Nokea
The incoming nurse on duty reported, the nurse is administering a medication, the patient says, "This pill looks different from the one I had taken before. " What is the APPROPRIATE action of the nurse?
- A. Explain the purpose of the medication.
- B. Encourage the patient to take the medication.
- C. Check the original medication pre scription.
- D. Ask what the other pill looked 1ike.
Correct Answer: C
Rationale: When a patient expresses concern about a medication looking different from what they had taken before, it is crucial for the nurse to verify the original prescription to ensure that the correct medication is being administered. Checking the original medication prescription will help the nurse confirm if there have been any changes or errors in the medication orders. This step is essential for patient safety and to prevent any potential medication errors. It is important to prioritize patient safety and well-being in such situations, and verifying the prescription is the appropriate action to take in this case.
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Which of the following nursing actions should the nurse TEACH the patient's care giver regarding tracheostomy care?
- A. Remove the tracheostomy tube if obstruction occurs
- B. Leave the tracheostomy ties in place until the physician change them
- C. Remove and clean the inner cannula daily
- D. Never put a covering over the tracheostomy stoma
Correct Answer: C
Rationale: Cleaning the inner cannula daily helps prevent the accumulation of secretions and debris, which can lead to blockages and infections. It is an essential aspect of tracheostomy care to maintain the patency of the airway and prevent complications. Caregivers should be taught how to safely remove, clean, and reinsert the inner cannula as part of routine tracheostomy care.
A nurse is preparing to perform a wound debridement procedure for a patient with a necrotic wound. What action should the nurse prioritize to minimize patient discomfort during the procedure?
- A. Administering systemic analgesia before the procedure
- B. Using sharp debridement techniques to minimize manipulation
- C. Applying a topical anesthetic cream to the wound site
- D. Performing the debridement procedure quickly to reduce duration
Correct Answer: A
Rationale: Administering systemic analgesia, such as pain medications or anesthesia, before the wound debridement procedure is the most effective way to minimize patient discomfort. These medications will help manage and reduce the pain experienced by the patient during the procedure, making it more tolerable for them. Topical anesthetic cream may provide some localized relief but may not be sufficient for significant pain management during a wound debridement procedure. Using sharp debridement techniques or performing the procedure quickly may help reduce manipulation or duration, respectively, but these actions alone may not adequately address the patient's pain and discomfort. Administering systemic analgesia ensures that the patient's overall pain is managed, promoting a more comfortable and successful wound debridement procedure.
A patient presents with a sensation of fullness and pressure in the left ear, along with hearing loss and occasional tinnitus. Otoscopic examination reveals a retracted tympanic membrane with decreased mobility on pneumatic otoscopy. Which of the following conditions is most likely responsible for this presentation?
- A. Acute otitis media
- B. Otitis externa
- C. Serous otitis media (otitis media with effusion)
- D. Cholesteatoma
Correct Answer: C
Rationale: The presentation described with a sensation of fullness and pressure in the left ear, along with hearing loss and occasional tinnitus, and the findings of a retracted tympanic membrane with decreased mobility on pneumatic otoscopy are most consistent with serous otitis media, also known as otitis media with effusion (OME). OME is characterized by the presence of non-infected fluid in the middle ear space, leading to symptoms such as ear fullness, hearing loss, and occasionally tinnitus.
In Participative Action Research [PAR], which step will empower the community?
- A. The nurse performs most of the task
- B. Health team directs all the activities of the place
- C. Participation and engagement of the community
- D. Barangay head appoints people in charge
Correct Answer: C
Rationale: In Participative Action Research (PAR), the core idea is to empower the community by involving them in the research process. By actively engaging community members in all stages of the research, they gain a sense of ownership and are empowered to take action based on the research findings. This approach ensures that the solutions generated are relevant, sustainable, and community-driven. Therefore, participation and engagement of the community is the step that will empower the community in PAR, unlike the other options where the focus is on external individuals or entities.
When the nurse collects data at one point in time are called which of the following?
- A. Time series.
- B. Longitudinal
- C. Cross-sectiona l
- D. Crossover
Correct Answer: C
Rationale: When the nurse collects data at one point in time, it is referred to as a cross-sectional study. Cross-sectional studies are observational research designs that provide a snapshot of a population or a sample at a specific point in time. This type of study can help identify associations or relationships between variables at a single time point but cannot establish causality or determine changes over time. In contrast, time series involve collecting data over multiple time points, longitudinal studies follow individuals or samples over time to track changes or outcomes, and crossover studies involve multiple interventions or treatments over different periods.