Nokea
What tasks can be delegated to his nursing assistant during his tour of duty.
- A. Changing wound dressings.
- B. Administering analgesic drug.
- C. Performing a physical assessment.
- D. Taking vital sign
Correct Answer: A
Rationale: A nursing assistant can be delegated the task of changing wound dressings because it is considered a basic nursing care activity that does not require specialized training or knowledge. Nursing assistants are trained to perform tasks related to personal care, hygiene, and basic wound care under the supervision of a registered nurse. Changing wound dressings is a routine nursing task that can be safely delegated to a nursing assistant, allowing the nurse to focus on other aspects of patient care that require specialized nursing skills and knowledge.
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Which of the following conditions is characterized by the presence of multiple fluid-filled sacs within the ovaries and is associated with menstrual irregularities and hyperandrogenism?
- A. Polycystic ovary syndrome (PCOS)
- B. Ovarian torsion
- C. Ovarian cyst rupture
- D. Ovarian cancer
Correct Answer: A
Rationale: Polycystic ovary syndrome (PCOS) is a common endocrine disorder in women of reproductive age. It is characterized by the presence of multiple fluid-filled sacs (cysts) within the ovaries, which can be visualized on ultrasound. Women with PCOS often experience menstrual irregularities such as irregular periods or no periods, as well as symptoms of hyperandrogenism like hirsutism (excessive hair growth) and acne. Other common features of PCOS include insulin resistance and obesity. It is important to note that not all women with PCOS will have ovarian cysts, but the presence of multiple cysts is a common finding in this condition.
A patient with terminal illness expresses a desire to spend quality time with their family but feels guilty for being a burden. How should the palliative nurse respond?
- A. Dismiss the patient's feelings and reassure them that they are not a burden.
- B. Encourage the patient to focus on their own needs rather than worrying about others.
- C. Validate the patient's feelings of guilt and offer support to address their concerns.
- D. Suggest involving family members in caregiving tasks to alleviate the patient's guilt.
Correct Answer: C
Rationale: In this situation, the most appropriate response for the palliative nurse is to validate the patient's feelings of guilt and offer support to address their concerns. It is important to acknowledge the patient's emotions and help them navigate through their guilt in a compassionate and understanding manner. By validating their feelings, the nurse can create a safe space for the patient to express their concerns and work towards finding solutions to alleviate their guilt. This approach fosters trust and a therapeutic relationship between the patient and the nurse, ultimately promoting emotional well-being and facilitating open communication.
The nurse specialist cites a situation. If a patient experiences episodes of severe nausea and vomiting with more than 1,000 ml. of vomitus with in a period of four hours, which of the following is the nurses MOST appropriate action?
- A. Withhold fluids for four hours
- B. Observe the patient for another four hours
- C. Notify the physician
- D. Place the patient on a liquid diet
Correct Answer: C
Rationale: Severe nausea and vomiting with a large volume of vomitus can indicate a serious underlying issue such as gastrointestinal obstruction or other medical emergencies. In this situation, it is crucial for the nurse to notify the physician immediately so that further assessment and appropriate management can be initiated promptly. Delay in seeking medical help can lead to complications and worsen the patient's condition. It is important to act quickly and involve the physician in situations where the patient's health may be at risk.
Upon further assessment, you notices that she had any scratches on her right ankle, a resulting infection, and cellulitis. When you asked her about the scratches, the patient states, "Oh, my cat might have been using my leg as a scratiching post again and I did not even feel it." Which diabetic complicatons suspect the patient to have?
- A. Neuropathy
- B. Retinopathy
- C. Macroangiopathy
- D. Nephropathy
Correct Answer: A
Rationale: The patient's lack of sensation in her right leg, allowing her cat to scratch her without her noticing, is indicative of neuropathy. Neuropathy is a common diabetic complication characterized by nerve damage that can result in loss of sensation or altered sensation in different parts of the body, including the extremities. In this case, neuropathy has likely affected the patient's right lower extremity, leading to her inability to feel the cat scratching her leg and resulting in the unnoticed scratches, infection, and subsequent cellulitis.
A woman in active labor is receiving intravenous fentanyl for pain relief. What fetal assessment finding indicates potential neonatal opioid withdrawal syndrome (NOWS)?
- A. Hypertonicity
- B. Bradycardia
- C. Hypoglycemia
- D. Respiratory depression
Correct Answer: A
Rationale: Neonatal Opioid Withdrawal Syndrome (NOWS), previously known as Neonatal Abstinence Syndrome (NAS), can occur when a newborn is exposed to opioids in utero. Opioid exposure in utero can lead to physical dependence in the fetus, and when the drug is no longer available after birth, withdrawal symptoms can occur.