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The team leader is reviewing what the HCP has just prescribed for Mr. N (non-Hodgkin lymphoma). What will the team leader question?
- A. Administer filgrastim 5 mcg/kg subcutaneously every day
- B. Catheterize to obtain a urinalysis specimen.
- C. Flush the IV saline lock every shift.
- D. Monitor vital signs every 4 hours.
Correct Answer: A
Rationale: The correct answer is A: Administer filgrastim 5 mcg/kg subcutaneously every day. The rationale for this is that filgrastim is a medication commonly prescribed for patients with non-Hodgkin lymphoma to stimulate the production of white blood cells. Therefore, the team leader should question the dosage, route of administration, and frequency to ensure it aligns with the prescribed treatment plan.
Incorrect choices:
B: Catheterize to obtain a urinalysis specimen - This is not relevant to the prescribed treatment for non-Hodgkin lymphoma.
C: Flush the IV saline lock every shift - Important for maintaining IV access but not directly related to the prescribed medication.
D: Monitor vital signs every 4 hours - Monitoring vital signs is important but not the primary concern when reviewing a prescribed medication for non-Hodgkin lymphoma.
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After the BCG treatment, the team leader delegates disposal of the fluid contents in Mr. B's (bladder cancer) urinary drainage bag to the UAP. What instructions should be given to the UAP?
- A. "No special handling of the bag or its contents is required."
- B. "Wear a lead apron when you are emptying the drainage container."
- C. "Discard the fluid in the toilet and disinfect the toilet with bleach for 6 hours."
- D. "Wear sterile gloves when you are handling the bag and its contents."
Correct Answer: C
Rationale: The correct answer is C because after BCG treatment, the fluid in the urinary drainage bag is considered hazardous due to the live bacteria used in the treatment. Therefore, instructing the UAP to discard the fluid in the toilet and disinfect it with bleach is crucial to prevent the spread of infection. This step helps to ensure proper disposal and minimize the risk of exposure to others.
Choice A is incorrect because special handling is indeed required due to the nature of the contents. Choice B is incorrect as wearing a lead apron is not necessary for handling the fluid in the urinary drainage bag. Choice D is also incorrect as sterile gloves are not specifically required for this task; instead, proper disinfection of the toilet is essential.
The nurse cares for a young adult patient in the emergency room after a sexual assault. Which action by the nurse is appropriate?
- A. Avoid situations in which the patient will be involved with decision making.
- B. Tell the patient to join a local support group for sexual assault victims.
- C. Actively listen to the patient express feelings related to the sexual assault.
- D. Provide detailed information about evidence collection and invasive procedures.
Correct Answer: C
Rationale: The correct answer is C because actively listening to the patient express their feelings related to the sexual assault is essential for providing emotional support and validating their experience. This action shows empathy and helps the patient feel heard and supported. It also allows the nurse to assess the patient's emotional well-being and provide appropriate care.
Avoiding decision-making situations (A) may lead to further distress for the patient. While joining a support group (B) can be beneficial, it may not be appropriate or feasible immediately after a traumatic event. Providing detailed information about evidence collection (D) is important but should be done after addressing the patient's emotional needs.
A 36-year-old woman who is in traction for a fractured femur that she received in an auto accident is found crying quietly. The nurse can best address this situation by saying:
- A. "What's the matter? Why are you crying? Are you in pain?"
- B. "Stop crying and tell me what your problem is."
- C. "This could have been much worse. You're lucky no one was killed."
- D. "You are upset. Can you tell me what's wrong?"
Correct Answer: D
Rationale: The correct answer is D because it acknowledges the patient's emotions, shows empathy, and encourages open communication. By stating "You are upset. Can you tell me what's wrong?" the nurse validates the patient's feelings and invites her to express her concerns. This approach fosters trust and allows the nurse to address the underlying issues causing the patient's distress.
Choice A is incorrect as it assumes the patient is in pain without confirmation and may come off as dismissive. Choice B is inappropriate as it lacks empathy and demands the patient to stop crying, which can further escalate the situation. Choice C is insensitive as it diminishes the patient's feelings by comparing her situation to a potential worse outcome, which is not helpful in addressing her emotional distress.
The community health nurse is listening to a client talk about a personal problem. Which of these actions by the nurse is most appropriate?
- A. The nurse should increase the physical distance from the client.
- B. The nurse should lean toward the client and make eye contact.
- C. The nurse should periodically interrupt the client to ask questions.
- D. The nurse should initiate the physical assessment to distract the client.
Correct Answer: B
Rationale: The correct answer is B because leaning towards the client and making eye contact shows active listening and empathy. This helps the client feel heard and supported. Increasing physical distance (A) may create a barrier. Interrupting the client (C) can be perceived as disrespectful. Initiating a physical assessment (D) is inappropriate as it may seem insensitive and dismissive of the client's concerns.
The nurse cares for diverse clients in a community health setting. Which action should the nurse take first to learn about delivering care to diverse clients?
- A. Adopt a transcultural framework to develop culturally appropriate care.
- B. Ask clients about their personal healthcare beliefs.
- C. Develop a self-awareness of personal healthcare beliefs.
- D. Recognize ethnocentric beliefs of minorities in the community.
Correct Answer: C
Rationale: Correct Answer: C - Develop a self-awareness of personal healthcare beliefs.
Rationale:
1. Self-awareness is foundational to cultural competence.
2. Understanding one's own biases and beliefs is crucial in providing culturally sensitive care.
3. It helps the nurse recognize potential sources of bias and work towards overcoming them.
4. By knowing personal beliefs, the nurse can better understand and respect the beliefs of diverse clients.
Summary of other choices:
A: Adopting a transcultural framework is important but should come after self-awareness.
B: While important, asking clients about their beliefs doesn't address the nurse's own biases.
D: Recognizing ethnocentric beliefs is important but doesn't directly address the nurse's self-awareness.