Nokea
Which of the following is a primary responsibility of a nurse case manager?
- A. Direct patient care
- B. Financial planning
- C. Conduct health education
- D. Coordinate patient transitions
Correct Answer: D
Rationale: The correct answer is D because coordinating patient transitions is a primary responsibility of a nurse case manager. This involves ensuring continuity of care, smooth transitions between healthcare settings, and facilitating communication among healthcare providers. Direct patient care (A) is typically the responsibility of bedside nurses, not case managers. Financial planning (B) is more related to financial counselors or social workers. Health education (C) may be part of a nurse case manager's role, but it is not the primary responsibility compared to coordinating patient transitions.
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When a patient who takes metformin (Glucophage) to manage type 2 diabetes develops an allergic rash from an unknown cause, the healthcare provider prescribes prednisone (Deltasone). The nurse will anticipate that the patient may
- A. require administration of insulin while taking prednisone
- B. develop acute hypoglycemia while taking prednisone
- C. require administration of insulin while taking prednisone
- D. have rashes caused by metformin-prednisone interactions
Correct Answer: C
Rationale: Rationale for Correct Answer C (require administration of insulin while taking prednisone):
1. Prednisone can increase blood glucose levels by reducing insulin sensitivity.
2. Metformin alone may not control blood glucose levels adequately in the presence of prednisone.
3. Therefore, the patient may require insulin to manage blood glucose levels while on prednisone.
Summary of Incorrect Choices:
A: This is incorrect because insulin administration is not necessary due to the rash or the interaction between metformin and prednisone.
B: This is incorrect because prednisone can actually increase blood glucose levels, leading to hyperglycemia rather than hypoglycemia.
D: This is incorrect because the rash is not likely caused by an interaction between metformin and prednisone, but rather an allergic reaction to an unknown cause.
A nurse is planning care of an adolescent who is postoperative following a lumbar laminectomy. Which of the following interventions should the nurse include in the plan of care?
- A. Limit the adolescent's visitors.
- B. Select the adolescent's food choices.
- C. Encourage the adolescent's guardian to assist with personal hygiene.
- D. Allow the adolescent to make decisions regarding their daily routine.
Correct Answer: C
Rationale: The correct answer is C. Encouraging the adolescent's guardian to assist with personal hygiene is crucial after a lumbar laminectomy. Postoperatively, the adolescent may require assistance with activities of daily living due to limited mobility and risk of injury. Involving the guardian ensures proper care and promotes faster recovery.
Choice A is incorrect as limiting visitors can negatively impact the adolescent's emotional well-being and support system. Choice B is incorrect as food choices are not typically restricted postoperatively unless medically necessary. Choice D is incorrect as the adolescent may not be in the optimal state to make decisions regarding their daily routine immediately after surgery.
To best reduce the potential for risk, what type of atmosphere is needed to be developed?
- A. Nurse-focused
- B. Physician-focused
- C. Family-focused
- D. Patient-focused
Correct Answer: D
Rationale: The correct answer is D: Patient-focused. Developing a patient-focused atmosphere is crucial to reduce potential risks in healthcare. Patients should be at the center of care, with their needs, preferences, and safety prioritized. In a patient-focused atmosphere, communication is enhanced, leading to better understanding and adherence to treatment plans, reducing errors and adverse events. Nurses, physicians, and families play important roles in patient care, but ultimately, the patient should be the primary focus.
Incorrect choices:
A: Nurse-focused - Focusing solely on nurses may neglect the holistic approach to patient care and fail to address the patient's needs directly.
B: Physician-focused - Similarly, focusing only on physicians may lead to a lack of patient involvement in decision-making and may not address the emotional and psychological aspects of care.
C: Family-focused - While involving families in care is important, solely focusing on them may not always align with the patient's best interests and may not address the patient's autonomy and individual needs.
Recent polls have placed nursing as one of the most trusted professions because of which of the following?
- A. Nurses engage in lifelong learning.
- B. Nurses abide by a dress code.
- C. Nurses have the skills needed to care for diverse populations.
- D. Nurses must pass the NCLEX in order to obtain a license to practice.
Correct Answer: C
Rationale: The correct answer is C because nurses having the skills to care for diverse populations is a crucial factor in earning trust. Nursing involves providing care to individuals from various backgrounds, cultures, and beliefs. Nurses who possess the skills to understand and cater to the unique needs of diverse populations build trust by ensuring culturally sensitive and competent care. This answer aligns with the essence of nursing, which emphasizes holistic care for all individuals regardless of their differences.
A: While lifelong learning is important in nursing, it is not the primary reason why nursing is one of the most trusted professions.
B: Abiding by a dress code is a professional expectation but not a significant factor in establishing trust with patients.
D: Passing the NCLEX is a requirement for licensure but does not directly correlate with the trustworthiness of nurses in caring for diverse populations.
A diabetic patient who has reported burning foot pain at night receives a new prescription. Which information should the nurse teach the patient about amitriptyline (Elavil)?
- A. Amitriptyline decreases the depression caused by your foot pain.
- B. Amitriptyline helps prevent transmission of pain impulses to the brain.
- C. Amitriptyline corrects some of the blood vessel changes that cause pain.
- D. Amitriptyline improves sleep and reduces awareness of nighttime pain.
Correct Answer: B
Rationale: The correct answer is B because amitriptyline is a tricyclic antidepressant that works by inhibiting the reuptake of serotonin and norepinephrine, thus helping to prevent the transmission of pain impulses to the brain. This mechanism of action is effective in managing neuropathic pain, such as burning foot pain in diabetic patients. Choices A, C, and D are incorrect because amitriptyline's primary mechanism of action is related to its effects on neurotransmitter reuptake, not directly related to mood improvement, blood vessel changes, or sleep improvement.