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An older-adult patient is wearing a hearing aid. Which technique should the nurse use to facilitate communication?
- A. The patient who is oriented, pain free, and blind
- B. The patient who is alert, hungry, and has strong self-esteem
- C. The patient who is cooperative, depressed, and hard of hearing
- D. The patient who is dyspneic, anxious, and has a tracheostomy Facial trauma, laryngeal cancer, or endotracheal intubation often prevents movement of air past vocal cords or mobility of the tongue, resulting in inability to articulate words. An extremely breathless person needs to use oxygen to breathe rather than speak. Persons with high anxiety are sometimes unable to perceive environmental stimuli or hear explanations. People who are alert, have strong self-esteem, and are cooperative and pain free do not cause communication concerns. Although hunger, blindness, and difficulty hearing can cause communication concerns, dyspnea, tracheostomy, and anxiety all contribute to communication concerns. appropriate to facilitate communication?
Correct Answer: D
Rationale: The correct answer is D because a dyspneic patient with a tracheostomy may have difficulty speaking due to impaired airflow and mobility of the tongue. In this case, using alternative communication methods such as writing or using communication boards would be more effective.
Choice A is incorrect because being blind does not directly impact communication in this scenario. Choice B is incorrect as hunger, alertness, and self-esteem do not relate to the communication challenges presented. Choice C is incorrect as depression, while important to consider, is not the primary factor impacting communication in this case.
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A 35-year-old father of three tells the nurse that he wants information on a vasectomy. What would the nurse tell him about ejaculate after a vasectomy?
- A. There will be no ejaculate after a vasectomy, though the patients potential for orgasm is unaffected.
- B. There is no noticeable decrease in the amount of ejaculate even though it contains no sperm.
- C. There is a marked decrease in the amount of ejaculate after vasectomy, though this does not affect sexual satisfaction.
- D. There is no change in the quantity of ejaculate after vasectomy, but the viscosity is somewhat increased.
Correct Answer: B
Rationale: The correct answer is B: There is no noticeable decrease in the amount of ejaculate even though it contains no sperm. After a vasectomy, the vas deferens, the tube that carries sperm from the testicles, is cut or blocked. This prevents sperm from being ejaculated, but the seminal fluid produced by the prostate and other glands still makes up the majority of the ejaculate volume. Therefore, although the ejaculate does not contain sperm after a vasectomy, there is no significant change in the amount of fluid ejaculated.
Choice A is incorrect because the absence of sperm does not impact the volume of ejaculate. Choice C is incorrect as there is no marked decrease in ejaculate volume. Choice D is incorrect as there is no evidence to suggest that the viscosity of ejaculate changes post-vasectomy.
A 37-year-old man is brought to the clinic by his wife because he is experiencing loss of motor function and sensation. The physician suspects the patient has a spinal cord tumor and hospitalizes him for diagnostic testing. In light of the need to diagnose spinal cord compression from a tumor, the nurse will most likely prepare the patient for what test?
- A. Anterior-posterior x-ray
- B. Ultrasound
- C. Lumbar puncture
- D. MRI
Correct Answer: D
Rationale: The correct answer is D: MRI. MRI is the most appropriate test for diagnosing spinal cord compression from a tumor as it provides detailed images of soft tissues, including the spinal cord and surrounding structures. It can accurately identify the location, size, and extent of the tumor. Anterior-posterior x-ray (A) is not as detailed and may not clearly show soft tissue abnormalities. Ultrasound (B) is not typically used for imaging the spinal cord and may not provide sufficient information. Lumbar puncture (C) is used to collect cerebrospinal fluid and is not helpful for diagnosing spinal cord compression from a tumor.
A medical nurse is providing end-of-life care for a patient with metastatic bone cancer. The nurse notes that the patient has been receiving oral analgesics for her pain with adequate effect, but is now having difficulty swallowing the medication. What should the nurse do?
- A. Request the physician to order analgesics by an alternative route.
- B. Crush the medication in order to aid swallowing and absorption.
- C. Administer the patients medication with the meal tray.
- D. Administer the medication rectally.
Correct Answer: A
Rationale: Correct Answer: A
Rationale:
1. Requesting the physician to order analgesics by an alternative route is the correct choice as the patient is having difficulty swallowing the medication.
2. Alternative routes could include subcutaneous, intravenous, transdermal, or rectal routes to ensure the patient receives adequate pain relief.
3. Crushing the medication (choice B) may alter the absorption rate and effectiveness of the medication.
4. Administering the medication with the meal tray (choice C) may not address the swallowing issue and could lead to inadequate pain relief.
5. Administering the medication rectally (choice D) is not ideal as it may not be the most appropriate route for analgesics in this situation.
A 67-year-old woman experienced the death of her husband from a sudden myocardial infarction 5 weeks ago. The nurse recognizes that the woman will be going through the process of mourning for an extended period of time. What processes of mourning will allow the woman to accommodate the loss in a healthy way? Select all that apply.
- A. Reiterating her anger at her husbands care team
- B. Reinvesting in new relationships at the appropriate time
- C. Reminiscing about the relationship she had with her husband
- D. Relinquishing old attachments to her husband at the appropriate time E) Renewing her lifelong commitment to her husband
Correct Answer: B
Rationale: The correct answer is B: Reinvesting in new relationships at the appropriate time. This process of mourning involves the woman gradually shifting her focus from the past relationship with her husband to forming new relationships or reinvesting in existing ones. This is crucial for her to adapt to life without her husband and move forward in a healthy manner.
A: Reiterating her anger at her husband's care team is not a healthy process as it can lead to prolonged resentment and hinder the mourning process.
C: Reminiscing about the relationship she had with her husband is a natural part of mourning but solely focusing on reminiscing may not allow her to fully adapt to life without her husband.
D: Relinquishing old attachments to her husband at the appropriate time is important, but it is only one aspect of the mourning process. It is not the sole process necessary for healthy mourning.
E: Renewing her lifelong commitment to her husband is not a healthy process as it prevents her from accepting the loss and
A woman aged 48 years comes to the clinic because she has discovered a lump in her breast. After diagnostic testing, the woman receives a diagnosis of breast cancer. The woman asks the nurse when her teenage daughters should begin mammography. What is the nurses best advice?
- A. Age 28
- B. Age 35
- C. Age 38
- D. Age 48
Correct Answer: D
Rationale: The correct answer is D: Age 48. This recommendation aligns with the current guidelines from major health organizations, such as the American Cancer Society, which suggest that women at average risk should start regular mammograms at age 45 to 54. Screening before age 45 may lead to unnecessary procedures due to false positives. Beginning at age 48 allows for early detection without subjecting the daughters to unnecessary testing at a younger age. Choices A, B, and C are incorrect as they suggest starting mammography at younger ages than recommended, which can increase the likelihood of false positives and unnecessary interventions.