Nokea
When the patient’s signature is witnessed by the nurse on the surgical consent, which of the following does the nurse’s signature indicate?
- A. The nurse obtained informed consent.
- B. The nurse provided informed consent.
- C. The nurse answered all surgical procedure questions.
- D. The nurse verified that the patient signed the consent.
Correct Answer: D
Rationale: The correct answer is D because the nurse's signature indicates that they verified the patient's signature on the consent form. This step ensures that the patient has signed the document willingly. Choice A is incorrect because the nurse doesn't obtain informed consent, that's the responsibility of the physician. Choice B is incorrect because nurses do not provide informed consent. Choice C is incorrect as the nurse witnessing the signature doesn't imply they answered all surgical procedure questions.
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Which of the ff is an initial sign or symptom of acute bronchitis?
- A. Nonproductive cough
- B. Anorexia
- C. Labored breathing
- D. Gastric ulceration
Correct Answer: A
Rationale: Step-by-step rationale:
1. Acute bronchitis is characterized by inflammation of the bronchial tubes.
2. An initial sign of acute bronchitis is a nonproductive cough due to irritation of the bronchial tubes.
3. Anorexia and labored breathing may occur later as the condition progresses.
4. Gastric ulceration is not typically associated with acute bronchitis.
Therefore, choice A (Nonproductive cough) is the correct answer as it aligns with the characteristic symptom of acute bronchitis, while the other choices are not typically observed in the initial stages of the condition.
During preoperative teaching for a client who will undergo subtotal thyroidectomy, the nurse should include which statement?
- A. “The head of your bed must remain flat for 24 hours after surgery.”
- B. “You should avoid deep breathing and coughing after surgery.”
- C. “You won’t be able to swallow for the first day or two.”
- D. “You must avoid hyperextending your neck after surgery.”
Correct Answer: D
Rationale: The correct answer is D: “You must avoid hyperextending your neck after surgery.” This is because hyperextending the neck can put strain on the surgical incision site and increase the risk of complications. A: Incorrect, as the head of the bed should be elevated to reduce swelling and promote drainage. B: Incorrect, as deep breathing and coughing are important to prevent pneumonia and promote lung expansion. C: Incorrect, as swallowing may be difficult initially but should improve gradually.
Mr. Chua has developed liver cirrhosis. Nurse Bea expects alteration in which laboratory values?
- A. carbon dioxide level
- B. prothrombin time
- C. gastric pH
- D. white blood cell count
Correct Answer: B
Rationale: The correct answer is B: prothrombin time. In liver cirrhosis, the liver's ability to produce clotting factors is impaired, leading to prolonged prothrombin time. This indicates an increased risk of bleeding. Choice A is incorrect as carbon dioxide levels are not typically affected by liver cirrhosis. Choice C, gastric pH, is unrelated to liver function. Choice D, white blood cell count, is not directly affected by liver cirrhosis. Therefore, the alteration in prothrombin time is the most relevant laboratory value to monitor in this case.
A nurse is formulating a diagnosis for a client who is reliving a brutal mugging that took place several months ago. The client is crying uncontrollably and states that he 'can’t live with this fear.' Which of the following diagnoses for this client is correctly written?
- A. Post-trauma syndrome related to being attacked
- B. Psychological overreaction related to being attacked
- C. Needs assistance coping with attack
- D. Mental distress related to being attacked
Correct Answer: A
Rationale: The correct answer is A: Post-trauma syndrome related to being attacked. This diagnosis accurately reflects the client's symptoms of reliving the traumatic event, crying uncontrollably, and expressing fear. Post-trauma syndrome encompasses a range of symptoms following a traumatic event, such as flashbacks, anxiety, and emotional distress. The other choices are incorrect because they are either too vague (B: Psychological overreaction) or do not capture the specific nature of the client's symptoms (C: Needs assistance coping; D: Mental distress). Therefore, option A is the most appropriate diagnosis based on the client's presentation.
Which of the ff. subjective data questions would assist the nurse in assessing the patient’s eye health?
- A. “Have you had any recent upper respiratory infections?”
- B. “Have you ridden in a car recently?”
- C. “Have you been scuba diving lately?”
- D. “Have you seen halos around lights?”
Correct Answer: D
Rationale: The correct answer is D. Asking about seeing halos around lights is relevant to assessing the patient's eye health as it could indicate conditions like glaucoma or cataracts. Upper respiratory infections (A), riding in a car (B), and scuba diving (C) are not directly related to eye health assessment. By focusing on symptoms directly related to the eyes, the nurse can gather relevant information for a more accurate assessment.