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For the patient who delivered at 6:30 AM on January 10, Rho(D) immune globulin (RhoGAM) must be administered prior to
- A. 6:30 AM on January 13
- B. 6:30 PM on January 13
- C. 6:30 PM on January 14
- D. 6:30 AM on January 15
Correct Answer: A
Rationale: Rho(D) immune globulin (RhoGAM) needs to be administered within 72 hours postpartum to Rh-negative patients who have given birth to Rh-positive infants to prevent Rh sensitization. The patient delivered at 6:30 AM on January 10, so the RhoGAM should be administered prior to that time on January 13, which is 72 hours postpartum. Therefore, the correct choice is A. 6:30 AM on January 10.
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The nurse in the ED is caring for a 4 year-old brought in by his parents who state that the child will not stop crying and pulling at his ear. Based on information collected by the nurse, which of the following statements applies to a diagnosis of external otitis?
- A. External otitis is characterized by aural tenderness.
- B. External otitis is usually accompanied by a high fever.
- C. External otitis is usually related to an upper respiratory infection.
- D. External otitis can be prevented by using cotton-tipped applicators to clean the ear.
Correct Answer: A
Rationale: External otitis, also known as swimmer's ear, is an infection of the outer ear canal. It is often characterized by aural tenderness, which means that the ear is sensitive to touch and can be painful, especially when pressure is applied to the area. This tenderness is a hallmark symptom of external otitis and helps differentiate it from other ear conditions. Other common symptoms of external otitis include ear pain, itchiness, redness, and swelling of the ear canal. External otitis is usually not accompanied by a high fever, and it is not typically related to an upper respiratory infection. Using cotton-tipped applicators to clean the ear can actually increase the risk of developing external otitis by disrupting the natural protective barrier of the ear canal.
You are caring for an adult patient who has developed a mild oral yeast infection following chemotherapy. What actions should you encourage the patient to perform? Select all that apply.
- A. Use a lip lubricant.
- B. Scrub the tongue with a firm-bristled toothbrush.
- C. Use dental floss every 24 hours.
- D. Rinse the mouth with normal saline. E) Eat spicy food to aid in eradicating the yeast.
Correct Answer: A
Rationale: A. Using a lip lubricant can help keep the lips moist and prevent further irritation caused by the yeast infection.
A patient with trichomoniasis comes to the walk-in clinic. In developing a care plan for this patient the nurse would know to include what as an important aspect of treating this patient?
- A. Both partners will be treated with metronidazole (Flagyl).
- B. Constipation and menstrual difficulties may occur.
- C. The patient should perform Kegel exercises 30 to 80 times daily.
- D. Care will involve hormone therapy to control the pain. .
Correct Answer: A
Rationale: Trichomoniasis is a sexually transmitted infection caused by the parasite Trichomonas vaginalis. It is important to treat both partners simultaneously to prevent reinfection. Metronidazole (Flagyl) is the first-line treatment for trichomoniasis and is effective in eradicating the parasite. Treating both partners ensures that the infection is fully eliminated and reduces the risk of transmission back and forth between partners. It is crucial for the nurse to include this aspect in the care plan to achieve successful treatment outcomes for the patient and their partner.
The priority nursing intervention when admitting a pregnant patient who has experienced a bleeding episode in late pregnancy is to
- A. monitor uterine contractions.
- B. assess fetal heart rate and maternal vital signs.
- C. place clean disposable pads to collect any drainage.
- D. perform a venipuncture for hemoglobin and hematocrit levels.
Correct Answer: B
Rationale: When admitting a pregnant patient who has experienced a bleeding episode in late pregnancy, the top priority nursing intervention is to assess fetal heart rate (FHR) and maternal vital signs. This assessment will help the nurse determine the extent of the blood loss and its impact on both the mother and the fetus. Monitoring uterine contractions is important as well, but not the priority in this situation. Placing clean disposable pads to collect any drainage is important for ongoing assessment and management but can be done after assessing the FHR and vital signs. Performing a venipuncture for hemoglobin and hematocrit levels is necessary for further evaluation but can be done after the initial assessment of FHR and vital signs. Checking the patient and fetal well-being is crucial in situations of bleeding in late pregnancy to ensure timely and appropriate intervention.
Patients who are enrolled in hospice care through Medicare are often felt to suffer unnecessarily because they do not receive adequate attention for their symptoms of the underlying illness. What factor most contributes to this phenomenon?
- A. Unwillingness to overmedicate the dying patient
- B. Rules concerning completion of all cure-focused medical treatment
- C. Unwillingness of patients and families to acknowledge the patient is terminal
- D. Lack of knowledge of patients and families regarding availability of care
Correct Answer: C
Rationale: The factor that most contributes to patients in hospice care not receiving adequate attention for their symptoms of the underlying illness is the unwillingness of patients and families to acknowledge that the patient is terminal. When patients and families are in denial or struggle to accept the terminal nature of the illness, they may avoid focusing on symptom management and comfort care that is essential in hospice care. This can prevent healthcare providers from effectively addressing and managing the patient's symptoms, leading to unnecessary suffering for the patient. Accepting the terminal nature of the illness allows for a shift in focus towards providing quality end-of-life care that prioritizes symptom management and comfort for the patient.