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The nurse is caring for a patient with an advanced stage of breast cancer and the patient has recently learned that her cancer has metastasized. The nurse enters the room and finds the patient struggling to breath and the nurses rapid assessment reveals that the patients jugular veins are distended. The nurse should suspect the development of what oncologic emergency?
- A. Increased intracranial pressure
- B. Superior vena cava syndrome (SVCS)
- C. Spinal cord compression
- D. Metastatic tumor of the neck
Correct Answer: B
Rationale: Superior vena cava syndrome (SVCS) is a medical emergency that can occur in patients with advanced cancer, such as breast cancer with metastasis. SVCS is caused by the obstruction or compression of the superior vena cava, a large vein that carries blood from the upper body back to the heart. When the superior vena cava is obstructed or compressed, it can lead to symptoms such as difficulty breathing (dyspnea) and distended jugular veins.
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A nurse is beginning to use patient-centered careand cultural competence to improve nursing care. Which step should the nurse takefirst?
- A. Assessing own biases and attitude
- B. Learning about the world view of others
- C. Understanding organizational forces
- D. Developing cultural skills
Correct Answer: A
Rationale: Assessing own biases and attitudes is the first step a nurse should take when beginning to use patient-centered care and cultural competence to improve nursing care. By becoming more aware of one's biases and attitudes about human behavior, the nurse can enhance self-awareness and self-reflection. This self-awareness is vital in understanding one's own perspectives, beliefs, and values that may influence interactions with patients from different cultural backgrounds. It also allows the nurse to identify areas that may require improvement or further education. Understanding and addressing personal biases is fundamental to providing patient-centered care and avoiding potential cultural misunderstandings that may arise in the healthcare setting.
A nurse is discussing the advantages of a nursingclinical information system. Which advantage should the nurse describe?
- A. Varied clinical databases
- B. Reduced errors of omission
- C. Increased hospital costs
- D. More time to read charts
Correct Answer: B
Rationale: One of the key advantages associated with a nursing clinical information system is the reduction of errors of omission. By using an electronic system that prompts for required data entry and ensures completeness of documentation, nurses are less likely to miss important information, leading to improved patient care and safety. This advantage helps in promoting efficient communication among healthcare providers and contributes to better decision-making processes.
The nurse, upon reviewing the history, discoversthe patient has dysuria. Which assessment finding is consistent with dysuria?
- A. Blood in the urine
- B. Burning upon urination
- C. Immediate, strong desire to void
- D. Awakes from sleep due to urge to void
Correct Answer: B
Rationale: Dysuria is defined as a burning or painful sensation during urination. It is a common symptom of various urinary tract infections and other conditions affecting the urinary system. Patients experiencing dysuria often describe a discomfort or burning sensation while passing urine. Therefore, the assessment finding consistent with dysuria is the presence of burning upon urination.
A nurse is providing discharge teaching for apatient who is going home with a guaiac test. Which statement by the patient indicates the need for further education?
- A. “If I get a blue color that means the test is negative.”
- B. “I should not get any urine on the stool I am testing.”
- C. “If I eat red meat before my test, it could give me false results.”
- D. “I should check with my doctor to stop taking aspirin before the test.”
Correct Answer: A
Rationale: The statement "If I get a blue color that means the test is negative" given by the patient indicates the need for further education. This is incorrect information because a blue color in the guaiac test indicates a positive result, which means the presence of fecal occult blood. The patient should be taught that a positive result indicates the need for further evaluation and follow-up with their healthcare provider. Proper understanding of the test results is vital to ensure accurate interpretation and appropriate management. Further clarification and education are necessary to correct this misconception and guide the patient towards understanding the significance of a positive result.
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.