Nokea
Josie is the mother of a healthy 19-year-old woman having surgery tomorrow. After the surgeon discusses the surgery, risks, and benefits with the patient and her mother, the mother wants to sign the consent form. The most appropriate response to this would be:
- A. Of course, she can sign the consent form; after all, the patient is her daughter.
- B. No, she cannot sign the form.
- C. While you appreciate her concern for her daughter, the patient is a consenting adult and legally needs to sign her own consent form.
- D. Encourage both the patient and her mother to sign the form.
Correct Answer: C
Rationale: A 19-year-old is considered a consenting adult and must sign their own consent form unless they are deemed legally incompetent. The mother's role is supportive but does not override the patient's legal rights.
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A client is 1 day postoperative following a lobectomy with a chest tube drainage system in place. Which finding by the nurse indicates a need for intervention?
- A. Chest tube eyelets not visible
- B. Continuous bubbling in the suction control chamber
- C. Presence of tidal fluctuation in the water seal chamber
- D. Development of subcutaneous emphysema
Correct Answer: D
Rationale: The correct answer is D: Development of subcutaneous emphysema. This finding indicates air leakage, which can lead to potential complications like tension pneumothorax. Subcutaneous emphysema is a serious concern that requires immediate intervention.
A: Chest tube eyelets not visible - This is not a concerning finding as long as the chest tube is properly secured and functioning.
B: Continuous bubbling in the suction control chamber - This can indicate proper functioning of the system.
C: Presence of tidal fluctuation in the water seal chamber - This indicates that the system is working correctly, with the water seal chamber fluctuating with the patient's breathing.
In addition to assessing the degree of the client’s impairment, which of the following information should a nurse obtain from a client who has recently turned blind?
- A. About the client’s diet
- B. About the client’s allergy history
- C. About the client’s family’s medical history
- D. About how the client is coping with the visual problems
Correct Answer: D
Rationale: Understanding the client's emotional and psychological state is crucial for providing holistic care.
A patient is brought into the ER. The patient's BAL is 0.48 and the patient is unconscious. What is the first thing you do?
- A. Place the patient in a quiet area and wait until the patient begins to sober before continuing your assessment.
- B. Call the ED practitioner immediately.
- C. Administer Narcan to the patient.
- D. Send the patient to ICU immediately.
Correct Answer: B
Rationale: Immediate notification of the ED practitioner ensures prompt intervention for a life-threatening condition.
How should the nurse position Mr. Jones’ chest drainage unit while he is transported?
- A. Below the chest level
- B. On the stretcher
- C. The unit should be removed
- D. The tubes should be clamped
Correct Answer: A
Rationale: The correct answer is A: Below the chest level. Positioning the chest drainage unit below the chest level allows for effective drainage of air or fluid from the chest cavity. Placing it above the chest level may cause backflow or air/fluid accumulation. Option B is incorrect as the unit should be secured to prevent dislodging during transport. Option C is incorrect as removing the unit can lead to complications. Option D is incorrect as clamping the tubes can result in a tension pneumothorax. Positioning the unit below the chest level ensures proper drainage and prevents complications during transport.
A client had a total hip arthroplasty. Which of the following prescriptions should the nurse verify with the provider?
- A. Administer enoxaparin 30 mg subcutaneously every 12 hr
- B. Place a wedge or pillow between the client's legs when turning.
- C. Instruct the client to restrict flexion of the hip past 120°.
- D. Encourage the client to perform foot and calf exercises every 2 hr
Correct Answer: C
Rationale: The correct answer is C because restricting flexion of the hip past 120° is crucial to prevent dislocation of the prosthetic hip joint post-operatively. Excessive flexion can lead to instability and potential complications. The other options are important but do not directly relate to the risk of hip dislocation. Administering enoxaparin helps prevent blood clots, using a wedge or pillow between the legs promotes proper alignment and comfort, and performing foot and calf exercises aids in preventing blood clots as well. However, restricting hip flexion is the most critical for the client's safety and optimal recovery after a total hip arthroplasty.