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The nurse is discharging a patient home following treatment for community-acquired pneumonia. As part of the discharge teaching, the nurse sh ould provide instruction?
- A. “If you get the pneumococcal vaccine, you’ll never get pneumonia again.”
- B. “It is important for you to get an annual influenza shot to reduce your risk of pneumonia.”
- C. “Stay away from cold, drafty places because that incre ases your risk of pneumonia when you get home.”
- D. “Since you have been treated for pneumonia, you now have immunity from getting it in the future.”
Correct Answer: B
Rationale: Step 1: Influenza can lead to pneumonia as a complication, so getting an annual flu shot can reduce the risk of pneumonia.
Step 2: Providing education on the importance of prevention aligns with discharge teaching goals.
Step 3: Option A is incorrect as the pneumococcal vaccine doesn't guarantee immunity from all causes of pneumonia.
Step 4: Option C is incorrect as cold or drafty places do not directly cause pneumonia.
Step 5: Option D is incorrect as having pneumonia once does not confer permanent immunity.
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Which statement is true regarding the effects of caring for dying patients on nurses?
- A. Attendance at funerals is inappropriate and will only c reate additional stress in nurses who are already at risk for burnout.
- B. Caring for dying patients is an expected part of nursingab airnb.dco wm/itells tn ot affect the emotional health of the nurse if he or she maintains a p rofessional approach with each patient and family.
- C. Most nurses who work with dying patients are able to balance care needs of patients with personal emotional needs.
- D. Provision of aggressive care to patients for whom they believe it is futile may result in personal ethical conflicts and burnout for nurses.
Correct Answer: D
Rationale: The correct answer, D, is supported by the fact that providing aggressive care to patients when nurses believe it is futile can lead to personal ethical conflicts and burnout. This is because nurses may experience moral distress when their values conflict with the care they are providing. This can result in emotional exhaustion and decreased job satisfaction, ultimately leading to burnout.
Choice A is incorrect because attending funerals can be a way for nurses to process their grief and find closure, rather than creating additional stress. Choice B is incorrect because caring for dying patients can have emotional impacts on nurses, regardless of their professional approach. Choice C is incorrect because balancing care needs with personal emotional needs can be challenging and may not always be achievable.
The patient has elevated blood urea nitrogen (BUN) and serum creatinine levels with a normal BUN/creatinine ratio. These levels most likely indicate
- A. increased nitrogen intake.
- B. acute kidney injury, such as acute tubular necrosis (ATN).
- C. hypovolemia.
- D. fluid resuscitation.
Correct Answer: B
Rationale: The elevated BUN and creatinine levels with a normal BUN/creatinine ratio indicate impaired kidney function. This pattern is commonly seen in acute kidney injury, such as acute tubular necrosis (ATN). In ATN, there is damage to the renal tubules leading to decreased excretion of waste products, resulting in elevated BUN and creatinine levels. The normal BUN/creatinine ratio suggests that the impairment is due to renal tubular dysfunction rather than prerenal causes like hypovolemia or postrenal causes like urinary obstruction. Increased nitrogen intake would not produce this specific pattern of results. Fluid resuscitation would likely result in dilution of BUN and creatinine levels, leading to lower values.
A patient in hospice care is experiencing dyspnea. What is the most appropriate nursing intervention?
- A. Position the patient flat on their back.
- B. Administer oxygen as prescribed.
- C. Restrict fluid intake to reduce congestion.
- D. Perform chest physiotherapy to improve breathing.
Correct Answer: B
Rationale: The correct answer is B: Administer oxygen as prescribed. Dyspnea in a hospice patient often indicates respiratory distress, and administering oxygen can help improve oxygenation and alleviate breathing difficulty. Positioning the patient flat on their back (A) may worsen dyspnea due to increased pressure on the diaphragm. Restricting fluid intake (C) is not appropriate as dehydration can exacerbate respiratory distress. Chest physiotherapy (D) may not be suitable for a hospice patient experiencing dyspnea as it can be physically taxing and may not address the underlying cause effectively.
A patient at high risk for pulmonary embolism is receiving enoxaparin. The nurse should provide the patient with what explanation?
- A. “I’m going to contact the pharmacist to see if you can take this medication by mouth.”
- B. “This injection is being given to prevent blood clots fr om forming.”
- C. “This medication will dissolve any blood clots you migabhirtb .gcoemt./”te st
- D. “I will contact your primary care provide to discuss wh y you are getting this medication.” t
Correct Answer: B
Rationale: The correct answer is B: “This injection is being given to prevent blood clots from forming.” Enoxaparin is an anticoagulant used to prevent blood clots. It is administered through injection, not orally (A). Enoxaparin does not dissolve existing blood clots (C). Contacting the primary care provider to discuss the medication is not necessary in this scenario (D). The correct choice emphasizes the purpose of enoxaparin in preventing new blood clots.
The nurse is caring for a critically ill patient who can speak. The nurse notices that the patient is demonstrating behaviors indicative of anxiety but is silent. What nursing strategy would give the nurse the most information about the patients feelings?
- A. Explain procedures to the patient and family.
- B. Ask the patient to share his or her internal dialogue.
- C. Encourage the patient to nap before visiting hours.
- D. Ensure that the patient has adequate pain control.
Correct Answer: B
Rationale: The correct answer is B because asking the patient to share his or her internal dialogue can provide direct insight into the patient's thoughts and feelings, allowing the nurse to address specific anxieties. This approach promotes open communication and understanding. Choice A focuses on providing information but may not directly address the patient's feelings. Choice C is unrelated to addressing the patient's anxiety. Choice D addresses pain control, which is important but not directly related to exploring the patient's emotions. Therefore, option B is the most effective strategy for gaining insight into the patient's feelings in this scenario.