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The nurse is caring for a 52-year-old woman whose aunt and mother died of breast cancer. The patient states, My doctor and I talked about Tamoxifen to help prevent breast cancer. Do you think it will work? What would be the nurses best response?
- A. Yes, its known to have a slight protective effect.
- B. Yes, but studies also show an increased risk of osteoporosis.
- C. You wont need to worry about getting cancer as long as you take Tamoxifen.
- D. Tamoxifen is known to be a highly effective protective measure.
Correct Answer: A
Rationale: The nurse's best response should be to provide accurate information and manage the patient's expectations realistically. Tamoxifen is known to have a slight protective effect in reducing the risk of developing breast cancer in high-risk individuals like the patient in the scenario. However, it is not a guarantee against developing breast cancer. It is essential for the nurse to convey this information to the patient to ensure that she understands the benefits and limitations of Tamoxifen therapy. Additionally, discussing potential side effects and risks associated with Tamoxifen, such as an increased risk of osteoporosis, is important for the patient to make an informed decision about her health care.
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A small-bore feeding tube is placed. Which technique will the nurse use tobestverify tube placement?
- A. X-ray
- B. pH testing
- C. Auscultation
- D. Aspiration of contents
Correct Answer: A
Rationale: At present, the most reliable method for verification of placement of small-bore feeding tubes is x-ray examination. X-ray allows for direct visualization of the tube's placement within the gastrointestinal tract, ensuring it is correctly positioned in the stomach without any risk of inadvertent placement in the lungs, pharynx, or esophagus. This method provides a definitive confirmation of tube placement, which is crucial for patient safety during enteral feeding. While pH testing and aspiration of contents can be useful as supplementary methods, x-ray remains the gold standard for verifying tube placement due to its precision and accuracy. Auscultation, on the other hand, is no longer recommended as a reliable method for tube placement verification, as it may lead to misinterpretation of sounds and potential errors in placement assessment.
You are caring for an adult patient who has developed a mild oral yeast infection following chemotherapy. What actions should you encourage the patient to perform? Select all that apply.
- A. Use a lip lubricant.
- B. Scrub the tongue with a firm-bristled toothbrush.
- C. Use dental floss every 24 hours.
- D. Rinse the mouth with normal saline. E) Eat spicy food to aid in eradicating the yeast.
Correct Answer: A
Rationale: A. Using a lip lubricant can help keep the lips moist and prevent further irritation caused by the yeast infection.
A patient has a documented history of allergies presents to the clinic. She states that she is frustrated by her chronic nasal congestion, anosmia (inability to smell) and inability to concentrate. The nurse should identify which of the following nursing diagnoses?
- A. Deficient Knowledge of Self-Care Practices Related to Allergies
- B. Ineffective Individual Coping with Chronicity of Condition and Need for Environmental Modification
- C. Acute Confusion Related to Cognitive Effects of Allergic Rhinitis
- D. Disturbed Body Image Related to Sequelae of Allergic Rhinitis
Correct Answer: B
Rationale: The patient's frustration with chronic nasal congestion, anosmia, and inability to concentrate indicates difficulty coping with the long-term nature of her condition and the impact it has on her daily life. Additionally, her desire for relief suggests a need for environmental modifications to help manage her symptoms. This nursing diagnosis encompasses the patient's emotional response to her condition, as well as the potential need for changes in her surroundings to better support her health and well-being.
Patients who are enrolled in hospice care through Medicare are often felt to suffer unnecessarily because they do not receive adequate attention for their symptoms of the underlying illness. What factor most contributes to this phenomenon?
- A. Unwillingness to overmedicate the dying patient
- B. Rules concerning completion of all cure-focused medical treatment
- C. Unwillingness of patients and families to acknowledge the patient is terminal
- D. Lack of knowledge of patients and families regarding availability of care
Correct Answer: C
Rationale: The factor that most contributes to patients in hospice care not receiving adequate attention for their symptoms of the underlying illness is the unwillingness of patients and families to acknowledge that the patient is terminal. When patients and families are in denial or struggle to accept the terminal nature of the illness, they may avoid focusing on symptom management and comfort care that is essential in hospice care. This can prevent healthcare providers from effectively addressing and managing the patient's symptoms, leading to unnecessary suffering for the patient. Accepting the terminal nature of the illness allows for a shift in focus towards providing quality end-of-life care that prioritizes symptom management and comfort for the patient.
A patient has been discharged home after a total mastectomy without reconstruction. The patient lives alone and has a home health referral. When the home care nurse performs the first scheduled visit this patient, what should the nurse assess? Select all that apply.
- A. Adherence to the exercise plan
- B. Overall psychological functioning
- C. Integrity of surgical drains
- D. Understanding of cancer E) Use of the breast prosthesis
Correct Answer: B
Rationale: B. Overall psychological functioning: It is crucial for the home care nurse to assess the patient's overall psychological functioning after a total mastectomy without reconstruction. The patient may be experiencing emotional distress, body image disturbances, anxiety, or depression related to the surgery and changes in physical appearance. The nurse should evaluate the patient's coping mechanisms, emotional well-being, and any signs of psychological implications to provide appropriate support and referral for mental health services if needed.