Nokea
The nurse is performing preoperative teaching with a patient who has cancer of the larynx. After completing patient teaching, what would be most important for the nurse to do?
- A. Give the patient his or her cell phone number.
- B. Refer the patient to a social worker or psychologist.
- C. Provide the patient with audiovisual materials about the surgery.
- D. Reassure the patient and family that everything will be alright.
Correct Answer: C
Rationale: Informational materials (written and audiovisual) about the surgery are given to the patient and family for review and reinforcement. The nurse never gives personal contact information to the patient. Nothing in the scenario indicates that a referral to a social worker or psychologist is necessary. False reassurance must always be avoided.
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The home care nurse is assessing the home environment of a patient who will be discharged from the hospital shortly after his laryngectomy. The nurse should inform the patient that he may need to arrange for the installation of which system in his home?
- A. A humidification system
- B. An air conditioning system
- C. A water purification system
- D. A radiant heating system
Correct Answer: A
Rationale: The nurse stresses the importance of humidification at home and instructs the family to obtain and set up a humidification system before the patient returns home. Air-conditioning may be too cool and too drying for the patient. A water purification system or a radiant heating system is not necessary.
A mother calls the clinic asking for a prescription for Amoxicillin for her 2-year-old son who has what the nurse suspects to be viral rhinitis. What should the nurse explain to this mother?
- A. I will relay your request promptly to the doctor, but I suspect that she wont get back to you if its a cold.
- B. Ill certainly inform the doctor, but if it is a cold, antibiotics wont be used because they do not affect the virus.
- C. Ill phone in the prescription for you since it can be prescribed by the pharmacist.
- D. Amoxicillin is not likely the best antibiotic, but Ill call in the right prescription for you.
Correct Answer: B
Rationale: Antimicrobial agents (antibiotics) should not be used because they do not affect the virus or reduce the incidence of bacterial complications. In addition, their inappropriate use has been implicated in development of organisms resistant to therapy. It would be inappropriate to tell the patient that the physician will not respond to her request.
The campus nurse at a university is assessing a 21-year-old student who presents with a severe nosebleed. The site of bleeding appears to be the anterior portion of the nasal septum. The nurse instructs the student to tilt her head forward and the nurse applies pressure to the nose, but the students nose continues to bleed. Which intervention should the nurse next implement?
- A. Apply ice to the bridge of her nose
- B. Lay the patient down on a cot
- C. Arrange for transfer to the local ED
- D. Insert a tampon in the affected nare
Correct Answer: D
Rationale: A cotton tampon may be used to try to stop the bleeding. The use of ice on the bridge of the nose has no scientific rationale for care. Laying the client down on the cot could block the clients airway. Hospital admission is necessary only if the bleeding becomes serious.
The nurse is caring for a patient who needs education on his medication therapy for allergic rhinitis. The patient is to take cromolyn (Nasalcrom) daily. In providing education for this patient, how should the nurse describe the action of the medication?
- A. It inhibits the release of histamine and other chemicals.
- B. It inhibits the action of proton pumps.
- C. It inhibits the action of the sodium-potassium pump in the nasal epithelium.
- D. It causes bronchodilation and relaxes smooth muscle in the bronchi.
Correct Answer: A
Rationale: Cromolyn (Nasalcrom) inhibits the release of histamine and other chemicals. It is prescribed to treat allergic rhinitis. Beta-adrenergic agents lead to bronchodilation and stimulate beta-3-adrenergic receptors in the smooth muscle of the bronchi and bronchioles. It does not affect proton pump action or the sodium-potassium pump in the nasal cells.
The nurse is performing an assessment on a patient who has been diagnosed with cancer of the larynx. Part of the nurses assessment addresses the patients general state of nutrition. Which laboratory values would be assessed when determining the nutritional status of the patient?
- A. White blood cell count
- B. Protein level
- C. Albumin level
- D. Platelet count
- E. Glucose level
Correct Answer: B,C,E
Rationale: The nurse also assesses the patients general state of nutrition, including height and weight and body mass index, and reviews laboratory values that assist in determining the patients nutritional status (albumin, protein, glucose, and electrolyte levels). The white blood cell count and the platelet count would not normally assist in determining the patients nutritional status.