Nokea
Which of the following is a common complication associated with long-term corticosteroid use in patients with rheumatoid arthritis?
- A. Osteoporotic fracture
- B. Osteonecrosis of the femoral head
- C. Avascular necrosis of the talus
- D. Septic arthritis
Correct Answer: A
Rationale: Long-term corticosteroid use in patients with rheumatoid arthritis can lead to osteoporosis, which is a common complication. Osteoporosis causes weakening of the bones, increasing the risk of fractures, particularly in weight-bearing bones such as the hip, spine, and wrist. Osteoporotic fractures are a significant concern in patients on long-term corticosteroid therapy, highlighting the importance of monitoring bone health and considering preventive measures such as calcium, Vitamin D supplementation, and regular bone density testing. While osteonecrosis of the femoral head and avascular necrosis of the talus can also occur as complications of corticosteroid use, osteoporotic fractures are more commonly associated with this type of therapy in patients with rheumatoid arthritis. Septic arthritis, on the other hand, is not directly related to corticosteroid use but can occur due to other factors such as joint infections.
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The Medical Director, with the Chief Nurse and other officers, of the hospital believe that Patient Relations is important in risk management because a dissatisfied customer is likely to sue. Which is NOT the way to handle complaints?
- A. Let the patient express himself,
- B. Be sure to rebut the patient point by point.
- C. Staff should not be defensive.
- D. Listen to the patient's cue carefully.
Correct Answer: B
Rationale: Option B, "Be sure to rebut the patient point by point," is NOT the way to handle complaints. When dealing with patient complaints, it is important to take a calm and empathetic approach rather than engaging in a defensive or confrontational manner. Rebutting the patient point by point can escalate the situation and may further alienate the patient. Effective complaint management involves active listening, showing empathy, addressing concerns, and working towards a resolution that benefits both the patient and the healthcare provider.
The purpose why the head nurse asked Nurse Rosie to submit an IR is to ______.
- A. note patterns of incidences in the same unit
- B. place it in Nurse Rosie's 201 file
- C. document immediately the incident
- D. evaluate Nurse Rosie's performance
Correct Answer: A
Rationale: The purpose of asking Nurse Rosie to submit an Incident Report (IR) is most likely to note patterns of incidences in the same unit. Incident reports are essential tools in healthcare settings to track and analyze unexpected events, errors, or situations that may impact patient care and safety. By collecting and reviewing incident reports, the head nurse can identify trends, patterns, or commonalities in the occurrences within the unit. This information allows for targeted interventions, improvements in practices, and enhanced patient safety. Therefore, asking Nurse Rosie to submit an IR would serve the purpose of noting patterns of incidences in the same unit for proactive and quality care delivery.
The nurse closely monitors the work she delegated to the barangay health worker. She is legally guided by this principle
- A. Respondent superior
- B. The good Samaritan
- C. Res ipsa loquitor
- D. Jurisprudence
Correct Answer: A
Rationale: Respondent superior is a legal doctrine that holds an employer (such as a nurse) responsible for the actions of their employees (such as a barangay health worker) performed within the scope of their employment. In the scenario provided, the nurse delegated tasks to the barangay health worker, making the health worker an agent of the nurse. By closely monitoring the delegated work, the nurse is fulfilling her legal responsibility under the principle of respondent superior to ensure that the health worker performs their duties properly and in accordance with professional standards.
Ms. C is at risk for refeeding syndrome that is caused by rapid feeding. What should be the priority action of the health care team to prevent complications associated with this syndrome?
- A. Assess for signs of pallor of the extremities and sluggish capillary refill
- B. Monitor for decreased bowel sounds, nausea, bloating, and abdominal distention
- C. Observe for signs of secret purging and ingestion of water to increase weight
- D. Monitor for peripheral edema, crackles in the lungs, and jugular vein distention
Correct Answer: B
Rationale: Refeeding syndrome is a potentially dangerous condition that can occur in malnourished individuals when nutrition is reintroduced too quickly. It is characterized by shifts in electrolytes, fluid imbalance, and metabolic abnormalities. Monitoring for decreased bowel sounds, nausea, bloating, and abdominal distention is the priority action to prevent complications associated with refeeding syndrome. These symptoms can indicate gastrointestinal issues such as ileus or overfeeding, which can lead to further complications. Early recognition and intervention can help prevent serious consequences of refeeding syndrome.
A patient with terminal cancer is experiencing severe pain despite receiving analgesics. Which intervention by the palliative nurse is most appropriate?
- A. Increase the dose of analgesics.
- B. Administer a different type of analgesic.
- C. Recommend non-pharmacological pain management techniques.
- D. Consult with a pain management specialist.
Correct Answer: D
Rationale: In a situation where a patient with terminal cancer is experiencing severe pain despite receiving analgesics, consulting with a pain management specialist is the most appropriate intervention. Pain management specialists have expertise in managing complex pain situations, especially in cases of terminal illness where pain control is crucial for improving quality of life. The specialist can review the current pain management plan, suggest alternative or adjunct therapies, adjust medication dosages, or explore different types of analgesics to optimize pain relief for the patient. Collaborating with a pain management specialist can help ensure the patient receives the most effective and personalized pain management approach tailored to their specific needs. Increasing the dose of analgesics, administering a different type of analgesic, or recommending non-pharmacological techniques may be appropriate interventions but should be guided by a specialist to ensure safe and effective pain management in a palliative care setting.