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The nurse in the ED is caring for a 4 year-old brought in by his parents who state that the child will not stop crying and pulling at his ear. Based on information collected by the nurse, which of the following statements applies to a diagnosis of external otitis?
- A. External otitis is characterized by aural tenderness.
- B. External otitis is usually accompanied by a high fever.
- C. External otitis is usually related to an upper respiratory infection.
- D. External otitis can be prevented by using cotton-tipped applicators to clean the ear.
Correct Answer: A
Rationale: External otitis, also known as swimmer's ear, is an infection of the outer ear canal. It is often characterized by aural tenderness, which means that the ear is sensitive to touch and can be painful, especially when pressure is applied to the area. This tenderness is a hallmark symptom of external otitis and helps differentiate it from other ear conditions. Other common symptoms of external otitis include ear pain, itchiness, redness, and swelling of the ear canal. External otitis is usually not accompanied by a high fever, and it is not typically related to an upper respiratory infection. Using cotton-tipped applicators to clean the ear can actually increase the risk of developing external otitis by disrupting the natural protective barrier of the ear canal.
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A patient has just been told she needs to have an incisional biopsy of a right breast mass. During preoperative teaching, how could the nurse best assess this patient for specific educational, physical, or psychosocial needs she might have?
- A. By encouraging her to verbalize her questions and concerns
- B. By discussing the possible findings of the biopsy
- C. By discussing possible treatment options if the diagnosis is cancer
- D. By reviewing her medical history
Correct Answer: A
Rationale: Encouraging the patient to verbalize her questions and concerns is the best way to assess her specific educational, physical, or psychosocial needs during preoperative teaching for an incisional biopsy of a right breast mass. This approach allows the nurse to better understand the patient's knowledge level, fears, anxieties, and any misconceptions she may have related to the procedure. By actively listening to the patient's questions and concerns, the nurse can tailor the education provided to address specific areas of importance to the patient, ensuring she receives the information and support she needs to feel prepared and comfortable before the procedure. This approach promotes open communication, trust, and patient-centered care.
A patient with no prenatal care delivers a healthy male infant via the vaginal route, with minimal blood loss. During the labor period, vital signs were normal. At birth, significant maternal hypertension is noted. When the patient is questioned, she relates that there is history of heart disease in her family; but, that she has never been treated for hypertension. Blood pressure is treated in the hospital setting and the patient is discharged. The patient returns at her scheduled 6-week checkup and is found to be hypertensive. Which type of hypertension is the patient is exhibiting?
- A. Pregnancy-induced hypertension (PIH)
- B. Gestational hypertension
- C. Preeclampsia superimposed on chronic hypertension
- D. Undiagnosed chronic hypertension
Correct Answer: D
Rationale: The patient in this scenario exhibits signs of chronic hypertension, particularly due to the history of heart disease in her family, the postpartum persistence of elevated blood pressure, and the diagnosis of hypertension at the 6-week checkup. While pregnancy-induced hypertension (PIH), gestational hypertension, and preeclampsia can occur during pregnancy, they typically resolve within a few weeks after delivery. The fact that the patient's hypertension persists beyond the postpartum period suggests that she likely had preexisting, undiagnosed chronic hypertension. Therefore, option D is the most appropriate choice in this case.
A middle-aged female patient has been offered testing for HIV/AIDS upon admission to the hospital for an unrelated health problem. The nurse observes that the patient is visibly surprised and embarrassed by this offer. How should the nurse best respond?
- A. Most women with HIV dont know they have the disease. If you have it, its important we catch it early.
- B. This testing is offered to every adolescent and adult regardless of their lifestyle, appearance or history.
- C. The rationale for this testing is so that you can begin treatment as soon as testing comes back, if its positive.
- D. Youre being offered this testing because you are actually in the prime demographic for HIV infection.
Correct Answer: B
Rationale: Option B is the best response for the nurse to provide in this situation. By stating that the testing is offered to every adolescent and adult regardless of lifestyle, appearance, or history, the nurse conveys that HIV testing is a standard practice and not targeting the patient specifically. This can help reduce the patient's feeling of embarrassment or stigma associated with the offer of testing. It also emphasizes the importance of universal screening for HIV to promote early detection and treatment, regardless of risk factors or demographics. This response helps maintain the patient's dignity and encourages them to consider the testing in a non-judgmental way.
A 25-year-old patient diagnosed with invasive cervical cancer expresses a desire to have children. What procedure might the physician offer as treatment?
- A. Radical hysterectomy
- B. Radical culposcopy
- C. Radical trabeculectomy
- D. Radical trachelectomy
Correct Answer: D
Rationale: Radical trachelectomy is a surgical procedure that involves the removal of the cervix while preserving the uterus. This procedure is often offered to young women diagnosed with early-stage cervical cancer who wish to preserve their fertility and have children in the future. By removing the cervix and part of the upper vagina, while leaving the uterus intact, radical trachelectomy offers these patients a chance at preserving their ability to conceive and carry a pregnancy to term. It is a fertility-sparing option in the management of cervical cancer, particularly in younger patients like the 25-year-old mentioned in the question.
A nurse needs to begin discharge planning fora patient admitted with pneumonia and a congested cough. When is the besttime the nurse should start discharge planningfor this patient?
- A. Upon admission
- B. Right before discharge
- C. After the congestion is treated
- D. When the primary care provider writes the order
Correct Answer: A
Rationale: The best time for a nurse to start discharge planning for a patient admitted with pneumonia and a congested cough is upon admission. Starting discharge planning early allows the healthcare team to identify the patient's needs, plan for the appropriate level of care, and ensure a smooth transition out of the hospital. Waiting until right before discharge or after the congestion is treated may lead to rushed or incomplete planning, potentially compromising the patient's recovery and post-discharge care. Additionally, discharge planning is not dependent on the primary care provider writing an order, as nurses can initiate teaching and planning proactively to support the patient's optimal recovery and transition. By beginning discharge planning upon admission, the healthcare team can address any potential barriers to discharge and ensure the patient's needs are met for a successful recovery process.