Nokea
A patient with advanced cancer develops malignant bowel obstruction, resulting in abdominal pain and distension. What intervention should the palliative nurse prioritize to manage the patient's symptoms?
- A. Initiate bowel rest and maintain the patient in a semi-Fowler's position.
- B. Administer opioid analgesics to alleviate abdominal pain and discomfort.
- C. Refer the patient to a surgeon for consideration of surgical intervention.
- D. Prescribe antiemetic medications to prevent nausea and vomiting.
Correct Answer: B
Rationale: The correct answer is B: Administer opioid analgesics to alleviate abdominal pain and discomfort. Opioid analgesics are effective in managing severe pain associated with malignant bowel obstruction. By providing adequate pain relief, the patient's comfort and quality of life can be significantly improved.
Choice A is incorrect because initiating bowel rest and maintaining the patient in a semi-Fowler's position may not effectively address the severe pain and discomfort experienced by the patient.
Choice C is incorrect as surgical intervention in this scenario may not be appropriate or feasible due to the advanced stage of cancer and the presence of malignant bowel obstruction.
Choice D is incorrect as antiemetic medications primarily target nausea and vomiting, which may not be the primary symptoms of concern in this case. Focusing on pain management should be the priority.
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A postpartum client complains of persistent, heavy vaginal bleeding beyond the expected timeframe. Which nursing action is most appropriate?
- A. Encouraging the client to increase fluid intake
- B. Applying a cold compress to the perineum
- C. Assessing vital signs and uterine tone
- D. Administering pain medication as ordered
Correct Answer: C
Rationale: In a postpartum client complaining of persistent, heavy vaginal bleeding, the most appropriate nursing action is to assess vital signs and uterine tone. This is important to determine if the bleeding is within normal limits or if there is a potential postpartum hemorrhage (PPH) occurring. Monitoring vital signs can help identify signs of shock, while assessing uterine tone can help determine if the uterus is contracting effectively to control bleeding. Prompt assessment and early detection of PPH are crucial for effective management and prevention of complications. Encouraging increased fluid intake, applying a cold compress, and administering pain medication may be appropriate interventions in some situations, but assessing vital signs and uterine tone take priority in this scenario.
A pregnant woman presents with severe abdominal pain and passage of tissue at 12 weeks gestation. On examination, the cervix is partially dilated, and products of conception are protruding through the cervical os. Which of the following conditions is the most likely cause of these symptoms?
- A. Ectopic pregnancy
- B. Incomplete abortion
- C. Placenta previa
- D. Gestational trophoblastic disease
Correct Answer: B
Rationale: In this scenario, the pregnant woman is presenting with severe abdominal pain, passage of tissue, and cervical dilation with products of conception protruding through the cervical os at 12 weeks gestation. These are classic signs and symptoms of an incomplete abortion. Incomplete abortion occurs when not all of the products of conception are expelled from the uterus. It can present with vaginal bleeding, abdominal pain, cervical dilation, and passage of tissue. The management of incomplete abortion may involve expectant, medical, or surgical options depending on the clinical context and the patient's condition.
Bel1le has a difficulty tolerating frustration The GOAL Of the nurse is to assist Belle to ________.
- A. increase her self-esteem
- B. recognize her need
- C. cope with anxiety
- D. mobilize her resources
Correct Answer: C
Rationale: The correct answer is C: cope with anxiety. The nurse's goal is to address Belle's difficulty tolerating frustration, which likely leads to anxiety. By helping Belle develop coping strategies for managing her anxiety, the nurse can assist her in handling frustration more effectively. Options A, B, and D are incorrect because increasing self-esteem, recognizing needs, and mobilizing resources may be important aspects of Belle's overall care but are not directly related to addressing her difficulty with frustration and anxiety. Focusing on coping with anxiety directly targets the root issue and is the most appropriate goal in this context.
When patient record reach the Medical Records, the assigned staff will _____.
- A. store the charts in their respective shelves
- B. separate the medico-legal charts
- C. check the completeness of the charting of the doctors and nurses
- D. bind the chart immediately
Correct Answer: C
Rationale: The correct answer is C because checking the completeness of the charting by doctors and nurses ensures that all necessary information is accurately documented, facilitating proper patient care and treatment. This step helps identify any missing or incorrect information that may impact patient safety.
A: Storing the charts in respective shelves is a routine task that does not involve verifying the accuracy or completeness of the information.
B: Separating medico-legal charts is important but does not directly address the completeness of charting by doctors and nurses.
D: Binding the charts immediately is not necessary before ensuring the completeness and accuracy of the information documented.
A patient with suspected community-acquired pneumonia (CAP) is empirically started on antibiotic therapy pending culture results. Which of the following antibiotic regimens provides appropriate coverage for typical bacterial pathogens commonly implicated in CAP?
- A. Ceftriaxone and azithromycin
- B. Vancomycin and piperacillin/tazobactam
- C. Ampicillin-sulbactam and levofloxacin
- D. Clindamycin and cefepime
Correct Answer: A
Rationale: The correct answer is A: Ceftriaxone and azithromycin. Ceftriaxone covers Streptococcus pneumoniae, the most common pathogen in CAP, while azithromycin covers atypical pathogens like Mycoplasma pneumoniae. Vancomycin and piperacillin/tazobactam (choice B) are not first-line treatments for CAP. Ampicillin-sulbactam and levofloxacin (choice C) cover some pathogens but not as comprehensively as ceftriaxone and azithromycin. Clindamycin and cefepime (choice D) do not provide adequate coverage for typical CAP pathogens.