Nokea
The nurse is providing patient teaching to a young mother who has brought her 3-month-old infant to the clinic for a well-baby checkup. What action should the nurse recommend to the woman to prevent the transmission of organisms to her infant during the cold season?
- A. Take preventative antibiotics, as ordered.
- B. Gargle with warm salt water regularly.
- C. Dress herself and her infant warmly.
- D. Wash her hands frequently.
Correct Answer: D
Rationale: Handwashing remains the most effective preventive measure to reduce the transmission of organisms. Taking prescribed antibiotics, using warm salt-water gargles, and dressing warmly do not suppress transmission. Antibiotics are not prescribed for a cold.
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A patient comes to the ED and is admitted with epistaxis. Pressure has been applied to the patients midline septum for 10 minutes, but the bleeding continues. The nurse should anticipate using what treatment to control the bleeding?
- A. Irrigation with a hypertonic solution
- B. Nasopharyngeal suction
- C. Normal saline application
- D. Silver nitrate application
Correct Answer: D
Rationale: If pressure to the midline septum does not stop the bleeding for epistaxis, additional treatment of silver nitrate application, Gelfoam, electrocautery, or vasoconstrictors may be used. Suction may be used to visualize the nasal septum, but it does not alleviate the bleeding. Irrigation with a hypertonic solution is not used to treat epistaxis.
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.
A nurse practitioner has provided care for three different patients with chronic pharyngitis over the past several months. Which patients are at greatest risk for developing chronic pharyngitis?
- A. Patients who are habitual users of alcohol and tobacco
- B. Patients who are habitual users of caffeine and other stimulants
- C. Patients who eat a diet high in spicy foods
- D. Patients who have gastrointestinal reflux disease (GERD)
Correct Answer: A
Rationale: Chronic pharyngitis is common in adults who live and work in dusty surroundings, use the voice to excess, suffer from chronic cough, and habitually use alcohol and tobacco. Caffeine and spicy foods have not been linked to chronic pharyngitis. GERD is not a noted risk factor.
A 42-year-old patient is admitted to the ED after an assault. The patient received blunt trauma to the face and has a suspected nasal fracture. Which of the following interventions should the nurse perform?
- A. Administer nasal spray and apply an occlusive dressing to the patients face.
- B. Position the patients head in a dependent position.
- C. Irrigate the patients nose with warm tap water.
- D. Apply ice and keep the patients head elevated.
Correct Answer: D
Rationale: Immediately after the fracture, the nurse applies ice and encourages the patient to keep the head elevated. The nurse instructs the patient to apply ice packs to the nose to decrease swelling. Dependent positioning would exacerbate bleeding and the nose is not irrigated. Occlusive dressings are not used.
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.