Nokea
The telephone triage nurse receives a call from a patient who is 5 days postoperative total
abdominal hysterectomy. The patient states that her pain is not relieved with the medications and
that she has noticed blood in her urine. The nurse instructs the patient to report immediately to the
emergency department. What does the nurse suspect as the surgical complication?
- A. Possible complication related to the anesthesia
- B. Possible injury to the ureters or bladder
- C. Possible hemorrhage from the internal incision
- D. Possible peritoneal venous thromboembolism
Correct Answer: D
Rationale: In this situation where the patient is 5 days postoperative total abdominal hysterectomy and experiencing pain that is not relieved with medications, the nurse should suspect a possible hemorrhage from the internal incision. Although some pain is expected postoperatively, severe or worsening pain that is not relieved with medications can indicate a complication such as internal bleeding. Immediate medical attention is needed to assess and manage any potential hemorrhage to prevent further complications or adverse outcomes. Other signs of internal bleeding may include symptoms such as increasing abdominal distention, tachycardia, hypotension, and signs of shock.
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A nurse is caring for a patient who has HSV and is pregnant. The patient is concerned about the fetus. What medication is safest to take?
- A. valacyclovir
- B. none
- C. acyclovir
- D. famciclovir
Correct Answer: C
Rationale: Acyclovir is the antiviral medication of choice for treating HSV (Herpes Simplex Virus) infections during pregnancy due to its known safety profile. It is classified as Category B by the FDA, indicating that there is no evidence of risk to the fetus based on animal studies. Valacyclovir and famciclovir, on the other hand, are both classified as Category B (risk cannot be ruled out) and Category C (animal studies have shown adverse effects) by the FDA, respectively. It is generally recommended to avoid taking unnecessary medications during pregnancy, but if treatment for HSV is necessary, acyclovir is considered the safest option.
Which patient will most likely seek prenatal care?
- A. A 15-year-old patient who tells her friends, “I just don’t believe that I am pregnant”
- B. A 28-year-old who is in her second pregnancy and abuses drugs and alcohol
- C. A 20-year-old who is in her first pregnancy and has access to a free prenatal clinic
- D. A 30-year-old who is in her fifth pregnancy and delivered her last infant at home with the help of her mother and sister
Correct Answer: C
Rationale: The patient in option C is the most likely to seek prenatal care. This is because she is in her first pregnancy, indicating that she may be more inclined to seek medical guidance and support for the first time experience of pregnancy. Furthermore, the fact that she has access to a free prenatal clinic suggests that she has the resources and opportunity to obtain proper prenatal care, which can significantly benefit her and her baby's health. In contrast, the patients in the other options either demonstrate risky behaviors (such as drug and alcohol abuse in option B) or have previously given birth without professional medical assistance (as indicated in option D), which may indicate lower likelihood of seeking prenatal care. The patient in option A also demonstrates denial of pregnancy, which could delay seeking necessary prenatal care.
Which issue is a major concern among members of lower socioeconomic groups?
- A. Practicing preventive health care
- B. Meeting health needs as they occur
- C. Maintaining an optimistic view of life
- D. Maintaining group health insurance for their families
Correct Answer: B
Rationale: Members of lower socioeconomic groups often struggle to access and afford healthcare services. Unlike those in higher socioeconomic classes who can afford preventive care, individuals in lower socioeconomic groups typically wait to seek medical care until they have significant health issues or emergencies. Factors such as cost barriers, lack of health insurance, transportation issues, and limited access to healthcare facilities contribute to this problem. As a result, the major concern among individuals in lower socioeconomic groups is the ability to meet their health needs as they occur rather than focusing on preventive healthcare practices. This issue can lead to poorer health outcomes and increased healthcare costs in the long run.
The nurse is teaching a parenting class to new parents. Which statement should the nurse include in the teaching session about the characteristics of a healthy family?
- A. Adults agree on the majority of basic parenting principles.
- B. The parents and children have rigid assignments for all the family tasks.
- C. Young families assume total responsibility for the parenting tasks, refusing any assistance.
- D. The family is overwhelmed by the significant changes that occur as a result of childbirth. N R I G B.C M U S N T O
Correct Answer: A
Rationale: The statement the nurse should include in the teaching session about the characteristics of a healthy family is that "Adults agree on the majority of basic parenting principles." This is because in a healthy family, it is crucial for adults to be on the same page when it comes to fundamental parenting principles. Having a shared understanding of how to raise children helps create consistency in parenting approaches, which is beneficial for the overall well-being of the family unit. Collaboration and agreement on parenting principles also lead to effective communication and support between parents, fostering a positive and nurturing environment for children to grow and thrive.
Which of the following statements highlights the nurse’s role as a researcher?
- A. Reading peer-reviewed journal articles
- B. Working as a member of the interdisciplinary team to provide patient care
- C. Helping patient to obtain home care postdischarge from the hospital
- D. Delegating tasks to unlicensed personnel to allow for more teaching time with patients
Correct Answer: A
Rationale: Reading peer-reviewed journal articles highlights the nurse's role as a researcher because it involves staying current with the latest evidence-based practices, advancements in healthcare, and research findings. Nurses who engage in reading such articles are able to enhance their knowledge, critical thinking skills, and decision-making abilities, which are crucial aspects of conducting research and applying research findings to patient care. By continuously educating themselves through reviewing peer-reviewed literature, nurses contribute to the advancement of nursing practice and further research in the field.