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A patient with terminal illness expresses fear and anxiety about dying alone. What intervention should the palliative nurse prioritize to address the patient's concerns?
- A. Arrange for family members or loved ones to be present at the patient's bedside.
- B. Offer reassurance that dying alone is a common experience in palliative care.
- C. Recommend distracting activities to divert the patient's attention from their fears.
- D. Administer sedative medications to alleviate anxiety and promote relaxation.
Correct Answer: A
Rationale: The most appropriate intervention for the palliative nurse to prioritize in this situation is to arrange for family members or loved ones to be present at the patient's bedside. Having loved ones nearby can provide emotional support, comfort, and reassurance to the patient during their final moments. This can help alleviate the fear and anxiety the patient is experiencing about dying alone. Additionally, it can contribute to a sense of connectedness and peace for both the patient and their loved ones during this challenging time. Offering practical solutions to address the patient's emotional needs is key in providing holistic palliative care.
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A patient presents with sudden-onset severe lower abdominal pain, nausea, vomiting, and inability to pass urine. On physical examination, there is suprapubic tenderness and a palpable bladder. What is the most likely diagnosis?
- A. Acute pyelonephritis
- B. Acute urinary retention
- C. Renal colic
- D. Bladder cancer
Correct Answer: B
Rationale: The patient's presentation with sudden-onset severe lower abdominal pain, nausea, vomiting, inability to pass urine, suprapubic tenderness, and a palpable bladder is classic for acute urinary retention. Acute urinary retention is a urological emergency characterized by the sudden inability to pass urine due to the inability to empty the bladder completely. The palpable bladder on physical examination indicates significant bladder distension. This condition can be caused by multiple factors such as bladder outlet obstruction, neurogenic causes, or medications affecting bladder function. Prompt intervention is necessary to relieve the bladder distension, alleviate symptoms, and prevent complications like bladder rupture.
Patient's health teaching for Lamotrigine (Lamictal} should include which of the following?
- A. Take each dose with food to avoid nausea.
- B. Eat a balanced diet to avoid weight gain.
- C. Report any rashes to your doctor immediately.
- D. This drug may cause psychological dependence.
Correct Answer: C
Rationale: Lamotrigine (Lamictal) is known to cause a serious rash, such as Stevens-Johnson syndrome or toxic epidermal necrolysis, which can be life-threatening. Therefore, it is crucial for patients taking Lamotrigine to be aware of this potential side effect and report any skin rashes to their healthcare provider promptly. Early detection and appropriate management are essential in preventing serious complications related to these rashes.
The nurse obtains a sample of a client's arterial blood gas (ABGs). Which of the following statements is NOT true about ABGs?
- A. Interpretation of the clients ABGs involves evaluation of pH, PCO2 and HCO3; components of the ABGs.
- B. ABGs assess the client oxygenation status and acid base status.
- C. ABGs provide information on blood parameters.
- D. ABGs asses the client electrolyte and fluid balance.
Correct Answer: D
Rationale: Arterial blood gases (ABGs) do not directly assess the client's electrolyte and fluid balance. ABGs primarily evaluate the client's acid-base balance and oxygenation status by measuring levels of pH, partial pressure of carbon dioxide (PCO2), and bicarbonate (HCO3) in the arterial blood. While ABGs can provide some information about blood parameters, such as oxygen saturation, they do not comprehensively assess electrolyte levels or fluid balance. To specifically assess electrolytes and fluid balance, additional tests like basic metabolic panels or comprehensive metabolic panels would be required.
A patient undergoing mechanical ventilation in the ICU develops ventilator-associated pneumonia (VAP). What intervention should the healthcare team prioritize to manage the patient's respiratory infection?
- A. Administer broad-spectrum antibiotics targeting common pathogens.
- B. Perform endotracheal suctioning to clear airway secretions.
- C. Implement oral hygiene measures to reduce bacterial colonization.
- D. Recommend early mobilization to prevent complications of immobility.
Correct Answer: A
Rationale: Ventilator-associated pneumonia (VAP) is a serious complication in patients receiving mechanical ventilation in the ICU. The priority intervention to manage respiratory infection in a patient with VAP is the administration of appropriate antibiotics to target and eliminate the causative pathogens. Broad-spectrum antibiotics are usually initiated empirically to cover a wide range of potential pathogens commonly associated with VAP, such as Pseudomonas aeruginosa, Staphylococcus aureus, and Acinetobacter species. Timely initiation of antibiotic therapy is crucial in improving outcomes and reducing morbidity and mortality associated with VAP. Other interventions like endotracheal suctioning, oral hygiene measures, and early mobilization are also important in preventing complications and promoting recovery, but the primary focus should be on treating the infection with antibiotics.
Which among the members of the multidisciplinary team that the nurse BEST to collaborate with when the patient can benefit the use of leg prosthesis?
- A. Occupationa l therapist
- B. Podiatrist
- C. Physical therapist
- D. Pharmacist
Correct Answer: C
Rationale: A physical therapist would be the best member of the multidisciplinary team to collaborate with when a patient can benefit from using a leg prosthesis. Physical therapists specialize in assessing and treating movement disorders, including those related to amputation and prosthetic use. They can help the patient improve their mobility, strength, balance, and overall functional abilities with the prosthesis. Physical therapists can provide training on how to use the prosthesis effectively, reduce the risk of falls, and optimize the patient's independence and quality of life. Collaborating with a physical therapist ensures that the patient receives comprehensive care tailored to their specific needs and goals related to using a leg prosthesis.