectively. Using pre-signals before the loss of speech can be helpful in maintaining communication with the patient. These pre-signals can include gestures, writing tools, communication boards, or technology-assisted communication devices. By introducing and practicing these pre-signals early on, the patient can adapt and utilize alternative communication methods before the loss of speech becomes more challenging. This proactive approach can significantly improve the patient's ability to communicate and maintain a sense of connection with others.
Disclosure of client information beyond the interdisciplinary team without consent of the client is a breach of ______.
- A. confidentiality
- B. duty
- C. beneficence
- D. veracity
Correct Answer: A
Rationale: Confidentiality is the ethical principle that requires healthcare providers to keep client information private and not disclose it without the client's consent. When client information is shared beyond the interdisciplinary team without the client's consent, it breaches the trust and privacy expected in the nurse-client relationship. This breach not only violates the ethical principle of confidentiality but also undermines the client's autonomy and right to control their own personal information. Maintaining confidentiality is crucial for building trust and ensuring the well-being of the client.
A patient admitted to the ICU develops delirium characterized by acute onset confusion and agitation. What intervention should the healthcare team prioritize to manage the patient's delirium?
- A. Administer antipsychotic medications to reduce agitation.
- B. Implement environmental modifications to promote orientation.
- C. Refer the patient to a psychiatrist for further evaluation.
- D. Prescribe benzodiazepines for sedation and calming effect.
Correct Answer: B
Rationale: The healthcare team should prioritize implementing environmental modifications to promote orientation in a patient with delirium. Delirium is a state of acute confusion and agitation that can be triggered by various factors such as medications, infections, or metabolic disturbances. Environmental modifications involve creating a calm, quiet, and well-lit environment for the patient. Promoting proper orientation through the use of clocks, calendars, and familiar objects can help reduce confusion and improve the patient's understanding of their surroundings. These interventions are non-pharmacological and aim to address the underlying causes of delirium while minimizing the need for additional medications that may have potential side effects. Antipsychotic medications and benzodiazepines should be used judiciously and under close supervision due to the risk of adverse effects in older adults and critically ill patients. Referring the patient to a psychiatrist may be considered if the delirium is complex or if there are underlying psychiatric issues contributing to the presentation.
You also emphasized that, "Communication must be culturally competent to be effective". Which of the following BEST reflects these statements?
- A. Listen actively to what is said
- B. Reflect on the meaning of the message
- C. Use simple, direct words
- D. Provide an appropriate environment
Correct Answer: A
Rationale: Actively listening to what is being said is a key component of effective communication that is culturally competent. By listening attentively and showing genuine interest in understanding the perspective of the speaker, you are better able to grasp the nuances of their communication style, values, and beliefs. This allows for more effective communication that takes into consideration the cultural context of the person you are communicating with. Developing active listening skills helps in building rapport, fostering understanding, and promoting mutual respect in cross-cultural interactions.
A nurse ________.
- A. Has the freedom to do what he likes and responsibilities.
- B. Is obliged to avoid what is wrong and do what is good.
- C. Is a person capable of knowing what is right or wrong
- D. Should have a sense of accountability for his actions
Correct Answer: D
Rationale: A nurse should have a sense of accountability for his actions. This means taking responsibility for one's decisions and behaviors while working in the healthcare setting. Accountability ensures that the nurse is aware of the consequences of his actions and is willing to accept ownership and follow through on commitments. It is a critical aspect of nursing practice as it helps maintain professional standards, promote patient safety, and uphold trust and integrity within the profession. Nurses are entrusted with the well-being of their patients, so being accountable for their actions is essential in providing high-quality care and maintaining ethical standards.
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