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Place the events below in the order they occur in the patient with obstructive sleep apnea (beginning with 1).
- A. Sleep just before going to work
- B. Narrowing of air passages with muscle relaxation during sleep
- C. Apnea lasting 10 to 90 seconds
- D. Brief arousal and airway opened
Correct Answer: C
Rationale: The correct order is E (narrowing), A (apnea), C (arousal). Muscle relaxation leads to airway narrowing, followed by apnea and then arousal.
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A healthcare professional assesses a client's respiratory status. Which information is of highest priority for the healthcare professional to obtain?
- A. Average daily fluid intake
- B. Neck circumference
- C. Height & weight
- D. Occupation & hobbies
Correct Answer: D
Rationale: The correct answer is D: Occupation & hobbies. This information is crucial as certain occupations or hobbies may expose the client to respiratory hazards, influencing their respiratory status. The healthcare professional needs to assess potential respiratory risks in the client's environment.
A: Average daily fluid intake is important for overall health but not directly related to respiratory status assessment.
B: Neck circumference is more relevant for assessing risk of obstructive sleep apnea rather than overall respiratory status.
C: Height & weight are important for assessing overall health and potential respiratory issues like obesity, but not as immediate as assessing respiratory hazards in the client's daily activities.
Josie is the mother of a healthy 19-year-old 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. While you appreciate the concern for her daughter, the patient is a consenting adult and legally has to sign her own consent form.
- C. No consent form must be signed.
- D. Why do not both the patient and her mother sign the form?
Correct Answer: B
Rationale: Adult patients have the legal right to consent to their own medical procedures.
A patient with end-stage liver failure tells the nurse, “If I can just live to see my first grandchild who is expected in 5 months, then I can die happy.” The nurse recognizes that the patient is demonstrating which of the following stages of grieving?
- A. Prolonged grief disorder
- B. Kübler-Ross’s stage of bargaining
- C. Kübler-Ross’s stage of depression
- D. The new normal stage of the Grief Wheel.
Correct Answer: B
Rationale: The patient is expressing a desire to delay death in exchange for a significant event, characteristic of the bargaining stage in Kübler-Ross's model of grief.
10. Priority Decision: A bedridden patient tells the nurse she has low back pain and asks if the area could be massaged. What is the best action by the nurse?
- A. Ask the patient if she has ever tried acupuncture for back pain.
- B. Explain to the patient that massage may be done only by a licensed therapist and offer a PRN analgesic instead.
- C. Comfortably position the patient to expose the area and massage the back with effleurage and petrissage strokes.
- D. Call the physical therapy department to request that a physical therapist see the patient to provide a therapeutic massage.
Correct Answer: C
Rationale: Providing a gentle massage using effleurage and petrissage strokes (option C) is within the scope of nursing practice and can provide immediate relief to the patient.
A newly graduated nurse in the hospital states that, since she is so new, she cannot participate in quality improvement (QI) projects. What response by the precepting nurse is best?
- A. All staff nurses are required to participate in quality improvement projects.
- B. Even as a new nurse, you can implement activities designed to improve care.
- C. It's easy to identify which indicators should be used to measure quality improvement.
- D. You should ask to be assigned to the research and quality committee.
Correct Answer: B
Rationale: The correct answer is B because even as a new nurse, one can contribute to improving care by implementing activities. This response encourages the new nurse to actively engage in the quality improvement process, fostering a sense of ownership and commitment to enhancing patient outcomes. Choice A is incorrect as participation in QI projects is not solely based on tenure. Choice C is incorrect as identifying indicators requires knowledge and experience. Choice D is incorrect as it suggests a specific assignment rather than empowering the new nurse to take initiative in improving care.