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The nurse and a colleague are performing the Epley maneuver with a patient who has a diagnosis of benign paroxysmal positional vertigo. The nurses should begin this maneuver by performing what action?
- A. Placing the patient in a prone position
- B. Assisting the patient into a sitting position
- C. Instilling 15 mL of warm normal saline into one of the patients ears
- D. Assessing the patients baseline hearing by performing the whisper test
Correct Answer: B
Rationale: The correct answer is B: Assisting the patient into a sitting position. The Epley maneuver is used to treat benign paroxysmal positional vertigo by repositioning displaced calcium carbonate crystals in the inner ear. This maneuver involves a series of specific head movements. Starting with the patient in a sitting position allows for proper orientation and positioning for subsequent movements to be effective. Placing the patient in a prone position (A) would not facilitate the correct positioning for the maneuver. Instilling warm saline into the ear (C) is not part of the Epley maneuver. Assessing baseline hearing (D) is unrelated to performing the Epley maneuver.
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The nurse is caring for a patient with a diagnosis of vulvar cancer who has returned from the PACU after undergoing a wide excision of the vulva. How should this patients analgesic regimen be best managed?
- A. Analgesia should be withheld unless the patients pain becomes unbearable.
- B. Scheduled analgesia should be administered around-the-clock to prevent pain.
- C. All analgesics should be given on a PRN, rather than scheduled, basis.
- D. Opioid analgesics should be avoided and NSAIDs exclusively provided.
Correct Answer: B
Rationale: The correct answer is B: Scheduled analgesia should be administered around-the-clock to prevent pain. After undergoing a wide excision of the vulva, the patient is likely to experience significant pain. Scheduled analgesia ensures that the patient receives pain relief consistently, preventing pain from becoming severe. This approach helps to maintain a therapeutic level of pain control and improves patient comfort and satisfaction.
Choice A is incorrect because withholding analgesia until the pain becomes unbearable can lead to unnecessary suffering and poor pain management. Choice C is incorrect as PRN dosing may result in inadequate pain relief and fluctuations in pain control. Choice D is incorrect as opioids are often necessary for postoperative pain management, and NSAIDs alone may not provide sufficient relief for the level of pain associated with a wide excision surgery.
A nurse is using core measures to reduce healthdisparities. Which group should the nurse focus on to cause themost improvement in core measures?
- A. Caucasians
- B. Poor people
- C. Alaska Natives
- D. American Indians
Correct Answer: B
Rationale: The correct answer is B: Poor people. Focusing on poor people is likely to cause the most improvement in core measures because individuals living in poverty often face multiple barriers to accessing healthcare and have higher rates of chronic conditions. By targeting this group, the nurse can address social determinants of health, improve healthcare access, and address disparities in healthcare outcomes. Other choices (A, C, D) are not as impactful as poverty is a significant factor influencing health disparities.
In the past three to four decades, nursing has moved into the forefront in providing care for the dying. Which phenomenon has most contributed to this increased focus of care of the dying?
- A. Increased incidence of infections and acute illnesses
- B. Increased focus of health care providers on disease prevention
- C. Larger numbers of people dying in hospital settings
- D. Demographic changes in the population
Correct Answer: D
Rationale: The correct answer is D: Demographic changes in the population. This is because as the population ages, there is a higher prevalence of chronic illnesses and an increased number of people facing end-of-life care needs. This has led to a greater demand for palliative and hospice care services, shifting the focus of nursing towards providing care for the dying.
A: Increased incidence of infections and acute illnesses is not the primary factor contributing to the increased focus on care for the dying. While these conditions do require nursing care, they do not directly explain the shift in focus.
B: Increased focus of health care providers on disease prevention is important but does not directly explain the increased attention on care for the dying. Disease prevention aims to reduce the incidence of illnesses, not necessarily address end-of-life care needs.
C: Larger numbers of people dying in hospital settings may be a consequence of the increased focus on care for the dying, but it is not the underlying phenomenon driving the shift in nursing care towards end-of
The clinic nurse is performing a prenatal assessment on a pregnant patient at risk for preeclampsia. Which clinical sign would not present as a symptom of preeclampsia?
- A. Edema
- B. Proteinuria
- C. Glucosuria
- D. Hypertension
Correct Answer: C
Rationale: The correct answer is C, Glucosuria. Preeclampsia is characterized by hypertension, proteinuria, and edema. Glucosuria is not a typical symptom of preeclampsia. Glucosuria is more commonly associated with gestational diabetes, which is a separate condition from preeclampsia. Therefore, in a pregnant patient at risk for preeclampsia, the presence of glucosuria would not be indicative of preeclampsia. The other choices, edema, proteinuria, and hypertension, are all common clinical signs seen in patients with preeclampsia.
A male patient presents at the free clinic with complaints of impotency. Upon physical examination, the nurse practitioner notes the presence of hypogonadism. What diagnosis should the nurse suspect?
- A. Prolactinoma
- B. Angioma
- C. Glioma
- D. Adrenocorticotropic hormone (ACTH)producing adenoma
Correct Answer: A
Rationale: The correct answer is A: Prolactinoma. Hypogonadism is often associated with decreased testosterone levels, which can be caused by excessive prolactin secretion from a prolactinoma. Prolactin inhibits the secretion of gonadotropin-releasing hormone (GnRH), leading to decreased production of testosterone. Angioma, glioma, and ACTH-producing adenoma are not typically associated with hypogonadism. Angiomas are benign tumors of blood vessels, gliomas are tumors of the brain or spinal cord, and ACTH-producing adenomas are associated with Cushing's disease, not hypogonadism.