Nokea
The RN is delegating tasks to the unlicensed assistive personnel (UAP). Which tasks can the nurse delegate? (Select all that apply.)
- A. Teaching the patient about breast care
- B. Assessment of a patient’s lochia and perineal area
- C. Assisting a patient to the bathroom for the first time after birth
- D. Vital signs on a postpartum patient who delivered the night before
Correct Answer: C
Rationale: A. Teaching the patient about breast care typically requires specialized knowledge and is best performed by the nurse.
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The nurse is educating a 24-year-old female patient who was newly diagnosed with polycystic ovary syndrome (PCOS). The patient was prescribed an antidiabetic medication. Which medication effects should the nurse educate the patient about? Select all that apply.
- A. A period of initial weight gain
- B. A change in her integumentary system
- C. Low blood sugar until her hormones stabilize
- D. Decreased likelihood of pregnancy
Correct Answer: A
Rationale: A. A period of initial weight gain: The nurse should educate the patient about the potential for initial weight gain when starting an antidiabetic medication. This can be a common side effect, and it is important for the patient to be aware of it to avoid unnecessary concern. Weight gain may occur due to factors such as fluid retention or changes in metabolism.
A nurse working in a labor and birth unit is asked to take care of two high-risk patients in the labor and birth suite: a 34 weeks’ gestation 28-year-old gravida 3, para 2 in preterm labor and a 40-year-old gravida 1, para 0 who is severely preeclamptic. The nurse refuses this assignment telling the charge nurse that based on individual patient acuity, each patient should have one-on-one care. Which ethical principle is the nurse advocating?
- A. Accountability
- B. Beneficence
- C. Justice
- D. Fidelity
Correct Answer: C
Rationale: Justice is the ethical principle that involves fair and equal distribution of resources and care. In this scenario, the nurse is advocating for justice by asserting that each high-risk patient should receive one-on-one care based on their individual acuity levels. By refusing to take on both patients simultaneously, the nurse is advocating for fairness and equal opportunity for proper care and attention for each patient. This is in line with the principle of justice, which emphasizes the importance of treating all individuals fairly and providing them with the appropriate level of care they need.
What hormonal medication can be used in a premenopausal patient without the concurrent use of ovarian suppression?
- A. letrozole (Femara)
- B. exemestane (Aromasin)
- C. elacestrant (Orserdu)
- D. tamoxifen (Soltamox)
Correct Answer: D
Rationale: Tamoxifen is a hormonal medication that can be used in premenopausal patients without the concurrent use of ovarian suppression. It is a selective estrogen receptor modulator (SERM) that acts by blocking estrogen receptors in breast tissue, thereby inhibiting the growth of hormone-sensitive breast cancer cells. Tamoxifen is commonly prescribed for hormone receptor-positive breast cancer in both premenopausal and postmenopausal women. Unlike aromatase inhibitors (e.g., letrozole and exemestane) which require ovarian suppression in premenopausal patients, tamoxifen can be used as monotherapy in premenopausal patients due to its different mechanism of action. Elacestrant is a selective estrogen receptor degrader (SERD) and not commonly used in clinical practice for this indication.
A nurse is caring for a patient with increased urination and pain with urination. What finding would the nurse expect if the patient has a UTI?
- A. white blood cells in urine
- B. ketones in urine
- C. blood in urine
- D. protein in urine
Correct Answer: A
Rationale: When a patient has a urinary tract infection (UTI) they may have increased white blood cells (leukocytes) in their urine. White blood cells are a sign of inflammation and infection in the urinary tract. It is a common finding in patients with UTIs. Symptoms such as increased urination and pain with urination are classic signs of a UTI. Therefore, the nurse would expect to see white blood cells in the urine of a patient with a UTI.
Regarding advanced roles of nursing, which statement related to clinical practice is the most accurate?
- A. Family nurse practitioners (FNPs) can assist with childbirth care in the hospital setting.
- B. Clinical nurse specialists (CNSs) provide primary care to obstetric patients.
- C. Neonatal nurse practitioners provide emergency care in the postbirth setting to high-risk infants.
- D. A certified nurse midwife (CNM) is not considered to be an advanced practice nurse.
Correct Answer: C
Rationale: The most accurate statement related to clinical practice among the choices presented is that neonatal nurse practitioners provide emergency care in the postbirth setting to high-risk infants. Neonatal nurse practitioners specialize in the care of newborns, particularly those who are premature or have health complications. They work in settings such as neonatal intensive care units (NICUs) and provide specialized care to meet the needs of high-risk infants. Neonatal nurse practitioners collaborate with neonatologists and other healthcare professionals to ensure that these fragile patients receive the necessary care and attention. This role involves advanced clinical skills and knowledge in the care of neonates, making it a crucial part of the healthcare team for newborns in need of specialized care.