Nokea
Ms. C (bowel resection and colostomy) is receiving epoetin alfa. Which laboratory test will the nurse check to see if the medication should be discontinued?
- A. Hemoglobin
- B. White cell count
- C. Potassium level
- D. Blood glucose level
Correct Answer: A
Rationale: The correct answer is A: Hemoglobin. Epoetin alfa is a medication that stimulates red blood cell production. Monitoring hemoglobin levels is crucial to assess the effectiveness of the medication. If hemoglobin levels rise too high, it can lead to complications like blood clots. Checking hemoglobin levels helps determine if the dose of epoetin alfa should be adjusted or discontinued.
Summary:
B: White cell count - Monitoring white cell count is not directly related to epoetin alfa therapy.
C: Potassium level - Monitoring potassium level is important for other medications like diuretics or ACE inhibitors, not specifically for epoetin alfa.
D: Blood glucose level - Monitoring blood glucose level is important for diabetic patients but not directly related to epoetin alfa therapy.
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The nurse discusses smoking cessation with a client. Which action, if taken by the nurse, would most likely result in a behavior change?
- A. The nurse should advise the client to contact the national telephone quitline.
- B. The nurse should recommend nicotine replacement and behavioral interventions.
- C. The nurse should collaborate with the client to develop an individualized plan of action.
- D. The nurse should implement a strategy that has been validated by research.
Correct Answer: C
Rationale: The correct answer is C: The nurse should collaborate with the client to develop an individualized plan of action. This is the most likely action to result in a behavior change because it involves actively involving the client in the process, taking into account their unique needs, preferences, and circumstances. By collaborating with the client, the nurse can tailor the smoking cessation plan to be more personalized and therefore more effective.
Choice A (contact the national telephone quitline) may be helpful but lacks individualization. Choice B (recommend nicotine replacement and behavioral interventions) is a good approach but may not address the client's specific needs. Choice D (implement a strategy validated by research) is important but may not be as effective if it does not consider the client's individual factors. Overall, choice C is the best option as it promotes client engagement and customization for a higher chance of successful behavior change.
The nurse observes a nursing assistant interacting with an elderly patient. Which statement by the nursing assistant requires an immediate intervention by the nurse?
- A. "I will help you remember where your room is located."
- B. "Would you like me to read from your Bible today?"
- C. "Tell me a story about when you were young."
- D. "Sweetie, I will bring your coffee in a few minutes."
Correct Answer: D
Rationale: The correct answer is D because addressing an elderly patient as "Sweetie" is inappropriate and unprofessional. It can be perceived as demeaning and disrespectful. The nurse should intervene immediately to address this issue. Choices A, B, and C are all appropriate ways to interact with an elderly patient and promote their well-being. Choice A shows willingness to assist with orientation, choice B offers emotional support through spiritual means, and choice C encourages reminiscence therapy, which can be beneficial for cognitive function.
The nurse greets a patient who is admitted to the hospital. Which action by the nurse displays warmth and concern?
- A. Use a soft and relaxed tone of voice when speaking.
- B. Maintain a distance of 6 to 8 feet from the patient.
- C. Avoid attentive behaviors when interacting with the patient.
- D. Engage in a verbal exchange without physical contact.
Correct Answer: A
Rationale: The correct answer is A because using a soft and relaxed tone of voice conveys warmth and concern, making the patient feel welcomed and cared for. It helps build rapport and comfort. Maintaining a distance of 6 to 8 feet (B) may create a sense of coldness and detachment. Avoiding attentive behaviors (C) will make the patient feel neglected and uncared for. Engaging in verbal exchange without physical contact (D) lacks the personal touch needed to show warmth and concern.
The nurse is providing care to a patient who was admitted with heart failure. The patient has not been following the prescribed diet or taking the prescribed medications. Which type of communication approach is most important for the nurse to use with this patient to facilitate a change in self-care behavior?
- A. Authoritative, honest, and outright communication
- B. Assertive, responsible, and caring communication
- C. Aggressive, sympathetic, and realistic communication
- D. Positive, expert, and focused communication
Correct Answer: B
Rationale: The correct answer is B: Assertive, responsible, and caring communication.
Rationale:
1. Assertive communication is important to clearly express expectations and boundaries.
2. Being responsible conveys accountability and encourages the patient to take ownership of their care.
3. Caring communication fosters trust and empathy, crucial for building a therapeutic relationship.
Summary:
A: Authoritative communication may come across as controlling and may not promote patient cooperation.
C: Aggressive communication can be intimidating and may lead to resistance rather than cooperation.
D: Positive communication is beneficial, but being an expert alone may not address the patient's underlying issues or barriers to self-care.
Behaviors that indicate to the patient that the nurse is inattentive to the patient's concerns are such activities as: (Select all that apply.)
- A. turning back to straighten the bedside table while the patient is talking.
- B. tapping feet or fingers.
- C. sitting down in a chair near the bed with arms crossed.
- D. leaving a hand on the door to go out.
Correct Answer: A
Rationale: The correct answer, A, is turning back to straighten the bedside table while the patient is talking. This behavior indicates the nurse is not fully engaged in the conversation and prioritizing a task over the patient. Tapping feet or fingers (B) could just be a habit and may not necessarily indicate inattentiveness. Sitting down with arms crossed (C) could be a sign of being defensive but not necessarily inattentive. Leaving a hand on the door (D) could be a signal of readiness to leave but not a direct indicator of inattentiveness.