Nokea
What is the most effective way to communicate with a patient who has expressive aphasia?
- A. Asking yes or no questions
- B. Encouraging the patient to write responses
- C. Using picture boards or communication cards
- D. Speaking slowly and clearly
Correct Answer: C
Rationale: The most effective way to communicate with a patient who has expressive aphasia is by using picture boards or communication cards. These tools allow patients to convey their needs and responses more effectively when they struggle to speak. Using picture boards or communication cards (Choice C) is preferred as it provides a visual aid to support communication. Asking yes or no questions (Choice A) may limit the patient's ability to express themselves fully. Encouraging the patient to write responses (Choice B) may not be suitable if the patient also has difficulty writing due to the aphasia. While speaking slowly and clearly (Choice D) is important, it may not be sufficient to overcome the communication challenges faced by patients with expressive aphasia.
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According to the principle of asepsis, which situation should the PN consider to be sterile?
- A. A one-inch border around the edges of a sterile field set up in the operating room
- B. A sterile glove that the PN thinks might have touched hair
- C. A wrapped, unopened sterile 4x4 gauze pad placed on a damp table top
- D. An open sterile Foley catheter kit set up on a table at the PN's waist level
Correct Answer: A
Rationale: According to the principle of asepsis, the one-inch border around the edges of a sterile field set up in the operating room is considered non-sterile, while the central area remains sterile. Therefore, the PN should consider the situation described in choice A to be sterile. Choice B is incorrect because a glove that may have touched hair is contaminated. Choice C is incorrect as a sterile item placed on a damp surface is considered contaminated. Choice D is incorrect as a sterile kit set up at the PN's waist level is prone to contamination.
While assessing an older male client who takes psychotropic medications, the nurse observes uncontrollable hand movements and excessive blinking. Which information in the client's medical record should the nurse review?
- A. Prescription for lorazepam
- B. History of Parkinson's disease
- C. Screening for tardive dyskinesia
- D. Recent urine drug screen report
Correct Answer: C
Rationale: The symptoms of uncontrollable hand movements and excessive blinking are indicative of tardive dyskinesia, a possible side effect of long-term use of psychotropic medications. Reviewing the screening for tardive dyskinesia is crucial to assess if these symptoms are related to the medication. Option A, the prescription for lorazepam, is less relevant as the focus should be on potential side effects rather than the specific medication. Option B, history of Parkinson's disease, is not directly related to the observed symptoms, which are more likely linked to medication side effects. Option D, recent urine drug screen report, is not as pertinent in this context compared to reviewing the screening for tardive dyskinesia.
When a woman in early pregnancy is leaving the clinic, she blushes and asks the nurse if it is true that sex during pregnancy is bad for the baby. What is the best response for the nurse to give?
- A. The baby is protected by the sac. Sex is perfectly alright.
- B. It is unlikely to harm the baby. What you do with your personal life is your concern.
- C. Intercourse during pregnancy is usually alright, but you need to ask the doctor if it is acceptable for you.
- D. In a normal pregnancy, intercourse will not harm the baby. However, many women experience a change in desire. How are you feeling?
Correct Answer: D
Rationale: Choice D is the best response as it reassures the patient that intercourse in a normal pregnancy will not harm the baby. It also shows empathy by acknowledging that many women experience changes in sexual desire during pregnancy. This response validates the patient's concerns and opens up a dialogue about her feelings. Choice A is incorrect as it lacks information about changes in sexual desire and oversimplifies the situation. Choice B is dismissive of the patient's concerns and does not provide adequate information. Choice C is not the best response as it suggests asking the doctor without offering immediate reassurance or addressing the patient's worries.
An older male client with Alzheimer's disease is admitted to an extended care facility. Which intervention should the PN include in the client's nursing care plan?
- A. Plan to have the same nursing staff provide care for the client whenever possible
- B. Describe the activities available to residents and encourage him to choose the ones he prefers
- C. Encourage the client to remain on the unit for three weeks until he is oriented to his new surroundings
- D. Introduce the client to the nursing staff and other residents as soon as possible
Correct Answer: A
Rationale: The correct intervention for a client with Alzheimer's disease in an extended care facility is to plan to have the same nursing staff provide care whenever possible. Consistency in caregivers helps reduce confusion and anxiety in clients with Alzheimer's disease, promoting a stable and supportive environment for the client. Choice B is incorrect as it focuses on activities rather than the consistency of caregivers. Choice C is incorrect as it suggests isolating the client, which can lead to increased confusion and distress. Choice D is incorrect as introducing the client to new people immediately can be overwhelming and may exacerbate their symptoms.
A homeless male client with a history of alcohol abuse had a CVA 10 years ago that resulted in left hemiparesis. Today he is brought to the clinic reporting pain in his left leg. He is afebrile, has 4+ pitting edema in the lower left leg, and has minimal swelling of the right leg. Which action should the PN implement first?
- A. Obtain a blood alcohol test
- B. Inspect legs for infection or trauma
- C. Complete a mental status exam
- D. Inquire about dietary salt intake
Correct Answer: B
Rationale: Inspecting the legs for infection or trauma is the priority to assess the cause of the pain and edema, which could indicate deep vein thrombosis or cellulitis. Checking for signs of infection or trauma is crucial in this scenario to rule out potentially serious conditions. Obtaining a blood alcohol test, completing a mental status exam, or inquiring about dietary salt intake can be considered after addressing the immediate concern of identifying any infection or trauma in the leg.