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The rate of obesity in the United States has reached epidemic proportions. Morbidity and mortality for both the mother and baby are increased in these circumstances. The nurse caring for the patient with an elevated BMI should be cognizant of these potential complications and plan care accordingly. Significant risks include (Select all that apply.)
- A. Breech presentation
- B. Ectopic pregnancy
- C. Birth defects
- D. Venous thromboembolism
Correct Answer: A
Rationale: The correct answer is A: Breech presentation. Obesity can lead to a larger fetus, increasing the risk of breech presentation. The rationale is that excess fat can hinder the baby's ability to turn head down. Other choices are incorrect because: B: Ectopic pregnancy is not related to obesity, C: Birth defects can be influenced by maternal health but are not directly linked to obesity, and D: Venous thromboembolism is more associated with immobility and hypercoagulable states rather than obesity.
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A patient is being discharged home after mastoid surgery. What topic should the nurse address in the patients discharge education?
- A. Expected changes in facial nerve function
- B. The need for audiometry testing every 6 months following recovery
- C. Safe use of analgesics and antivertiginous agents
- D. Appropriate use of OTC ear drops
Correct Answer: C
Rationale: Step 1: After mastoid surgery, patients may experience pain and dizziness, hence addressing the safe use of analgesics and antivertiginous agents is crucial for symptom management.
Step 2: Analgesics help in managing post-operative pain, while antivertiginous agents help control dizziness, reducing the risk of falls.
Step 3: Educating the patient on safe use ensures proper pain and symptom management, preventing complications.
Step 4: Other choices are incorrect as they do not directly address immediate post-operative care needs such as pain and dizziness management.
A nurse is charting on a patient’s record. Whichaction will the nurse take that is accurate legally?
- A. Charts legibly
- B. States the patient is belligerent
- C. Writes entry for another nurse
- D. Uses correction fluid to correct error
Correct Answer: A
Rationale: The correct answer is A: Charts legibly. This is accurate legally because clear and legible documentation is crucial for accurately conveying patient information, ensuring continuity of care, and meeting legal standards. Illegible handwriting can lead to errors in patient care and legal issues.
Choice B is incorrect as labeling a patient as "belligerent" without evidence can be perceived as unprofessional and potentially harmful to the patient. Choice C is incorrect as writing an entry for another nurse can lead to inaccurate documentation and legal consequences. Choice D is incorrect because using correction fluid can raise suspicion of tampering with records and compromise the integrity of the documentation.
The organization of a patients care on the palliative care unit is based on interdisciplinary collaboration. How does interdisciplinary collaboration differ from multidisciplinary practice?
- A. It is based on the participation of clinicians without a team leader.
- B. It is based on clinicians of varied backgrounds integrating their separate plans of care.
- C. It is based on communication and cooperation between disciplines.
- D. It is based on medical expertise and patient preference with the support of nursing.
Correct Answer: B
Rationale: Interdisciplinary collaboration involves clinicians from different backgrounds integrating their separate plans of care, ensuring a holistic approach to patient care. This fosters a comprehensive understanding of the patient's needs and individualized care. In contrast, multidisciplinary practice involves clinicians working independently without integrating their plans, potentially leading to fragmented care.
Choice A is incorrect as interdisciplinary collaboration does have a team leader to coordinate and facilitate communication among team members.
Choice C is incorrect because while communication and cooperation are essential in interdisciplinary collaboration, the key distinction is the integration of different perspectives and plans of care.
Choice D is incorrect as interdisciplinary collaboration goes beyond just medical expertise and patient preference, involving professionals from various disciplines working together to address all aspects of patient care.
A patient comes to the ophthalmology clinic for an eye examination. The patient tells the nurse that he often sees floaters in his vision. How should the nurse best interpret this subjective assessment finding?
- A. This is a normal aging process of the eye.
- B. Glasses will minimize this phenomenon.
- C. The patient may be exhibiting signs of glaucoma.
- D. This may be a result of weakened ciliary muscles.
Correct Answer: A
Rationale: The correct answer is A because floaters are commonly caused by age-related changes in the vitreous humor of the eye, such as the formation of tiny fibers or clumps. These floaters are typically harmless and not a cause for concern. Choice B is incorrect because glasses do not affect floaters in the eye. Choice C is incorrect because floaters are not a primary symptom of glaucoma. Choice D is incorrect because weakened ciliary muscles are not typically associated with floaters. Therefore, the most appropriate interpretation is that seeing floaters is a normal aging process of the eye.
A patient is scheduled for enucleation and the nurse is providing anticipatory guidance about postoperative care. What aspects of care should the nurse describe to the patient? Select all that apply.
- A. Application of topical antibiotic ointment
- B. Maintenance of a supine position for the first 48 hours postoperative
- C. Fluid restriction to prevent orbital edema
- D. Administration of loop diuretics to prevent orbital edema E) Use of an ocular pressure dressing Chapter 64: Ear/Hearing: Hearing tests, Hearing loss, Otitis externa, Otitis media, Trauma, Meniere’s disease, Mastoidectomy – perioperative care, Impacted cerumen & Cochlear implant
Correct Answer: A
Rationale: The correct answer is A: Application of topical antibiotic ointment. After enucleation, there is a risk of infection at the surgical site. By applying topical antibiotic ointment as directed, the patient can help prevent infection and promote healing. This is a crucial aspect of postoperative care.
B: Maintenance of a supine position for the first 48 hours postoperative is incorrect. Patients may be advised to avoid lying flat on their back to prevent complications such as pressure on the surgical site.
C: Fluid restriction to prevent orbital edema is incorrect. Fluid restriction is not typically necessary post-enucleation unless specifically advised by the healthcare provider.
D: Administration of loop diuretics to prevent orbital edema is incorrect. Loop diuretics are not typically used for preventing orbital edema post-enucleation.
E: Use of an ocular pressure dressing is incorrect. While dressings may be used postoperatively, the application of topical antibiotic ointment is more