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What is the appropriate initial management for a conscious patient experiencing a syncopal episode (fainting)?
- A. Elevating the legs above the level of the heart.
- B. Administering intravenous fluids rapidly.
- C. Providing reassurance and assisting the patient to a lying position.
- D. Administering oxygen via nasal cannula.
Correct Answer: C
Rationale: The appropriate initial management for a conscious patient experiencing a syncopal episode (fainting) is to provide reassurance and assist the patient to a lying position. This is important to ensure adequate blood flow to the brain and to prevent further injury in case the patient faints again. Elevating the legs above the level of the heart is not recommended as a routine intervention for syncope. Administering intravenous fluids rapidly is not usually needed in the initial management of syncope without signs of dehydration or significant bleeding. Administering oxygen via nasal cannula is not necessary for most cases of syncope unless there are specific indications such as signs of respiratory distress.
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A nurse is resistant to the change and is not taking an active part in facilitating the process of change. Which is the BEST approach in dealing with the nurse?
- A. Exert coercion on the nurse
- B. Provide a positive reward system for the nurse
- C. Talk and encourage verbalizing feelings of the change
- D. Ignore the resistance of the nurse.
Correct Answer: C
Rationale: The best approach in dealing with a nurse who is resistant to change and not actively participating is to communicate and encourage verbalizing feelings about the change. By talking with the nurse and allowing them to express their concerns and feelings, you can address any underlying issues that may be causing the resistance. This approach can help build trust, improve communication, and ultimately increase the nurse's engagement in the change process. Coercion (Choice A) can create negative feelings and resistance, while ignoring the nurse's resistance (Choice D) will not resolve the issue. Providing positive rewards (Choice B) may be helpful but may not address the underlying reasons for resistance. Communication is key in addressing resistance to change and fostering a positive, open environment for all involved.
The female client who is very anxious and fidgety is blowing off to much carbon dioxide develops tingling sensation of the lips and fingers and is not able to control her respirations. The MOST appropriate nursing intervention for this client is to _____.
- A. Instruct the client to blow her nose and take deep breath
- B. Administer oxygen
- C. Have the client breath into a paper bag
- D. Administer IV fluids as ordered
Correct Answer: C
Rationale: The client is experiencing symptoms of hyperventilation, a condition that occurs when there is excessive elimination of carbon dioxide from the body. Breathing into a paper bag can help by allowing the client to rebreathe carbon dioxide, which can help restore the balance of gases in the blood and alleviate the tingling sensations in the lips and fingers. This technique is commonly used to help regulate breathing in cases of hyperventilation. Administering oxygen (choice B) may not be necessary as the issue lies with an imbalance of carbon dioxide, not a lack of oxygen. Instructing the client to blow her nose and take deep breaths (choice A) may not address the underlying problem effectively. Administering IV fluids (choice D) is not relevant to the client's symptoms of hyperventilation.
A patient expresses frustration with the treatment plan proposed by the healthcare team. What is the most appropriate response from the nurse?
- A. Dismiss the patient's concerns and assure them that the treatment plan is the best option.
- B. Empathize with the patient's frustration and explore their concerns further.
- C. Ignore the patient's frustration and proceed with implementing the treatment plan.
- D. Tell the patient that they have no choice but to follow the treatment plan.
Correct Answer: B
Rationale: The most appropriate response from the nurse when a patient expresses frustration with the treatment plan proposed by the healthcare team is to empathize with the patient's frustration and explore their concerns further. It is important to actively listen to the patient, acknowledge their feelings, and address any questions or uncertainties they may have about the treatment plan. By engaging in open communication and demonstrating empathy, the nurse can foster a therapeutic relationship with the patient and work towards finding a solution that is mutually agreeable and beneficial for the patient's well-being. Dismissing the patient's concerns (Option A) or ignoring their frustration (Option C) can lead to a breakdown in communication and trust, which may ultimately impact the patient's compliance with the treatment plan. Similarly, telling the patient that they have no choice but to follow the treatment plan (Option D) can be perceived as dismissive and confrontational, which is not conducive to promoting patient-centered care.
When can the patient tell all information to the nurse?
- A. All diagnostic laboratory tests performed had been completed
- B. Once the feeling of security is established in the nurse-patient relationship
- C. A change in physical appearance occurs
- D. The nurse knows the genogram of the patient
Correct Answer: B
Rationale: The patient can tell all information to the nurse once the feeling of security is established in the nurse-patient relationship. Open communication and sharing of information are essential components of nursing care. Patients are more likely to disclose personal information, concerns, and feelings when they trust their nurse and feel secure in the relationship. Building trust and creating a safe and supportive environment are crucial for effective therapeutic communication and holistic patient care. It is important for the nurse to establish a trusting relationship with the patient to encourage open communication and provide patient-centered care.
A woman in active labor is receiving intravenous antibiotics for group B streptococcus (GBS) prophylaxis. What maternal assessment finding indicates a potential adverse reaction to the antibiotics?
- A. Respiratory depression
- B. Urticaria and pruritus
- C. Hypertension
- D. Decreased uterine contractility
Correct Answer: B
Rationale: Urticaria (hives) and pruritus (itching) are common signs of an allergic reaction to antibiotics, including those used for GBS prophylaxis during labor. Other signs of an adverse reaction may include flushing, fever, chills, and anaphylaxis. It is important to monitor the woman closely for any signs of an allergic reaction and to intervene promptly if one occurs to ensure the safety of both the mother and the baby.