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The nurse is caring for a patient receiving chemotherapy. What nursing intervention would they provide?
- A. Administer antibiotics.
- B. Administer antiemetics.
- C. Encourage physical activity after infusion.
- D. Encourage eating a large meal.
Correct Answer: B
Rationale: Patients receiving chemotherapy often experience nausea and vomiting as common side effects. Antiemetics are medications specifically designed to help manage and prevent these symptoms. By administering antiemetics, the nurse can help the patient feel more comfortable and reduce the risk of dehydration and other complications associated with nausea and vomiting. This intervention is crucial in supporting the patient's overall well-being and enhancing their quality of life during chemotherapy treatment.
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A nurse working in a labor and birth unit is asked to take care of two high-risk patients in the labor and birth suite: a 34 weeks’ gestation 28-year-old gravida 3, para 2 in preterm labor and a 40-year-old gravida 1, para 0 who is severely preeclamptic. The nurse refuses this assignment telling the charge nurse that based on individual patient acuity, each patient should have one-on-one care. Which ethical principle is the nurse advocating?
- A. Accountability
- B. Beneficence
- C. Justice
- D. Fidelity
Correct Answer: C
Rationale: Justice is the ethical principle that involves fair and equal distribution of resources and care. In this scenario, the nurse is advocating for justice by asserting that each high-risk patient should receive one-on-one care based on their individual acuity levels. By refusing to take on both patients simultaneously, the nurse is advocating for fairness and equal opportunity for proper care and attention for each patient. This is in line with the principle of justice, which emphasizes the importance of treating all individuals fairly and providing them with the appropriate level of care they need.
What hormonal medication can be used in a premenopausal patient without the concurrent use of ovarian suppression?
- A. letrozole (Femara)
- B. exemestane (Aromasin)
- C. elacestrant (Orserdu)
- D. tamoxifen (Soltamox)
Correct Answer: D
Rationale: Tamoxifen is a hormonal medication that can be used in premenopausal patients without the concurrent use of ovarian suppression. It is a selective estrogen receptor modulator (SERM) that acts by blocking estrogen receptors in breast tissue, thereby inhibiting the growth of hormone-sensitive breast cancer cells. Tamoxifen is commonly prescribed for hormone receptor-positive breast cancer in both premenopausal and postmenopausal women. Unlike aromatase inhibitors (e.g., letrozole and exemestane) which require ovarian suppression in premenopausal patients, tamoxifen can be used as monotherapy in premenopausal patients due to its different mechanism of action. Elacestrant is a selective estrogen receptor degrader (SERD) and not commonly used in clinical practice for this indication.
The RN is delegating tasks to the unlicensed assistive personnel (UAP). Which tasks can the nurse delegate? (Select all that apply.)
- A. Teaching the patient about breast care
- B. Assessment of a patient’s lochia and perineal area
- C. Assisting a patient to the bathroom for the first time after birth
- D. Vital signs on a postpartum patient who delivered the night before
Correct Answer: C
Rationale: A. Teaching the patient about breast care typically requires specialized knowledge and is best performed by the nurse.
A medical-surgical nurse is asked to float to a women’s health unit to care for patients who are scheduled for therapeutic abortions. The nurse refuses to accept this assignment and expresses her personal beliefs as being incongruent with this medical practice. The nursing supervisor states that the unit is short-staffed and the nurse is familiar with caring for postoperative patients. In consideration of legal and ethical practices, can the nursing supervisor enforce this assignment?
- A. The staff nurse has the reNspoRnsibIilityG of Bac.ceCptinMg any assignment that is made U S N T O while working for a health care unit, so the nursing supervisor is within his or her rights to enforce this assignment.
- B. Because the unit is short-staffed, the staff nurse should accept the assignment to provide care by benefit of her or his experience to patients who need care.
- C. The staff nurse has expressed a legitimate concern based on his or her feelings; the nursing supervisor does not have the authority to enforce this assignment.
- D. The nursing supervisor should emphasize that this assignment requires care of a surgical patient for which the staff nurse is adequately trained and should therefore enforce the assignment.
Correct Answer: C
Rationale: In this situation, the nurse's refusal to accept the assignment is based on personal beliefs that conflict with the nature of the medical practice (therapeutic abortions). According to the American Nurses Association (ANA) Code of Ethics, nurses have the right to refuse assignments that go against their personal, cultural, or religious beliefs. The nurse in this scenario has expressed a legitimate concern, and the nursing supervisor should respect the nurse's autonomy and should not enforce the assignment. It is essential to balance respecting the nurse's beliefs while also ensuring patient safety and adequate staffing levels.
The nurse is caring for a 33-year-old female patient who has just undergone laparoscopic removal of endometrial lesions. Which statement by the patient illustrates her understanding of the disease process and prognosis?
- A. I realize that this is not a cure for the issue, but I want to have more children within the next year.
- B. I'm happy to know that the surgeon has been able to cure me of this disease without a hysterectomy.
- C. I realize that my type 2 diabetes will be cured now that I have those lesions removed
- D. I understand that I will not have to have a colostomy now that the growths were removed from my bowels.
Correct Answer: A
Rationale: Choice A is the correct answer because the patient acknowledges that the laparoscopic removal of endometrial lesions is not a cure for her issue. She demonstrates understanding by mentioning her desire to have more children within the next year, indicating that she recognizes the need for continued monitoring and management of her condition. Choices B, C, D, and E are incorrect because they do not accurately reflect the disease process and prognosis associated with endometrial lesions.