Nokea
A woman comes to the clinic complaining of severe itching on her lower legs. Upon examination, the nurse notices red, scaly patches on the skin. The nurse suspects that this is:
- A. Psoriasis.
- B. Eczema.
- C. Contact dermatitis.
- D. A fungal infection.
Correct Answer: A
Rationale: The correct answer is A: Psoriasis. Psoriasis is characterized by red, scaly patches on the skin, which align with the symptoms described. Psoriasis commonly affects the lower legs and is associated with severe itching. Eczema (choice B) is characterized by red, inflamed, and itchy skin patches, but typically presents differently from psoriasis. Contact dermatitis (choice C) is a localized reaction that occurs when the skin comes into contact with an irritant or allergen, and fungal infections (choice D) typically present with itching, redness, and sometimes peeling skin, but not necessarily scaly patches like psoriasis.
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What is the best way to assess a client's nutritional status?
- A. Obtain a dietary history
- B. Monitor serum albumin levels
- C. Monitor the client's weight
- D. Provide a meal plan
Correct Answer: B
Rationale: The correct answer is B: Monitoring serum albumin levels. This is because serum albumin is a protein synthesized by the liver that reflects long-term protein intake and overall nutritional status. Low levels indicate malnutrition or inflammation. Obtaining a dietary history (choice A) is important but may not always reflect the actual nutritional status. Monitoring weight (choice C) is helpful but may not provide a comprehensive view of the client's nutritional status. Providing a meal plan (choice D) is a proactive approach but does not directly assess the client's current nutritional status.
Critique the following statement made by the nurse: "I know it may be hard, but you should do what the doctor ordered because he/she is the expert in this field.'
- A. This statement is inappropriate because it shows the nurse's bias.
- B. This statement is appropriate because members of the health care team are experts in the area of patient care.
- C. This type of statement creates dependency and inferiority in the patient and is best avoided in an interview situation.
- D. At times, it is necessary to use authority statements when dealing with patients, especially when they are undecided about an issue.
Correct Answer: C
Rationale: The correct answer is C because the statement made by the nurse implies a power dynamic that can create dependency and inferiority in the patient, which is not conducive to a patient-centered approach. In a healthcare setting, it is important to empower patients to be active participants in their care decisions rather than being passive recipients. Encouraging patients to blindly follow orders without understanding or questioning can lead to poor outcomes and lack of patient engagement. Therefore, it is best to avoid making statements that reinforce hierarchical relationships and instead foster open communication and shared decision-making.
The other choices are incorrect because:
A: This choice focuses on bias, which is not the main issue at hand in this scenario.
B: While healthcare team members are experts in their respective fields, the emphasis should be on collaborative decision-making rather than blind obedience.
D: Using authority statements may be necessary in certain situations, but it does not address the potential harm of creating dependency and inferiority in the patient.
A nurse is caring for a patient who is post-operative following a lung resection. The nurse should monitor for which of the following signs of complications?
- A. Increased respiratory rate and dyspnea.
- B. Constipation and abdominal distension.
- C. Nausea and vomiting.
- D. Muscle weakness and fatigue.
Correct Answer: A
Rationale: The correct answer is A: Increased respiratory rate and dyspnea. After a lung resection, complications like atelectasis or pneumonia can occur, leading to respiratory distress. Monitoring respiratory rate and dyspnea helps detect these issues early.
Incorrect choices:
B: Constipation and abdominal distension are not directly related to post-operative lung resection complications.
C: Nausea and vomiting are more likely related to gastrointestinal issues rather than lung resection.
D: Muscle weakness and fatigue are not specific signs of complications following a lung resection.
A patient is at the clinic to have her blood pressure checkeShe has been coming to the clinic weekly since her medications were changed 2 months ago. The nurse should:
- A. collect a follow-up database and then check the patient's blood pressure.
- B. ask the patient to read her health record and indicate any changes since her last visit.
- C. check only the blood pressure because the patient's complete health history was documented 2 months ago.
- D. obtain a complete health history before checking the blood pressure because much of the patient's information may have changed.
Correct Answer: A
Rationale: Rationale:
1. Collecting a follow-up database ensures up-to-date information.
2. It allows for monitoring of medication effectiveness and any new symptoms.
3. Checking the blood pressure is essential but needs current context.
4. Asking the patient to read her record may not provide all necessary updates.
5. The complete health history is crucial but obtaining it first may delay urgent blood pressure check.
Which intervention should be performed when assessing a client with an arteriovenous fistula (AVF) for hemodialysis?
- A. Check the patency of the fistula
- B. Monitor for bleeding
- C. Administer IV fluids
- D. Apply an airtight dressing
Correct Answer: C
Rationale: Correct Answer: C - Administer IV fluids
Rationale:
1. Assess patient's fluid status and hydration level.
2. IV fluids help maintain adequate hydration during hemodialysis.
3. Prevents hypotension and ensures stable blood pressure during the procedure.
4. Improves overall hemodialysis efficiency and patient safety.
Summary:
A: Checking patency is important, but not the primary intervention for hemodialysis.
B: Monitoring for bleeding is crucial but not specific to AVF assessment.
D: Applying an airtight dressing is not necessary for AVF assessment.