Nokea
The nurse is preparing to care for a patient who is HIV positive. Which action should the nurse take when following standard precautions for protection from HIV exposure?
- A. Put on gloves before touching body fluids.
- B. Recap intramuscular needles after injection.
- C. Wash own open skin lesion after providing care.
- D. Remove one finger on a glove during venipuncture.
Correct Answer: A
Rationale: The correct answer is A: Put on gloves before touching body fluids. This is because wearing gloves is a standard precaution to prevent exposure to HIV through contact with bodily fluids. Gloves create a barrier between the nurse's skin and the patient's fluids, reducing the risk of transmission. Recapitulating needles (B) can increase the risk of needle-stick injuries. Washing own open skin lesions (C) is important for personal hygiene but does not prevent HIV transmission. Removing one finger on a glove (D) compromises the protective barrier and exposes the nurse to potential infection.
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Jack and Ann have come to the clinic for family therapy. They have been married for 18 years. Jack had an affair with his secretary 5 years ago. He fired the secretary and assures Ann and the nurse that he has been faithful ever since. Jack tells the nurse, 'We have never been able to get along with each other. We can’t talk about anything . . . all we do is shout at each other. And every time she gets angry with me, she brings up my infidelity. I can’t even imagine how many times each of us has threatened divorce over the years. Our kids don’t have any idea what it is like to have parents who get along with each other. I’ve really had enough!' The nurse would most likely document which of the following in her assessment of this couple?
- A. Marital skew
- B. Pseudohostility
- C. Double-bind communication
- D. Marital schism
Correct Answer: D
Rationale: The correct answer is D: Marital schism. Marital schism refers to a state of constant conflict and disengagement in a marriage. In this scenario, Jack and Ann exhibit a significant disconnect in their relationship, as evidenced by their inability to communicate effectively, frequent shouting matches, and unresolved issues such as Jack's infidelity. The nurse would likely document a marital schism in her assessment due to the ongoing discord and lack of emotional connection between the couple.
Incorrect choices:
A: Marital skew typically refers to power imbalances in a relationship, which is not the primary issue in this case.
B: Pseudohostility involves false or exaggerated hostility, which is not the main concern in Jack and Ann's situation.
C: Double-bind communication involves contradictory messages leading to confusion, which is not the central issue in this scenario.
A patient with AIDS is planning a trip to Mexico. What teaching should the nurse provide to this patient to prevent the development of an opportunistic infection? (Select all that apply.)
- A. Use beach towels.
- B. Do not walk barefoot.
- C. Do not eat raw fruits or vegetables.
- D. Clean bathroom supplies with bleach.
Correct Answer: A
Rationale: The correct answer is A: Use beach towels. Using beach towels can help prevent skin infections caused by exposure to contaminated surfaces. Walking barefoot (B) can increase the risk of skin infections. Eating raw fruits or vegetables (C) is not directly related to preventing opportunistic infections in this scenario. Cleaning bathroom supplies with bleach (D) is important for general hygiene but not specific to preventing opportunistic infections.
Which of the following is unlikely to influence the doctor-patient relationship?
- A. The cleanliness of the office
- B. Physician's bias toward patients
- C. Past experiences of patients
- D. Personal prejudices of patients against certain ethnic groups
Correct Answer: A
Rationale: Office cleanliness has minimal direct impact compared to interpersonal factors.
Which of the following is not a reason adults often do not seek interventions for hearing loss?
- A. Cost of treatment
- B. One in four
- C. Perception that problem is not severe
- D. Availability of treatment
Correct Answer: B
Rationale: ‘One in four' is irrelevant; cost and perception are common barriers.
Common Level 2 issues typically include...
- A. Triangles, alliances and boundaries
- B. Marital conflict, alcoholism, or gambling
- C. Inner conflicts, problems with intimacy
- D. Executive capacity issues
Correct Answer: B
Rationale: Level 2 families typically struggle with relational dynamics such as marital conflict or substance abuse, which disrupt family functioning beyond basic survival needs.