Nokea
What consideration is important when caring for a female Muslim patient?
- A. Make eye contact
- B. Provide long-sleeved gowns or allow her to use her own
- C. Touch while talking
- D. Assign male caregivers when possible
Correct Answer: B
Rationale: When caring for a female Muslim patient, providing long-sleeved gowns or allowing her to use her own clothing is crucial. Most Muslim women prefer to cover their whole body, even during examinations. Offering long gowns with long sleeves or allowing the patient to use her own clothing respects her cultural and religious preferences. Making eye contact is not a common practice in some Muslim cultures, so it's important to be mindful of this and respect the patient's preferences. Touching while talking may not be culturally appropriate for some Muslim patients, so it's best to avoid it unless necessary. Assigning female caregivers is often preferred to respect the patient's modesty and religious beliefs. If a male caregiver or physician needs to interact with the patient, the patient's husband may request to be present in the room.
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The clinic nurse teaches a patient with a 42 pack-year history of cigarette smoking about lung disease. Which information will be most important for the nurse to include?
- A. Options for smoking cessation
- B. Reasons for annual sputum cytology testing
- C. Erlotinib (Tarceva) therapy to prevent tumor risk
- D. Computed tomography (CT) screening for lung cancer
Correct Answer: A
Rationale: The most critical information for the nurse to provide to a patient with a significant smoking history is options for smoking cessation. Smoking is the primary cause of lung cancer, making smoking cessation essential in reducing the risk of developing the disease. Annual sputum cytology testing is not a standard screening test for lung cancer; instead, CT scanning is being explored for this purpose. Erlotinib therapy is used in lung cancer treatment but not for preventing tumor risk in individuals without cancer. CT screening for lung cancer is still under investigation and is not primarily aimed at prevention but rather early detection in high-risk individuals.
You are turning your patient in bed and notice that a confused and lethargic patient had loose car keys and lipstick in the bed and had been lying on them. What is this person at risk for due to all three of these factors: confusion, lethargy, and items in the bed?
- A. Falls
- B. Skin breakdown
- C. Apnea
- D. Lack of mobility
Correct Answer: B
Rationale: This patient is at great risk for skin breakdown due to the presence of three specific risk factors: confusion, lethargy, and items in the bed. While confusion puts the patient at risk for falls, confusion and lethargy together may lead to a lack of mobility. However, skin breakdown is the primary concern in this scenario as it is associated with all three risk factors - confusion, lethargy, and the presence of items in the bed. Therefore, the correct answer is 'Skin breakdown'.
Which information given by a 70-year-old patient during a health history indicates to the nurse that the patient should be screened for hepatitis C?
- A. The patient had a blood transfusion in 2005
- B. The patient used IV drugs about 20 years ago
- C. The patient frequently eats in fast-food restaurants
- D. The patient traveled to a country with poor sanitation
Correct Answer: B
Rationale: The correct answer is 'The patient used IV drugs about 20 years ago.' Any patient with a history of IV drug use should be tested for hepatitis C due to the increased risk of transmission through sharing needles. Blood transfusions given after 1992, when an antibody test for hepatitis C became available, do not pose a risk for hepatitis C. Hepatitis C is not spread by the oral-fecal route, so contaminated food or traveling to countries with poor sanitation are not direct risk factors for hepatitis C.
Which of these devices is considered a protective device, rather than a restraint?
- A. A mitten on the hands to prevent scratching
- B. A mitten on the hands to prevent the person from pulling their IV out
- C. A side rail to prevent the patient from falling
- D. A soft wrist restraint to prevent the patient from pulling their IV tubing
Correct Answer: A
Rationale: A mitten on the hands to prevent scratching is considered a protective device because its primary purpose is to protect the patient from harming themselves by scratching. It does not restrict the patient's movement. Choice B, a mitten on the hands to prevent the person from pulling their IV out, is considered a restraint as it limits the patient's movement. Choice C, a side rail to prevent the patient from falling, is also a protective device as it aims to keep the patient safe by providing support and preventing falls. Choice D, a soft wrist restraint to prevent the patient from pulling their IV tubing, is a type of restraint as it restricts the patient's movement to prevent them from interfering with medical equipment.
One of the complications of complete bed rest and immobility is which of the following?
- A. Plantar flexion
- B. Dorsiflexion
- C. Extension contractures
- D. Adduction contractures
Correct Answer: A
Rationale: Plantar flexion, or foot drop, is a common complication of complete bed rest and immobility. This condition occurs due to the weakening of muscles that lift the foot, leading to the foot dragging or being unable to clear the ground during walking. Dorsiflexion refers to moving the foot upwards, which is not a typical complication of immobility. Extension contractures involve the inability to fully extend a joint, while adduction contractures refer to the inability to move a limb away from the body. These types of contractures can also occur with immobility, but they are not specifically associated with foot drop.