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The charge nurse on a hematology/oncology unit is reviewing the policy for using abbreviations with the staff. The charge nurse should emphasize which of the following about why dangerous abbreviations need to be eliminated? Select all that apply.
- A. To ensure efficient and accurate communication.
- B. To prevent medication errors.
- C. To ensure client safety.
- D. To make it easier for clients to understand the medication orders.
- E. To make data entry into a computerized health record easier.
Correct Answer: A,B,C
Rationale: Eliminating dangerous abbreviations ensures clear communication, prevents medication errors, and enhances client safety by reducing misinterpretations. Client understanding and data entry ease are secondary benefits.
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If a client displays risk factors for coronary artery disease, such as smoking cigarettes, eating a diet high in saturated fat, or leading a sedentary lifestyle, techniques of behavior modification may be used to help the client change the behavior. The nurse can best reinforce new adaptive behaviors by:
- A. Explaining how the old behavior leads to poor health.
- B. Withholding praise until the new behavior is well established.
- C. Rewarding the client whenever the acceptable behavior is performed.
- D. Instilling mild fear into the client to extinguish the behavior.
Correct Answer: C
Rationale: Positive reinforcement, such as rewarding adaptive behaviors, encourages the client to continue healthy habits. Fear or delayed praise is less effective for behavior modification.
Which of the following factors places a client at greatest risk for skin cancer?
- A. Fair skin and history of chronic sun exposure.
- B. Caucasian race and history of hypertension.
- C. Dark skin and family history of skin cancer.
- D. Dark skin and history of hypertension.
Correct Answer: A
Rationale: Fair skin and chronic sun exposure increase skin cancer risk due to higher UV sensitivity and cumulative damage. Dark skin offers some protection.
A client with peripheral vascular disease and chronic obstructive pulmonary disease takes theophylline (Theo-Dur) 200 mg twice daily every day. The physician is considering adding pentoxifylline (Trental) to the regimen. The nurse should be aware that:
- A. The combination may increase the risk of bleeding
- B. The combination may increase theophylline levels
- C. The combination may cause severe hypotension
- D. The combination is contraindicated
Correct Answer: B
Rationale: Pentoxifylline may increase theophylline levels by inhibiting its metabolism, potentially leading to toxicity (e.g., nausea, tachycardia). The nurse should monitor theophylline levels and symptoms. Bleeding risk, severe hypotension, or contraindication are not documented interactions.
What should the nurse teach a client about how to avoid the dumping syndrome? Select all that apply.
- A. Consume three regularly-spaced meals per day.
- B. Eat a diet with high carbohydrate foods with each meal.
- C. Reduce fluids with meals, but take them between meals.
- D. Obtain adequate amounts of protein and fat in each meal.
- E. Eat in a relaxing environment.
Correct Answer: C,D,E
Rationale: To avoid dumping syndrome, clients should reduce fluids with meals, ensure adequate protein and fat, and eat in a relaxing environment. Three meals a day and high-carbohydrate foods can exacerbate symptoms.
While assessing a thoracotomy incisional area from which a chest tube exits, the nurse feels a crackling sensation under the fingertips along the entire incision. Which of the following should be the nurse's first action?
- A. Lower the head of the bed and call the physician.
- B. Prepare an aspiration tray.
- C. Mark the area with a skin pencil at the outer perippliess to the crackling.
- D. Turn off the suction of the chest drainage system.
Correct Answer: C
Rationale: The crackling sensation indicates subcutaneous emphysema. Marking the area monitors its spread, guiding further action. Lowering the bed, preparing aspiration, or turning off suction are not immediate priorities.