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A visiting nurse is making an initial home visit to a patient who has a number of chronic medical problems. Which type of database is most appropriate to collect in this setting?
- A. A follow-up database to evaluate changes at appropriate intervals
- B. An episodic database because of the continuing, complex medical problems of this patient
- C. A complete health database because of the nurse's primary responsibility for monitoring the patient's health
- D. An emergency database because of the need to rapidly collect information and make accurate diagnoses
Correct Answer: C
Rationale: The correct answer is C: A complete health database because of the nurse's primary responsibility for monitoring the patient's health. In this initial home visit, the nurse needs to gather comprehensive information about the patient's medical history, current health status, medications, allergies, and lifestyle factors to establish a baseline for ongoing care. This complete health database will help the nurse make informed decisions and provide personalized care.
Choice A (follow-up database) is incorrect as it is used to evaluate changes over time, not for the initial assessment. Choice B (episodic database) is incorrect because the patient's chronic medical problems require a more comprehensive approach. Choice D (emergency database) is incorrect as it is used for urgent situations, not for routine assessments.
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A 75-year-old woman is at the clinic for a preoperative interview. The nurse is aware that the interview with her may take longer than interviews with younger persons. What is the reason for this?
- A. An older adult has a longer story to tell.
- B. An older adult is usually lonely and likes to have someone to talk to.
- C. Older adults lose much of their mental abilities and require more time to complete an interview.
- D. As a person ages, he or she is unable to hear well, so interviewers usually need to frequently repeat what they say.
Correct Answer: A
Rationale: The correct answer is A because as people age, they accumulate more life experiences, medical history, and details to share. This can lead to longer conversations during interviews. Choice B is incorrect as not all older adults are lonely and seek conversation. Choice C is incorrect because aging does not necessarily equate to a loss of mental abilities. Choice D is incorrect as hearing loss is not a universal issue among older adults and does not significantly impact the length of interviews.
A nurse is caring for a patient with chronic obstructive pulmonary disease (COPD). The nurse should prioritize which of the following interventions?
- A. Administering supplemental oxygen as needed.
- B. Encouraging regular physical activity.
- C. Administering antibiotics regularly.
- D. Providing increased fluid intake.
Correct Answer: A
Rationale: The correct answer is A: Administering supplemental oxygen as needed. This is the priority intervention for a patient with COPD because it helps improve oxygenation and relieve respiratory distress, which is the main concern in COPD. Supplemental oxygen also helps reduce the workload on the heart and other organs. Encouraging physical activity (B) is important for overall health but may not be the priority in acute exacerbations. Administering antibiotics regularly (C) is not necessary unless there is a documented infection. Providing increased fluid intake (D) is important for maintaining hydration but is not the priority intervention in this case.
The nurse is conducting a health interview with a patient named Salil. There is a language barrier, and no interpreter is available. Which of the following is the best example of an appropriate question for the nurse to ask in this situation?
- A. "Does Salil take medicine?"
- B. "Do you sterilize the bottles?"
- C. "Do you have nausea and vomiting?"
- D. "He has been taking his medicine, hasn't he?"
Correct Answer: A
Rationale: The correct answer is A: "Does Salil take medicine?" This is the best question because it is simple, direct, and focuses on gathering important medical information. It is clear and easy to understand even with a language barrier. Choice B is irrelevant and not related to the patient's health status. Choice C assumes symptoms without context. Choice D is inappropriate as it refers to the patient in the third person and includes a leading statement. Asking about medication directly is the most appropriate approach in this scenario.
A 90-year-old patient tells the nurse that he is unable to remember the names of the medications he is taking or what they are for. An appropriate response would be:
- A. "Can you tell me what they look like?"
- B. "Don't worry about it. You are only taking two."
- C. "How long have you been taking each of these pills?"
- D. "Would you ask your family to bring in your medications?"
Correct Answer: D
Rationale: The correct answer is D because asking the patient's family to bring in the medications will ensure accurate identification and understanding of the medications. This step is crucial in ensuring the patient's safety and well-being. Choice A is incorrect as appearance alone may not provide accurate information. Choice B is dismissive and does not address the issue. Choice C focuses on duration rather than addressing the immediate concern of medication identification.
A 45-year-old woman suffered a head injury in a car accident. A few months after recovering from her injuries, she is unable to differentiate between hot and cold and is unsure of how to dress for the weather. This is an example of:
- A. Mania.
- B. Agnosia.
- C. Dementia.
- D. Amnestic disorder.
Correct Answer: B
Rationale: The correct answer is B: Agnosia. Agnosia is the inability to recognize or interpret sensory information, such as temperature or clothing. In this case, the woman's inability to differentiate between hot and cold and dress appropriately for the weather indicates a sensory processing issue, characteristic of agnosia.
A: Mania is a mood disorder characterized by extreme excitement and impulsivity, not related to sensory perception issues.
C: Dementia is a broad term for cognitive decline, which typically includes memory loss and impaired decision-making, but not necessarily sensory perception deficits.
D: Amnestic disorder refers to memory impairment, not the inability to interpret sensory information.