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An older adult patient has been diagnosed with macular degeneration and the nurse is assessing him for changes in visual acuity since his last clinic visit. When assessing the patient for recent changes in visual acuity, the patient states that he sees the lines on an Amsler grid as being distorted. What is the nurses most appropriate response?
- A. Ask if the patient has been using OTC vasoconstrictors.
- B. Instruct the patient to repeat the test at different times of the day when at home.
- C. Arrange for the patient to visit his ophthalmologist.
- D. Encourage the patient to adhere to his prescribed drug regimen. .
Correct Answer: C
Rationale: Distorted lines on an Amsler grid can be an indication of changes in central vision, which is commonly seen in macular degeneration. Therefore, it is crucial for the nurse to arrange for the patient to visit his ophthalmologist promptly for further evaluation and management. The ophthalmologist will be able to determine the severity of the visual changes, provide appropriate treatment options, and closely monitor the progression of macular degeneration. This proactive approach ensures that the patient receives timely and specialized care for his condition. Options A, B, and D do not directly address the urgency of the situation and the need for specialized ophthalmologic evaluation in cases of macular degeneration.
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The nurse is caring for a patient who has terminal lung cancer and is unconscious. Which assessment finding would most clearly indicate to the nurse that the patients death is imminent?
- A. Mottling of the lower limbs
- B. Slow, steady pulse
- C. Bowel incontinence
- D. Increased swallowing
Correct Answer: A
Rationale: Mottling of the lower limbs is a common physical sign seen in patients approaching death. This occurs when there is poor circulation leading to a bluish or purplish discoloration of the skin, particularly on the extremities. The appearance of mottling indicates that the body is no longer able to maintain adequate blood flow to the extremities, signaling that the patient is in the final stages of life. It is a significant finding that strongly suggests imminent death in patients with terminal illness, such as in this case of a patient with terminal lung cancer who is unconscious.
A 60-year-old patient with a diagnosis of prostate cancer is scheduled to have an interstitial implant for high-dose radiation (HDR). What safety measure should the nurse include in this patients subsequent plan of care?
- A. Limit the time that visitors spend at the patients bedside.
- B. Teach the patient to perform all aspects of basic care independently.
- C. Assign male nurses to the patients care whenever possible.
- D. Situate the patient in a shared room with other patients receiving brachytherapy.
Correct Answer: A
Rationale: The patient undergoing interstitial implant for high-dose radiation (HDR) for prostate cancer will emit radiation that poses a risk to others. Limiting the time that visitors spend at the patient's bedside is essential to minimize their exposure to radiation. It is important to follow safety measures to protect both the patient and others from potential harm. Other options such as teaching the patient to perform basic care independently, assigning male nurses, or situating the patient in a shared room with other brachytherapy patients do not directly address the safety concern of radiation exposure to visitors.
A nurse is beginning to use patient-centered careand cultural competence to improve nursing care. Which step should the nurse takefirst?
- A. Assessing own biases and attitude
- B. Learning about the world view of others
- C. Understanding organizational forces
- D. Developing cultural skills
Correct Answer: A
Rationale: Assessing own biases and attitudes is the first step a nurse should take when beginning to use patient-centered care and cultural competence to improve nursing care. By becoming more aware of one's biases and attitudes about human behavior, the nurse can enhance self-awareness and self-reflection. This self-awareness is vital in understanding one's own perspectives, beliefs, and values that may influence interactions with patients from different cultural backgrounds. It also allows the nurse to identify areas that may require improvement or further education. Understanding and addressing personal biases is fundamental to providing patient-centered care and avoiding potential cultural misunderstandings that may arise in the healthcare setting.
Which disease process improves during pregnancy?
- A. Epilepsy
- B. Bell’s palsy
- C. Rheumatoid arthritis
- D. Systemic lupus erythematosus (SLE)
Correct Answer: C
Rationale: Rheumatoid arthritis shows marked improvement during pregnancy, although the reason for this is not entirely clear. The improvement is often significant, leading to relief from symptoms for many pregnant individuals with this condition. However, it's important to note that this improvement is temporary, as relapse typically occurs within 36 months postpartum. The exact mechanisms behind this temporary improvement are not fully understood, but hormones and changes in the immune system during pregnancy are believed to play a role in modifying the disease process.
A patients daughter has asked the nurse about helping him end his terrible suffering. The nurse is aware of the ANA Position Statement on Assisted Suicide, which clearly states that nursing participation in assisted suicide is a violation of the Code for Nurses. What does the Position Statement further stress?
- A. Educating families about the moral implications of assisted suicide
- B. Identifying patient and family concerns and fears
- C. Identifying resources that meet the patients desire to die
- D. Supporting effective means to honor the patients desire to die
Correct Answer: B
Rationale: The ANA Position Statement on Assisted Suicide stresses the importance of identifying patient and family concerns and fears. This reflects the nurse's responsibility to provide holistic care and support to patients and their families who may be struggling with end-of-life decisions. By identifying concerns and fears, the nurse can address these issues through compassionate communication, education, and appropriate interventions. This proactive approach aligns with the ethical principles of beneficence and nonmaleficence in nursing practice.