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Which model of nursing is focused on the task-oriented approach to client care?
- A. Total patient care
- B. Modular
- C. Functiona l
- D. Primary care nursing
Correct Answer: A
Rationale: Total patient care model of nursing is focused on the task-oriented approach to client care. In this model, the nurse is responsible for all aspects of care for a group of patients during their shift. It involves providing direct care, coordinating with other healthcare team members, and overseeing the patients' overall well-being. This approach emphasizes a comprehensive and holistic view of the patient's needs, where the nurse is actively involved in all aspects of care delivery.
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Which of the following is not a characteristic of quality improvement that the medical director is interested in?
- A. The leader is the empowerer
- B. Problem-solving is by everyone
- C. The employees are treated as customers
- D. Reacts to correct or bad situation
Correct Answer: D
Rationale: Quality improvement focuses on proactive measures rather than reactive responses. The medical director would be more interested in establishing processes and systems that prevent issues from occurring in the first place, rather than just reacting to problems as they arise. Continuous improvement involves identifying problems, analyzing root causes, and implementing long-term solutions to prevent the issues from recurring. Therefore, reacting to correct or bad situations is not a characteristic of quality improvement that the medical director would prioritize.
To remove the ingested poisonous substance, the physician ordered a gastric lavage. What is the role of the nurse immediately prior to the procedure?
- A. Get the right size of the nasogastric tube
- B. Remind parents to be careful next time
- C. Obtain an informed consent immediately
- D. Tell the parent that they are negligent
Correct Answer: A
Rationale: Prior to a gastric lavage procedure, it is essential for the nurse to ensure the correct size of the nasogastric tube is selected. The appropriate size of the tube will allow for effective removal of the ingested poisonous substance during the procedure. Proper sizing also helps in preventing complications such as injury to the gastrointestinal tract or inadequate removal of the substance. This step is crucial for the safe and successful completion of gastric lavage. Reminding parents to be careful, obtaining informed consent immediately, or accusing them of negligence are not immediate responsibilities of the nurse in this context.
A patient with a history of rheumatoid arthritis presents with acute pain and swelling of the wrist joint. Physical examination reveals ulnar deviation of the fingers and swan-neck deformity of the digits. Which imaging modality is most appropriate for further evaluation of wrist involvement in rheumatoid arthritis?
- A. X-ray
- B. Magnetic resonance imaging (MRI)
- C. Ultrasound
- D. Dual-energy X-ray absorptiometry (DEXA) scan
Correct Answer: A
Rationale: X-ray is the most appropriate imaging modality for evaluating wrist involvement in rheumatoid arthritis. It can show joint space narrowing, erosions, soft tissue swelling, and periarticular osteopenia. X-rays are readily available, cost-effective, and provide valuable information about joint damage and disease progression in rheumatoid arthritis. In this case, X-ray would be able to confirm the presence of erosions, joint deformities, and assess the severity of the disease in the wrist joint. While MRI and ultrasound can also be helpful in evaluating rheumatoid arthritis, X-ray remains the initial imaging modality of choice due to its convenience and ability to assess bony changes. Dual-energy X-ray absorptiometry (DEXA) scan is not indicated for evaluating wrist involvement in rheumatoid arthritis.
A pregnant woman presents with lower abdominal pain, fever, and vaginal discharge. On examination, cervical motion tenderness and bilateral adnexal tenderness are noted. Which of the following conditions is the most likely cause of these symptoms?
- A. Ectopic pregnancy
- B. Pelvic inflammatory disease
- C. Placenta previa
- D. Ovarian torsion
Correct Answer: B
Rationale: Pelvic inflammatory disease (PID) is the most likely cause of the symptoms described in the pregnant woman. PID is an infection of the female reproductive organs, typically caused by sexually transmitted bacteria like Chlamydia or Gonorrhea. The classic presentation includes lower abdominal pain, fever, vaginal discharge, cervical motion tenderness, and bilateral adnexal tenderness on examination. This condition can lead to serious complications if not promptly treated, including infertility, ectopic pregnancy, and chronic pelvic pain. Therefore, it is crucial to diagnose and manage PID promptly, especially in pregnant women, to prevent adverse outcomes.
A patient asks the nurse about alternative treatment options for their condition. What is the nurse's best response?
- A. Dismiss the patient's question and assert that the current treatment plan is the only option.
- B. Provide the patient with information about alternative treatment options, including benefits and risks.
- C. Ignore the patient's question and redirect the conversation to a different topic.
- D. Tell the patient that alternative treatments are ineffective and should be avoided.
Correct Answer: B
Rationale: The nurse's best response when a patient asks about alternative treatment options is to provide the patient with information about those options, including their benefits and risks. It is important for the nurse to support the patient in their exploration of different treatment approaches and empower them to make informed decisions about their care. Dismissing the question, ignoring it, or discouraging alternative treatments are not appropriate responses and may hinder the patient's ability to make choices that align with their values and preferences. Therefore, providing information and facilitating an open discussion about alternative treatments is the most appropriate approach for the patient's best interest.