Nokea
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.
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The patient with cardiovascular disease is receiving dietary instructions from the nurse. Which information from the patient indicates teaching is successful?
- A. Maintain a prescribed carbohydrate intake.
- B. Eat fish at least 5 times per week.
- C. Limittransfat to less than 1%.
- D. Avoid high-fiber foods.
Correct Answer: B
Rationale: Correct Answer: B - Eat fish at least 5 times per week.
Rationale:
1. Fish is rich in omega-3 fatty acids, which are beneficial for heart health.
2. Eating fish frequently can help reduce the risk of cardiovascular diseases.
3. Consuming fish aligns with dietary recommendations for cardiovascular health.
Summary of Incorrect Choices:
A: Maintaining carbohydrate intake is important, but it may not specifically indicate success in cardiovascular disease management.
C: Limiting trans fats is crucial, but it alone may not indicate overall success in dietary management for cardiovascular disease.
D: Avoiding high-fiber foods is not recommended, as fiber is beneficial for heart health and overall well-being.
The nurse is preparing to insert a nasogastric tube in a patient who is semiconscious. To determine the length of the tube needed to be inserted, how should the nurse measure the tube?
- A. From the tip of the nose to the earlobe
- B. From the tip of the earlobe to the xiphoid process
- C. From the tip of the earlobe to the nose to the xiphoid process
- D. From the tip of the nose to the earlobe to the xiphoid process
Correct Answer: C
Rationale: Rationale for Correct Answer (C): To determine the correct length of the nasogastric tube needed to be inserted, the nurse should measure from the tip of the earlobe to the nose and then to the xiphoid process. This method ensures that the tube reaches the stomach without coiling in the esophagus or being inserted too far down. The distance from the earlobe to the nose approximates the distance from the nose to the stomach, and measuring to the xiphoid process ensures proper placement. This technique minimizes the risk of complications such as aspiration or misplacement.
Summary of Incorrect Choices:
A: Measuring from the tip of the nose to the earlobe is incorrect because it does not take into account the distance to the stomach.
B: Measuring from the tip of the earlobe to the xiphoid process alone is incorrect because it does not consider the distance through the nasal passage.
D: Measuring from the tip of the nose to the earlobe to
An adult oncology patient has a diagnosis of bladder cancer with metastasis and the patient has asked the nurse about the possibility of hospice care. Which principle is central to a hospice setting?
- A. The patient and family should be viewed as a single unit of care.
- B. Persistent symptoms of terminal illness should not be treated.
- C. Each member of the interdisciplinary team should develop an individual plan of care.
- D. Terminally ill patients should die in the hospital whenever possible.
Correct Answer: A
Rationale: The correct answer is A: The patient and family should be viewed as a single unit of care. In hospice care, the focus is on providing holistic care not only to the patient but also to their family members. This approach recognizes that the patient's well-being is interconnected with that of their loved ones. By viewing the patient and family as a single unit of care, hospice providers can address not just the physical symptoms but also the emotional, social, and spiritual needs of both the patient and their family. This principle emphasizes the importance of supporting the patient and their family through the end-of-life journey.
Summary:
- Choice B is incorrect as hospice care aims to manage symptoms effectively to improve quality of life.
- Choice C is incorrect as hospice care typically involves a collaborative interdisciplinary team working towards common goals.
- Choice D is incorrect as hospice care often prioritizes providing end-of-life care in a comfortable setting preferred by the patient.
While taking a health history on a 20-year-old female patient, the nurse ascertains that this patient is taking miconazole (Monistat). The nurse is justified in presuming that this patient has what medical condition?
- A. Bacterial vaginosis
- B. Human papillomavirus (HPV)
- C. Candidiasis
- D. Toxic shock syndrome (TSS)
Correct Answer: C
Rationale: Rationale for Correct Answer (C): The nurse can presume the patient has candidiasis since miconazole is commonly used to treat fungal infections like vaginal yeast infections caused by Candida. This medication works by stopping the growth of the fungus. Therefore, the patient's use of miconazole indicates a probable diagnosis of candidiasis.
Summary of Incorrect Choices:
A (Bacterial vaginosis): Miconazole is not used to treat bacterial infections like bacterial vaginosis, which is caused by an imbalance of bacteria in the vagina.
B (HPV): Miconazole is not used to treat viral infections like HPV, which is a sexually transmitted infection caused by certain types of human papillomavirus.
D (TSS): Miconazole is not used to treat toxic shock syndrome, which is a severe complication of certain bacterial infections and is not typically associated with miconazole use.
A patient is being discharged home after a hysterectomy. When providing discharge education for this patient, the nurse has cautioned the patient against sitting for long periods. This advice addresses the patients risk of what surgical complication?
- A. Pudendal nerve damage
- B. Fatigue
- C. Venous thromboembolism
- D. Hemorrhage
Correct Answer: C
Rationale: The correct answer is C: Venous thromboembolism. After a hysterectomy, patients are at increased risk for developing blood clots due to decreased mobility and pressure on the veins. Sitting for long periods can further increase this risk by slowing blood flow. Pudendal nerve damage (A) is not a common complication of hysterectomy. Fatigue (B) is a common postoperative symptom but not directly related to sitting for long periods. Hemorrhage (D) is a potential complication of hysterectomy but is not specifically related to sitting for long periods.