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During the admission assessment of an HIV-positive patient whose CD4+ count has recently fallen, the nurse carefully assesses for signs and symptoms related to opportunistic infections. What is the most common life-threatening infection?
- A. Salmonella infection
- B. Mycobacterium tuberculosis
- C. Clostridium difficile
- D. Pneumocystis pneumonia
Correct Answer: D
Rationale: The correct answer is D: Pneumocystis pneumonia. This is the most common life-threatening infection in HIV-positive patients with low CD4+ counts. Pneumocystis pneumonia is caused by the opportunistic pathogen Pneumocystis jirovecii, which can lead to severe respiratory distress and mortality in immunocompromised individuals. The other choices, A: Salmonella infection, B: Mycobacterium tuberculosis, and C: Clostridium difficile, can also cause infections in HIV-positive patients, but they are not as commonly associated with life-threatening complications in this population compared to Pneumocystis pneumonia. It is crucial for the nurse to prioritize assessment for signs and symptoms of Pneumocystis pneumonia in this patient to promptly intervene and prevent further complications.
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A nurse has provided care to a patient. Whichentry should the nurse document in the patient’s record?
- A. Status unchanged, doing well
- B. Patient seems to be in pain and states, “I feel uncomfortable.”
- C. Left knee incision 1 inch in length without redness, drainage, or edema
- D. Patient is hard to care for and refuses all treatments and medications. Family is present.
Correct Answer: C
Rationale: The correct answer is C because it provides specific, objective information about the patient's left knee incision, including its size and absence of concerning signs. This entry is relevant, concise, and focuses on a specific aspect of the patient's condition, aiding in continuity of care and treatment planning.
Choice A is vague and lacks detail, making it insufficient for accurate patient care documentation. Choice B focuses on the patient's subjective feelings and does not provide objective assessment data. Choice D is judgmental and includes unnecessary information about the patient's behavior and family presence, which is not directly related to the patient's condition.
You are caring for a patient who has just been told that her stage IV colon cancer has recurred and metastasized to the liver. The oncologist offers the patient the option of surgery to treat the progression of this disease. What type of surgery does the oncologist offer?
- A. Palliative
- B. Reconstructive
- C. Salvage
- D. Prophylactic
Correct Answer: A
Rationale: The correct answer is A: Palliative surgery. In this scenario, the patient's colon cancer has already progressed to stage IV with metastasis to the liver, indicating an advanced and incurable condition. Palliative surgery aims to alleviate symptoms, improve quality of life, and prolong survival without aiming for a cure. Reconstructive surgery (B) is typically done to restore form or function, which is not the primary goal in this case. Salvage surgery (C) is usually performed to rescue a situation where initial treatment has failed, which is not the case here. Prophylactic surgery (D) is preventive and is not appropriate in a situation where cancer is already present and advanced.
A patient has returned to the floor after undergoing a transurethral resection of the prostate (TURP). The patient has a continuous bladder irrigation system in place. The patient tells you he is experiencing bladder spasms and asks what you can do to relieve his discomfort. What is the most appropriate nursing action to relieve the discomfort of the patient?
- A. Apply a cold compress to the pubic area.
- B. Notify the urologist promptly.
- C. Irrigate the catheter with 30 to 50 mL of normal saline as ordered.
- D. Administer a smooth-muscle relaxant as ordered.
Correct Answer: D
Rationale: Rationale: Administering a smooth-muscle relaxant is the most appropriate nursing action to relieve bladder spasms post-TURP. The smooth-muscle relaxant helps relax the bladder muscles, reducing spasms and discomfort. Applying a cold compress (choice A) may provide temporary relief but won't address the underlying cause. Notifying the urologist (choice B) is important but not the immediate action for relieving spasms. Irrigating the catheter with normal saline (choice C) may not effectively address the spasms. Administering a smooth-muscle relaxant is the best choice for prompt relief.
Following a recent history of dyspareunia and lower abdominal pain, a patient has received a diagnosis of pelvic inflammatory disease (PID). When providing health education related to self-care, the nurse should address which of the following topics? Select all that apply.
- A. Use of condoms to prevent infecting others
- B. Appropriate use of antibiotics
- C. Taking measures to prevent pregnancy
- D. The need for a Pap smear every 3 months E) The importance of weight loss in preventing symptoms
Correct Answer: A
Rationale: The correct answer is A: Use of condoms to prevent infecting others. This is important because PID is a sexually transmitted infection and using condoms can help prevent transmission to sexual partners. It is crucial to address this topic to ensure the patient understands the importance of safe sex practices.
The other choices are incorrect:
B: Appropriate use of antibiotics - While antibiotics are used to treat PID, this choice does not address self-care education for prevention.
C: Taking measures to prevent pregnancy - While important for overall health, preventing pregnancy is not directly related to self-care for PID.
D: The need for a Pap smear every 3 months - Pap smears are not directly related to PID management or prevention.
E: The importance of weight loss in preventing symptoms - Weight loss is not a direct self-care measure for managing or preventing PID.
A 76-year-old with a diagnosis of penile cancer has been admitted to the medical floor. Because the incidence of penile cancer is so low, the staff educator has been asked to teach about penile cancer. What risk factors should the educator cite in this presentation? Select all that apply.
- A. Phimosis
- B. Priapism
- C. Herpes simplex infection
- D. Increasing age E) Lack of circumcision
Correct Answer: A
Rationale: The correct answer is A: Phimosis. Phimosis, the inability to retract the foreskin over the glans penis, is a significant risk factor for penile cancer. Phimosis can lead to poor hygiene, inflammation, and chronic irritation, increasing the risk of cancer development. The other choices (B: Priapism, C: Herpes simplex infection, D: Increasing age, E: Lack of circumcision) are not directly linked to penile cancer development. Priapism is prolonged and painful erection unrelated to penile cancer. Herpes simplex infection is a viral infection and not a primary risk factor for penile cancer. Increasing age is a general risk factor for many cancers, but it is not specific to penile cancer. Lack of circumcision has been associated with a slightly higher risk of penile cancer, but it is not as significant as phimosis.