Nokea
Which of the following questions or statements would be appropriate in eliciting further information when conducting a health history interview?
- A. “Why didn’t you go to the doctor when you began to have this pain?”
- B. “Are you feeling better now than you did during the night?”
- C. “Tell me more about what caused your pain.”
- D. “If I were you, I would not wait to get medical help next time.”
Correct Answer: C
Rationale: The correct answer is C because it encourages the patient to provide more detailed information about the cause of their pain, which can help in understanding the underlying health issues. Choice A is judgmental and may make the patient defensive. Choice B is closed-ended and does not prompt for specific details. Choice D is directive and may not be well-received by the patient. Asking the patient to elaborate on what caused their pain allows for a more open-ended response, leading to a more thorough health history assessment.
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The most common buffer system in the body is the:
- A. Plasma protein buffer system
- B. Phosphate buffer system
- C. Hemoglobin buffer system
- D. Bicarbonate-carbonic system
Correct Answer: D
Rationale: The correct answer is D, the bicarbonate-carbonic system. This buffer system is crucial in maintaining the body's pH balance. When CO2 combines with water in the blood, it forms carbonic acid, which dissociates into bicarbonate ions and hydrogen ions. Bicarbonate acts as a base, accepting excess hydrogen ions to prevent a decrease in pH. Hemoglobin and plasma proteins primarily function as transport molecules, not as buffer systems. Phosphate buffer system is present in intracellular fluids, not as commonly in the body. The bicarbonate-carbonic system is the most prevalent buffer system in the blood and plays a vital role in regulating blood pH.
The physician orders furosemide (Lasix) 40 mg IV STAT for an acutely fluid-overloaded patient. Why was the IV route likely chosen?
- A. Furosemide can be administered only by the IV route.
- B. IV is the route of choice for rapid administration.
- C. IV dosing is more accurate.
- D. IV furosemide has a fewer side effects than oral.
Correct Answer: B
Rationale: The correct answer is B: IV is the route of choice for rapid administration. IV route allows for quick onset of action, crucial in acutely fluid-overloaded patients needing immediate diuresis. Option A is incorrect as furosemide can be given orally too. Option C is less relevant in this urgent situation where speed is key. Option D is also incorrect as the side effects are not determined by route of administration.
Antimetabolites are a diverse group of antineoplastic agents that interfere with various metabolic actions of the cell. The mechanism of action of antimetabolites interferes with:
- A. Cell division or mitosis during the M phase of the cell cycle.
- B. Normal cellular processes during the S phase of the cell cycle.
- C. The chemical structure of deoxyribonucleic acid (DNA) and chemical binding between DNA molecules (cell cycle-nonspecific).
- D. One or more stages of ribonucleic acid (RNA) synthesis, DNA synthesis, or both (cell cycle- nonspecific).
Correct Answer: D
Rationale: The correct answer is D because antimetabolites interfere with the synthesis of nucleic acids (RNA and/or DNA), affecting multiple stages of RNA and DNA synthesis. This disruption hinders cell division and leads to cell death. Choices A and B are incorrect because antimetabolites do not specifically target cell division during the M phase or normal cellular processes during the S phase. Choice C is also incorrect because antimetabolites primarily target nucleic acid synthesis rather than altering the chemical structure of DNA or the binding between DNA molecules.
A new nurse is completing an assessment on an 80-year-old patient who is alert and oriented. The patient’s daughter is present in the room. Which action by the nurse will require follow-up by the charge nurse?
- A. The nurse makes eye contact with the patient.
- B. The nurse speaks only to the patient’s daughter.
- C. The nurse leans forward while talking with the patient.
- D. The nurse nods periodically while the patient is speaking.
Correct Answer: B
Rationale: The correct answer is B because it is important for the nurse to communicate directly with the patient, especially when the patient is alert and oriented. Speaking only to the patient's daughter may undermine the patient's autonomy and dignity. It is crucial for the nurse to establish rapport and build a therapeutic relationship with the patient. Making eye contact with the patient (choice A) is a good nonverbal communication technique. Leaning forward while talking with the patient (choice C) shows attentiveness and engagement. Nodding periodically while the patient is speaking (choice D) demonstrates active listening and encourages the patient to continue sharing. However, speaking only to the patient's daughter (choice B) is the incorrect choice as it neglects the patient's role in the conversation and may lead to potential issues in communication and patient-centered care.
A 36-year-old man is scheduled for a unilateral orchiectomy for treatment of testicular cancer. He is withdrawn and does not interact with the nurse. Which action is most appropriate?
- A. Identify the problem with a nursing diagnosis of impaired communication related to the diagnosis of cancer
- B. Set a patient outcome that the patient will verbalize his concerns about his diagnosis
- C. Ask the patient whether he is worried about future sexual functioning
- D. Say, “You seem quiet. Are you feeling concerned about your diagnosis or treatment?”
Correct Answer: D
Rationale: Step-by-step rationale for choosing answer D as correct:
1. Acknowledges patient's withdrawn behavior
2. Demonstrates empathy and concern
3. Open-ended question allows patient to express feelings
4. Encourages patient to communicate concerns
Summary:
- Option A assumes a specific problem without patient input
- Option B focuses on verbalization, not necessarily addressing underlying concerns
- Option C makes assumptions about patient's worries without allowing him to express himself