Nokea
The physician ordered to start Ms. Mely on Total Parenteral Nutrition (TPN). What Is your INITIAL step to be undertaken PRIOR to this intervention?
- A. Determine if the family can afford the whole treatment,
- B. Evaluate the tolerance of the patient to glucose.
- C. Identify allergies of patient to the supplemental nutrition.
- D. Assess the basic understanding of the patient regarding TPN
Correct Answer: B
Rationale: The correct initial step before starting TPN is to evaluate the patient's tolerance to glucose. This is crucial to ensure the patient can metabolize the glucose effectively and avoid complications such as hyperglycemia. Assessing affordability (A) is important but not the immediate concern. Identifying allergies (C) should be done but is not the first step. Assessing the patient's understanding (D) is important but not as critical as evaluating glucose tolerance before starting TPN.
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A patient receiving palliative care for end-stage cancer experiences intractable pain despite receiving opioid medications. What intervention should the palliative nurse prioritize to address the patient's pain?
- A. Increase the dosage of the current opioid medication.
- B. Switch to a different opioid medication with a different potency.
- C. Administer adjuvant analgesic medications to enhance pain relief.
- D. Refer the patient to a pain management specialist for evaluation.
Correct Answer: D
Rationale: The correct answer is D because referring the patient to a pain management specialist for evaluation is essential in this scenario. The specialist can conduct a comprehensive assessment to identify the underlying causes of the intractable pain and recommend a tailored pain management plan. This approach ensures a multidisciplinary approach to address the complex nature of the patient's pain.
Choice A is incorrect because simply increasing the dosage of the current opioid medication may not effectively address the underlying cause of the pain and can lead to potential side effects or opioid tolerance.
Choice B is incorrect as switching to a different opioid medication without a thorough evaluation may not guarantee better pain control and can increase the risk of adverse effects or inadequate pain relief.
Choice C is incorrect as administering adjuvant analgesic medications without addressing the root cause of the pain may not provide adequate pain relief and does not address the need for a specialized pain management plan.
Nurse Rica, would like to start a conversation, which comunication technique she should use?
- A. Clarifying
- B. Challenging
- C. Restating
- D. Broad opening
Correct Answer: D
Rationale: The correct answer is D, Broad opening. Nurse Rica should use this communication technique to encourage the patient to freely express themselves without leading or interrupting. This technique helps build rapport and trust, setting a positive tone for the conversation.
A: Clarifying may be too direct and might make the patient feel pressured.
B: Challenging can create defensiveness and hinder open communication.
C: Restating may not be as effective in initiating a conversation as broad opening.
In summary, broad opening allows for a more open and relaxed conversation, fostering a conducive environment for effective communication with the patient.
The Nurse asks Baste, who is being admitted in a district hospital with uncontrolled diabetes mellitus, about his employment status. She knows that _____.
- A. A person's compliance is affected by one's affected economic status
- B. Baste's employment will cause complication to his diabetes
- C. External variables have little effected on compliance
- D. Diabetes mellitus will affect his client's work condition
Correct Answer: A
Rationale: Rationale: A person's compliance with diabetes management can be influenced by economic status, as financial concerns can impact access to medications, healthy food, and healthcare. This can affect treatment adherence and overall health outcomes. Choice A is correct because addressing economic factors is important in promoting compliance. Choices B, C, and D are incorrect as they do not directly address the relationship between economic status and compliance with diabetes management.
A patient presents with palpitations, dizziness, and syncope. An electrocardiogram (ECG) shows ventricular tachycardia. Which cardiovascular disorder is most likely responsible for these symptoms?
- A. Stable angina
- B. Unstable angina
- C. Atrial fibrillation
- D. Ventricular tachycardia
Correct Answer: D
Rationale: The correct answer is D: Ventricular tachycardia. Ventricular tachycardia is a serious arrhythmia that can lead to palpitations, dizziness, and syncope due to the rapid and abnormal heart rhythm originating in the ventricles. This arrhythmia can be life-threatening if not promptly treated.
A: Stable angina is characterized by chest discomfort or pain due to reduced blood flow to the heart muscle, usually during physical exertion or stress. It does not typically present with palpitations, dizziness, or syncope.
B: Unstable angina is a more severe form of angina where symptoms occur even at rest. While it can lead to serious complications like heart attack, it does not commonly present with palpitations, dizziness, or syncope.
C: Atrial fibrillation is a common arrhythmia originating in the atria, leading to an irregular and often rapid heartbeat. While it can cause palpitations and dizziness,
A patient presents with sudden-onset severe headache, vomiting, and altered mental status. Imaging reveals a noncontrast-enhancing hemorrhagic lesion within the subarachnoid space. Which of the following neurological conditions is most likely responsible for these symptoms?
- A. Ischemic stroke
- B. Subdural hematoma
- C. Intracerebral hemorrhage
- D. Subarachnoid hemorrhage
Correct Answer: D
Rationale: The correct answer is D: Subarachnoid hemorrhage. This condition presents with sudden-onset severe headache, vomiting, and altered mental status due to bleeding in the subarachnoid space. This type of hemorrhage is typically noncontrast-enhancing on imaging.
A: Ischemic stroke does not typically present with sudden-onset severe headache and vomiting.
B: Subdural hematoma usually presents with a slower onset of symptoms and often develops after head trauma.
C: Intracerebral hemorrhage presents with focal neurological deficits rather than altered mental status and vomiting.
In summary, based on the sudden onset of symptoms, imaging findings, and clinical presentation, subarachnoid hemorrhage is the most likely diagnosis in this case.