Nokea
The nurse is providing care to a 72-year-old female patient. While providing care, the nurse instructs the patient to slowly rise from a sitting or prone position. What is the pathophysiological reason for this instruction?
- A. The patient is at higher risk for fractures due to postmenopausal osteoporosis.
- B. The patient is at higher risk for hypotension due to decreased baroreceptor sensitivity.
- C. The patient is at higher risk for falls due to decreased muscle strength and balance
- D. The patient is at higher risk for adverse drug reactions due to decreased hepatic function
Correct Answer: B
Rationale: As people age, their baroreceptor sensitivity decreases, making them more prone to orthostatic hypotension, especially when changing positions quickly. Orthostatic hypotension is a significant concern in the elderly population as it can lead to falls and injuries. By instructing the patient to rise slowly from a sitting or prone position, the nurse is helping to prevent a rapid drop in blood pressure that can occur with sudden position changes. This precaution is particularly important in elderly patients to minimize the risk of falls and subsequent injuries.
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A patient arrives to the clinic 2 hours late for her prenatal appointment. This is the third time she has been late. What is the nurse’s best action in response to this patient’s tardiness?
- A. Ask the patient if she has a way to tell the time.
- B. Ask the patient if she is deliberately being late for her appointments.
- C. Determine if the patient wants this baby and if this is her way of acting out.
- D. Determine if the patient arrives after the start time for other types of appointments.
Correct Answer: C
Rationale: The nurse's best action in response to the patient's tardiness is to determine if the patient wants this baby and if this is her way of acting out. Tardiness to prenatal appointments can sometimes indicate underlying issues such as ambivalence towards the pregnancy or emotional distress. By addressing the patient's motivation for being consistently late, the nurse can better understand and support her needs. This approach allows for a more patient-centered and compassionate response, aiming to address any possible concerns or challenges the patient may be facing.
A college-aged female patient states that she understands the risk of sexual assault with overdrinking. She asks the nurse what health risks are associated with excessive alcohol intake for her age. What diseases or conditions should the nurse include in her response? Select all that
apply
- A. Infertility
- B. Cancer of mouth
- C. Hypertension
- D. Brain shrinkage
Correct Answer: A
Rationale: A. Excessive alcohol intake is a risk factor for developing cancer, particularly cancers of the mouth, throat, esophagus, liver, and breast. Chronic alcohol use can increase the individual's susceptibility to these types of cancers.
The telephone triage nurse receives a call from a patient who is 5 days postoperative total
abdominal hysterectomy. The patient states that her pain is not relieved with the medications and
that she has noticed blood in her urine. The nurse instructs the patient to report immediately to the
emergency department. What does the nurse suspect as the surgical complication?
- A. Possible complication related to the anesthesia
- B. Possible injury to the ureters or bladder
- C. Possible hemorrhage from the internal incision
- D. Possible peritoneal venous thromboembolism
Correct Answer: D
Rationale: In this situation where the patient is 5 days postoperative total abdominal hysterectomy and experiencing pain that is not relieved with medications, the nurse should suspect a possible hemorrhage from the internal incision. Although some pain is expected postoperatively, severe or worsening pain that is not relieved with medications can indicate a complication such as internal bleeding. Immediate medical attention is needed to assess and manage any potential hemorrhage to prevent further complications or adverse outcomes. Other signs of internal bleeding may include symptoms such as increasing abdominal distention, tachycardia, hypotension, and signs of shock.
The nurse is providing care to a 35-year-old female patient who complains of low back pain, pain with defecation, pelvic pressure, and premenstrual spotting. The health care provider has prescribed the hormonal therapy Lupron for this condition. What is the goal of this prescription?
- A. To prevent pregnancy at this time to promote healing
- B. To suppress menstruation and further growth of the tissue
- C. To prevent retrograde menstruation outside the uterine cavity
- D. To increase blood flow to decrease the endometrial lining
Correct Answer: B
Rationale: The goal of prescribing Lupron for this patient is to suppress menstruation and further growth of the tissue. Lupron is a hormonal therapy that works by suppressing the production of certain hormones that stimulate the growth of endometrial tissue. In conditions like endometriosis, where the endometrial tissue grows outside the uterus, suppressing menstruation can help alleviate symptoms such as pelvic pain, back pain, and pelvic pressure. By halting the growth of the tissue, Lupron can help manage the symptoms associated with endometriosis and improve the patient's quality of life.
A nurse is caring for a patient who has HSV and is pregnant. The patient is concerned about the fetus. What medication is safest to take?
- A. valacyclovir
- B. none
- C. acyclovir
- D. famciclovir
Correct Answer: C
Rationale: Acyclovir is the antiviral medication of choice for treating HSV (Herpes Simplex Virus) infections during pregnancy due to its known safety profile. It is classified as Category B by the FDA, indicating that there is no evidence of risk to the fetus based on animal studies. Valacyclovir and famciclovir, on the other hand, are both classified as Category B (risk cannot be ruled out) and Category C (animal studies have shown adverse effects) by the FDA, respectively. It is generally recommended to avoid taking unnecessary medications during pregnancy, but if treatment for HSV is necessary, acyclovir is considered the safest option.