Nokea
What is the minimum level of practice that a reasonably prudent nurse is expected to provide?
- A. Standard of care
- B. Risk management
- C. Sentinel event
- D. Failure to rescue
Correct Answer: A
Rationale: Guidelines for standards of care are published by professional nursing organizations.
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The nurse is assessing a 64-year-old female patient. The patient states that she is able to reduce the risk of urinary tract infections (UTIs) by drinking a quart of cranberry juice a day. Which health condition, if present in this patient, contraindicates the use of cranberry juice?
- A. Hypertension, managed with lisinopril
- B. Diabetes type 1, managed with insulin
- C. Atrial fibrillation, managed with warfarin
- D. COPD, managed with inhaled steroids
Correct Answer: C
Rationale: Cranberry juice has the potential to interact with warfarin, a common blood thinner prescribed for conditions such as atrial fibrillation. Cranberry juice contains components that can inhibit the metabolism of warfarin in the body, leading to an increased risk of bleeding. Therefore, patients taking warfarin should avoid or limit their intake of cranberry juice to prevent potential negative interactions. In this case, the patient's use of warfarin to manage atrial fibrillation contraindicates the consumption of cranberry juice in large quantities. It is essential to consult a healthcare provider before making any changes to the diet, especially when taking medications that may interact with certain foods or beverages.
Which response by the nurse is the most therapeutic when the patient states, “I’m so afraid to N R I G B.C M U S N T O have a cesarean birth”?
- A. “Everything will be OK.”
- B. “Don’t worry about it. It will be over soon.”
- C. “What concerns you most about a cesarean birth?”
- D. “The physician will be in later and you can talk to him.”
Correct Answer: C
Rationale: The most therapeutic response by the nurse when the patient expresses fear about having a cesarean birth is to offer an open-ended question that explores the patient's concerns further. By asking, "What concerns you most about a cesarean birth?" the nurse acknowledges the patient's fears, encourages communication, and allows the patient to express her feelings and fears in more detail. This response shows empathy and enables the nurse to better address the specific worries and anxieties the patient may have about the procedure. The other options do not effectively address the patient's fears and do not promote therapeutic communication.
Preconception and prenatal care have become important components of women's health. What is the guiding principle of preconception care?
- A. Ensure that pregnancy complications do not occur.
- B. Identify the woman who should not become pregnant.
- C. Encourage healthy lifestyles for families desiring pregnancy.
- D. Ensure that women know about prenatal care.
Correct Answer: C
Rationale: The main focus of preconception care is to encourage healthy lifestyles and address any potential risks before pregnancy occurs.
A nurse is caring for a client who is receiving oxytocin to augment labor. The client has an intrauterine pressure catheter and an internal fetal scalp electrode for monitoring. Which of the following is an indication that the nurse should discontinue the infusion?
- A. Contraction frequency every 3 min
- B. Contraction duration of 100 seconds
- C. Fetal heart rate with moderate variability
- D. Fetal heart rate of 118/min
Correct Answer: B
Rationale: Contractions lasting longer than 90 seconds (tachysystole) can lead to fetal distress by reducing uteroplacental blood flow. Oxytocin should be discontinued if contractions become excessive. Moderate variability and normal fetal heart rate do not indicate distress.
Which statement is true regarding the shortage of nurses in the United States?
- A. There are a larger proportion of younger nurses in the workforce as compared with older nurses.
- B. As a result of decreased RN-to-patient ratios, there is a decrease in patient mortality in the clinical setting.
- C. Nursing programs are turning away qualified applicants.
- D. There are adequate classroom and clinical facilities for training RNs.
Correct Answer: C
Rationale: The statement that nursing programs are turning away qualified applicants is true regarding the shortage of nurses in the United States. Despite the growing demand for healthcare services and the critical need for more nurses, nursing schools across the country face challenges in accepting all qualified applicants due to a shortage of nursing faculty, limited clinical space, and budget constraints. This bottleneck in nursing education and training contributes to the shortage of nurses in the workforce. As a result, many potential nursing students who are qualified and interested in pursuing a career in nursing are being turned away from programs, exacerbating the shortage.