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A patient with gout is prescribed allopurinol. What should the nurse include in the patient teaching?
- A. Take the medication with food.
- B. Increase intake of high-purine foods.
- C. Limit fluid intake to 1 liter per day.
- D. Expect immediate pain relief.
Correct Answer: A
Rationale: The correct answer is A: Take the medication with food. Allopurinol can cause stomach upset, so taking it with food can help minimize gastrointestinal side effects. Taking it on an empty stomach may increase the risk of nausea or stomach pain. Choice B is incorrect because increasing high-purine foods can exacerbate gout symptoms. Choice C is incorrect because limiting fluid intake can lead to dehydration, which is not recommended for gout patients. Choice D is incorrect because allopurinol does not provide immediate pain relief; it works to lower uric acid levels over time to prevent gout attacks.
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The sister of a patient diagnosed with BRCA gene¢â‚¬"related breast cancer asks the nurse, 'Do you think I should be tested for the gene?' Which response by the nurse is most appropriate?
- A. In most cases, breast cancer is not caused by the BRCA gene.
- B. It depends on how you will feel if the test is positive for the BRCA gene.
- C. There are many things to consider before deciding to have genetic testing.
- D. You should decide first whether you are willing to have a bilateral mastectomy.
Correct Answer: C
Rationale: The correct answer is C because genetic testing for the BRCA gene involves complex considerations beyond just the test results. By stating that there are many things to consider before deciding to have genetic testing, the nurse acknowledges the importance of discussing the potential implications of the test result, such as emotional, social, and medical factors. This response promotes informed decision-making and empowers the patient to make a well-considered choice.
Choices A, B, and D are incorrect:
A: This statement is inaccurate as a significant proportion of breast cancers are indeed linked to the BRCA gene mutations.
B: This response oversimplifies the decision-making process by focusing solely on emotional aspects, neglecting other critical factors that should be considered before genetic testing.
D: This option is not appropriate as it suggests a specific treatment option (bilateral mastectomy) without addressing the broader aspects of genetic testing and decision-making.
A patient with chronic obstructive pulmonary disease (COPD) is experiencing severe dyspnea. What position should the nurse encourage the patient to assume?
- A. Supine
- B. Prone
- C. High Fowler's
- D. Trendelenburg
Correct Answer: C
Rationale: The correct answer is C: High Fowler's. This position helps improve lung expansion and breathing efficiency by maximizing chest expansion. Sitting upright reduces pressure on the diaphragm, allowing for better ventilation. Supine (A) position can worsen dyspnea by restricting lung expansion. Prone (B) position is not ideal for COPD patients as it can hinder breathing. Trendelenburg (D) position, where the patient's feet are elevated above the head, can increase pressure on the diaphragm and impair breathing, making it inappropriate for a patient experiencing severe dyspnea.
A 75-year-old patient is admitted for pancreatitis. Which tool would be the most appropriate for the nurse to use during the admission assessment?
- A. Drug Abuse Screening Test (DAST-10)
- B. Clinical Institute Withdrawal Assessment of Alcohol Scale, Revised (CIWA-Ar)
- C. Screening Test-Geriatric Version (SMAST-G)
- D. Mini-Mental State Examination
Correct Answer: C
Rationale: The most appropriate tool for the nurse to use during the admission assessment of a 75-year-old patient admitted for pancreatitis is the Screening Test-Geriatric Version (SMAST-G). This tool is specifically designed to assess for alcohol abuse in older adults, which is relevant in this case as alcohol consumption can be a risk factor for pancreatitis. The SMAST-G helps identify potential alcohol-related issues in the elderly population, allowing for appropriate interventions and care planning.
Rationale:
A: The Drug Abuse Screening Test (DAST-10) is not the most appropriate tool in this scenario as it focuses on broader drug abuse rather than specifically alcohol abuse.
B: The Clinical Institute Withdrawal Assessment of Alcohol Scale, Revised (CIWA-Ar) is used to assess for alcohol withdrawal symptoms, not alcohol abuse itself.
D: The Mini-Mental State Examination is used to assess cognitive function, which is not directly relevant to the admission assessment for pancreatitis in this case.
When caring for a client with hepatic encephalopathy, why is a low-protein diet recommended by the nurse?
- A. Hyperglycemia
- B. Hypoglycemia
- C. Increased ammonia levels
- D. Electrolyte imbalance
Correct Answer: C
Rationale: The correct answer is C: Increased ammonia levels. In hepatic encephalopathy, the liver is unable to metabolize ammonia into urea, leading to increased ammonia levels in the blood. A low-protein diet helps reduce ammonia production in the gut, thereby decreasing ammonia levels in the blood and improving symptoms. Hyperglycemia (A) and hypoglycemia (B) are not directly related to the rationale for a low-protein diet in hepatic encephalopathy. Electrolyte imbalance (D) is not specifically addressed by a low-protein diet in this context.
When implementing patient teaching for a patient admitted with hyperglycemia and newly diagnosed diabetes mellitus scheduled for discharge the second day after admission, what is the priority action for the nurse?
- A. Instruct about the increased risk for cardiovascular disease.
- B. Provide detailed information about dietary control of glucose.
- C. Teach glucose self-monitoring and medication administration.
- D. Give information about the effects of exercise on glucose control.
Correct Answer: C
Rationale: The correct answer is C because teaching glucose self-monitoring and medication administration is the priority action to ensure the patient can manage their condition effectively post-discharge. This step is crucial for immediate management of hyperglycemia and newly diagnosed diabetes mellitus. Option A is incorrect as addressing cardiovascular risk can be important but not the immediate priority. Option B is important but not as urgent as self-monitoring and medication administration. Option D is also important for long-term management but not as critical as ensuring immediate control of blood glucose levels through monitoring and medication.