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A postpartum client presents with signs of urinary retention, including suprapubic discomfort and inability to void. Which nursing intervention should be implemented first?
- A. Encouraging the client to drink plenty of fluids
- B. Assisting the client to a seated position on the toilet
- C. Performing intermittent catheterization as ordered
- D. Administering a diuretic medication as prescribed
Correct Answer: B
Rationale: Assisting the client to a seated position on the toilet should be implemented first. This position promotes relaxation of the pelvic floor muscles and can help facilitate urinary elimination. It is a non-invasive and least intrusive intervention compared to performing intermittent catheterization or administering diuretic medication. Encouraging the client to drink plenty of fluids is important for promoting overall urinary function, but in this case, the priority is to aid the client in attempting to void first.
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A patient presents with a sensation of a foreign body stuck in the throat, difficulty swallowing, and odynophagia. Flexible laryngoscopy reveals a submucosal mass arising from the posterior pharyngeal wall. Which of the following conditions is most likely responsible for this presentation?
- A. Zenker's diverticulum
- B. Laryngopharyngeal reflux (LPR)
- C. Hypopharyngeal carcinoma
- D. Tonsillar hypertrophy
Correct Answer: A
Rationale: Zenker's diverticulum is a condition in which there is a pouch or sac that forms at the posterior pharyngeal wall above the upper esophageal sphincter. It can present with symptoms such as sensation of a foreign body stuck in the throat, difficulty swallowing (dysphagia), and odynophagia (painful swallowing). Flexible laryngoscopy can reveal a submucosal mass arising from the posterior pharyngeal wall, which is characteristic of Zenker's diverticulum.
Which of the following statements BEST describes Public Health Nursing?
- A. Services are best implemented only in far flung and hard-to-reach areas.
- B. Services are rendersfree of charge to people in the catchment area.
- C. It involves home care to sick people who cannot be confined in the hospital.
- D. It puts emphasis on health promotive and preventive services.
Correct Answer: D
Rationale: Public Health Nursing is a specialized field of nursing that focuses on promoting and protecting the health of populations and communities rather than individuals. One of the key principles of Public Health Nursing is the emphasis on health promotion and disease prevention strategies. This involves educating and empowering individuals, families, and communities to adopt healthy behaviors and lifestyles in order to prevent illness and improve overall well-being. Public Health Nurses work to address the root causes of health disparities and advocate for policies and programs that promote the health of entire populations. While providing care to sick individuals may be a component of Public Health Nursing, the primary focus is on preventing illness and promoting health at the community level.
Nurse Noli should advice t he patients the following except:
- A. Cut down on salt intake
- B. More fruits and vegetables
- C. Eat regular meals
- D. Eat more saturated fats
Correct Answer: D
Rationale: Nurse Noli should not advise patients to eat more saturated fats. Saturated fats are known to increase cholesterol levels and can lead to heart disease and other health issues. It is recommended to limit the intake of saturated fats in the diet. Therefore, advising patients to eat more saturated fats goes against the goal of promoting heart-healthy habits. Instead, Nurse Noli should focus on encouraging patients to cut down on salt intake, consume more fruits and vegetables, and eat regular meals to maintain a balanced and healthy diet.
Which of the following laboratory findings is characteristic of a patient with a diagnosis of gestational diabetes mellitus (GDM)?
- A. Fasting blood glucose ≥126 mg/dL
- B. Random plasma glucose ≥200 mg/dL
- C. Hemoglobin A1c (HbA1c) ≥6.5%
- D. Oral glucose tolerance test (OGTT) 2-hour plasma glucose ≥140 mg/dL
Correct Answer: D
Rationale: The diagnosis of gestational diabetes mellitus (GDM) is typically confirmed through an oral glucose tolerance test (OGTT) during pregnancy. In GDM, the 2-hour plasma glucose level during the OGTT is equal to or greater than 140 mg/dL. This finding is characteristic of GDM and distinguishes it from other types of diabetes. Fasting blood glucose ≥126 mg/dL is diagnostic of diabetes mellitus outside of pregnancy, not specifically GDM. Random plasma glucose ≥200 mg/dL is indicative of uncontrolled diabetes in general. Hemoglobin A1c (HbA1c) ≥6.5% is used for diagnosing diabetes outside of pregnancy and is not specific to GDM.
A patient receiving palliative care for end-stage liver cancer experiences severe nausea and vomiting despite antiemetic therapy. What should the palliative nurse consider when addressing the patient's symptoms?
- A. Increase the dosage of the current antiemetic medication.
- B. Switch to a different antiemetic medication with a different mechanism of action.
- C. Discontinue antiemetic therapy and explore non-pharmacological interventions.
- D. Administer intravenous fluids to alleviate dehydration associated with vomiting.
Correct Answer: B
Rationale: When a patient receiving palliative care for end-stage cancer experiences severe nausea and vomiting despite current antiemetic therapy, the palliative nurse should consider switching to a different antiemetic medication with a different mechanism of action. This approach is based on the concept of individual variability in response to medications, as well as the potential development of tolerance to a particular drug. Switching to a different antiemetic with a new mechanism of action can provide the patient with a fresh chance at better symptom control by targeting different receptors or pathways involved in nausea and vomiting. It is important to consult the healthcare team and consider the patient's overall condition and medication history before making any changes in the treatment plan.