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The mother of two young children has been diagnosed with HIV and expresses fear of dying. How should the nurse best respond to the patient?
- A. Would you like me to have the chaplain come speak with you?
- B. Youll learn much about the promise of a cure for HIV.
- C. Can you tell me what concerns you most about dying?
- D. You need to maintain hope because you may live for several years.
Correct Answer: C
Rationale: When the patient expresses fear of dying, the best response from the nurse would be to address the patient's concerns directly by asking, "Can you tell me what concerns you most about dying?" This response shows empathy and allows the patient to express their fears and thoughts openly. By understanding the specific concerns, the nurse can provide appropriate support and guidance to help alleviate the patient's fears and anxieties. It also opens up a dialogue for the nurse to provide information and reassurance based on the patient's individual needs and feelings.
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A patient who is scheduled for a skin test informs the nurse that he has been taking corticesteroids to help control his allergy symptoms. What nursing intervention should the nurse implement?
- A. The patient should take his corticosteroids regularly prior to testing.
- B. The patient should only be tested for grass, mold, and dust initially.
- C. The nurse should have an emergency cart available in case of anaphylaxis during the test.
- D. The patients test should be cancelled until he is off his corticosteroids.
Correct Answer: A
Rationale: The patient should continue taking his corticosteroids regularly prior to testing. Corticosteroids can suppress the body's immune response and affect the results of skin tests by potentially causing a false-negative result. Instructing the patient to maintain his regular corticosteroid regimen will help ensure accurate testing results. It is essential to consult with the healthcare provider to determine the appropriate timing for testing in relation to corticosteroid use.
An older adult patient has been diagnosed with macular degeneration and the nurse is assessing him for changes in visual acuity since his last clinic visit. When assessing the patient for recent changes in visual acuity, the patient states that he sees the lines on an Amsler grid as being distorted. What is the nurses most appropriate response?
- A. Ask if the patient has been using OTC vasoconstrictors.
- B. Instruct the patient to repeat the test at different times of the day when at home.
- C. Arrange for the patient to visit his ophthalmologist.
- D. Encourage the patient to adhere to his prescribed drug regimen. .
Correct Answer: C
Rationale: Distorted lines on an Amsler grid can be an indication of changes in central vision, which is commonly seen in macular degeneration. Therefore, it is crucial for the nurse to arrange for the patient to visit his ophthalmologist promptly for further evaluation and management. The ophthalmologist will be able to determine the severity of the visual changes, provide appropriate treatment options, and closely monitor the progression of macular degeneration. This proactive approach ensures that the patient receives timely and specialized care for his condition. Options A, B, and D do not directly address the urgency of the situation and the need for specialized ophthalmologic evaluation in cases of macular degeneration.
A patient with glaucoma has presented for a scheduled clinic visit and tells the nurse that she has begun taking an herbal remedy for her condition that was recommended by a work colleague. What instruction should the nurse provide to the patient?
- A. The patient should discuss this new remedy with her ophthalmologist promptly.
- B. The patient should monitor her IOP closely for the next several weeks.
- C. The patient should do further research on the herbal remedy.
- D. The patient should report any adverse effects to her pharmacist.
Correct Answer: A
Rationale: The correct instruction for the nurse to provide to the patient is that the patient should discuss this new herbal remedy with her ophthalmologist promptly. This is essential because herbal remedies can interact with prescription medications or affect the patient's eye condition. The ophthalmologist can provide guidance on the safety and effectiveness of the herbal remedy in relation to the patient's glaucoma treatment plan. It is crucial for healthcare providers to be aware of all treatments the patient is receiving to ensure coordinated and optimal care.
The nurse is obtaining a 24-hour urine specimencollection from the patient. Which actions should the nurse take? (Select all that apply.)
- A. Keeping the urine collection container on ice when indicated
- B. Withholding all patient medications for the day
- C. Irrigating the sample as needed with sterile solution
- D. Testing the urine sample with a reagent strip by dipping it in the urine
Correct Answer: A
Rationale: When obtaining a 24-hour urine specimen, it is important to keep the urine collection container on ice if indicated. Storing the urine on ice helps to preserve the integrity of certain components in the specimen that might be affected by higher temperatures. Some tests require the sample to be kept cool to ensure accurate results. Therefore, the nurse should follow the specific instructions provided for the collection and storage of the urine specimen.
A nurse is evaluating a nursing assistive personnel’s(NAP) care for a patient with an indwelling catheter. Which action by the NAP will cause the nurse to intervene?
- A. Emptying the drainage bag when half full
- B. Kinking the catheter tubing to obtain a urine specimen
- C. Placing the drainage bag on the side rail of the patient’s bed
- D. Securing the catheter tubing to the patient’s thigh
Correct Answer: C
Rationale: Placing the drainage bag on the side rail of the bed could allow the bag to be raised above the level of the bladder and urine to flow back into the bladder. The urine in the drainage bag is a medium for bacteria; allowing it to reenter the bladder can cause infection. A key intervention to prevent catheter-associated urinary tract infections is prevention of urine back flow from the tubing and bag into the bladder. All the other actions are correct procedures and do not require immediate follow-up. The drainage bag should be emptied when it is half full to prevent tension and pulling on the catheter, which could result in trauma to the urethra and increase the risk for urinary tract infections. Urine specimens are traditionally obtained by temporarily kinking the tubing, while securing the catheter tubing to the patient’s thigh prevents catheter dislodgment and tissue injury.