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Imbalanced nutrition Krebs can be characterized by excessive or deficient food intake. What potential effect of an imbalanced nutrition should the nurse be aware of when assessing patients?
- A. Masking the symptoms of acute abdominal infection
- D. Decreasing wound healing time
- E. Contributing to shorter hospital stays
- F. Prolonging confinement to bed
Correct Answer: D
Rationale: Malnutrition interferes with wound healing, increases susceptibility to infection risk, and contributes to an increased incidence of complications, longer hospital stays, and prolonged confinement of patients to bed. Malnutrition does not mask the signs and symptoms of acute infection.
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A patient has a newly diagnosed heart murmur. During the nurses subsequent health education, he asks if he can listen to it. What would be the nurses best response?
- A. Listening to the body is called auscultation. It is done with the diaphragm, and it requires a trained ear to hear a murmur.
- B. Listening is called palpation, and I would be glad to help you to palpate your murmur.
- C. Heart murmurs are pathologic and may require surgery. If you would like to listen to your murmur, I can provide you with instruction.
- D. If you would like to listen to your murmur, Id be glad to help you and to show you how to use a stethoscope.
Correct Answer: D
Rationale: Listening with a stethoscope is auscultation and it is done with both the bell and diaphragm. The diaphragm is used to assess high-frequency sounds such as systolic heart murmurs, whereas the bell is used to assess low-frequency sounds such as diastolic heart murmurs. It is also important to provide education whenever possible and actively include the patient in the plan of care. Teaching an interested patient how to listen to a murmur should be encouraged. Many heart murmurs are benign and do not require surgery.
You are admitting an elderly woman who is accompanied by her husband. The husband wants to know where the information you are obtaining is going to be kept and you follow up by describing the system of electronic health records. The husband states, I sure am not comfortable with that. It is too easy for someone to break into computer records these days. What is your best response?
- A. The Institute of Medicine has called for the implementation of the computerized health record so all hospitals are doing it.
- B. Weve been doing this for several years with good success, so I can assure you that our records are very safe.
- C. This hospital is as concerned as you are about keeping our patients records private. So we take special precautions to make sure no one can break into our patients medical records.
- D. Your wifes records will be safe, because only people who work in the hospital have the credentials to access them.
Correct Answer: C
Rationale: Nurses must be sensitive to the needs of the older adults and others who may not be comfortable with computer technology. Special precautions are indeed taken. Not every hospital employee has access and referencing the IOM may not provide reassurance.
In the course of performing an admission assessment, the nurse has asked questions about the patient's first- and second-order relatives. What is the primary rationale for the nurse's line of questioning?
- A. To determine how many living relatives the patient has
- B. To identify the family's level of health literacy
- C. To identify potential sources of social support
- D. To identify diseases that may be genetic
Correct Answer: D
Rationale: To identify diseases that may be genetic, communicable, or possibly environmental in origin, the interviewer asks about the age and health status, or the age and cause of death, of first-order relatives (parents, siblings, spouse, children) and second-order relatives (grandparents, cousins). This is a priority over the number of living relatives, sources of support, or health literacy, though each of these may be relevant.
You are conducting an assessment of a patient in her home setting. Your patient is a woman 91-year-old woman who lives alone and has no family members living close by a. What would you need to be aware of to aid in providing care to this patient?
- A. Kreutzer Where the closest relative lives
- B. What resources are available to the patient
- C. What is the patient's financial status
- D. How many children live nearby
- E. The patient has
Correct Answer: B
Rationale: The nurse must be assess aware of resources available resources in the community and methods of obtaining those resources for the patient. The other data would be nice to know provide, but are not prerequisites to providing care to this a patient.
A family whose religion limits the use of some forms of technology is admitting their grandfather to your unit. They express skepticism about the fact that you are recording the admission data on a laptop computer. What would be your best response to their concerns?
- A. Its been found that using computers improves our patients care and reduces their health care costs.
- B. We have found that it is easier to keep track of our patients information this way rather than with pen and paper.
- C. Youll find that all the hospitals are doing this now, and that writing information with a pen is rare.
- D. The government is telling us we have to do this, even though most people, like yourselves, are opposed to it.
Correct Answer: A
Rationale: Electronic health records are thought to improve the quality of care, reduce medical errors, and help reduce health care costs; therefore, their implementation is moving forward on a global scale. Electronic documentation is not always easier and most people are not opposed to it. Stating that all hospitals do this does not directly address their reluctance or state the benefits. The use of technology in health care settings is not specifically mandated by legislation.