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You are a Drug Abuse Treatment and Rehabilitation Center Nurse. During the assessment of a newly admitted Person Who Uses Drugs (PWUDs) named Korino, which of the following is the MOST APPROPRIATE question to ask?
- A. Ask Korino how long he thought that he could take drugs without someone finding it.
- B. Ask Korino why he started taking illegal drugs.
- C. Not ask any questions for fear Korino will deny and may become assaultive.
- D. Ask Korino about the amount of drug used and its effect and how long he had been using.
Correct Answer: D
Rationale: The most appropriate question to ask during the assessment of a newly admitted Person Who Uses Drugs (PWUDs) like Korino is to ask about the amount of drug used, its effects, and how long he has been using. This question provides valuable information for treatment planning and understanding the extent of Korino's drug use. By asking about the specific details of his drug use, the nurse can assess the severity of the addiction, potential health risks, and the duration of substance abuse. This information is crucial for developing an individualized treatment plan and providing appropriate care for Korino's needs. Asking open-ended questions about drug use also helps build rapport and trust between the nurse and the patient, which is essential for effective treatment.
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The patient during labor would anticipate some emotional support. Which of the following nursing interventions should Nurse Sarah provide to keep the patient calm?
- A. Giving praise for her the sense of satisfaction regarding quick labor.
- B. Support in maintaining a sense of control.
- C. Explanation of the effect of labor on the newborn.
- D. Allowing the patient to express pain and anxiety
Correct Answer: B
Rationale: Support in maintaining a sense of control is essential in keeping the patient calm during labor. Giving the patient a sense of control allows them to feel empowered and more in charge of their experience. This can help reduce anxiety and fear, ultimately promoting a more positive and calm labor experience. Providing emotional support by assisting the patient in maintaining control can greatly benefit their overall emotional well-being during this stressful time.
The INITIAL priority assessment performed by the nurse, when admitting a patients the unit after abdominal surgery is to check for ______.
- A. surgical site for drainage and hemorrhage
- B. skin color and temperature
- C. responsiveness to painful stimuli and noise
- D. respiratory function and airway
Correct Answer: D
Rationale: When admitting a patient to the unit after abdominal surgery, the initial priority assessment performed by the nurse should focus on assessing the patient's respiratory function and airway. This is crucial because post-surgical patients are at risk for complications such as respiratory depression, atelectasis, and airway obstruction. Monitoring the patient's breathing pattern, oxygen saturation levels, and ensuring a patent airway are essential in preventing respiratory distress or failure. Prompt assessment and intervention in this area can help prevent respiratory complications and ensure the patient's safety and well-being. Once the patient's respiratory status is stable, the nurse can then proceed to assess other aspects such as the surgical site, skin color, temperature, and responsiveness to stimuli.
A patient presents with a yellowish-white spot on the cornea, surrounded by a ring of inflammation. Slit-lamp examination reveals branching, filamentous opacities extending from the corneal lesion. Which of the following conditions is most likely responsible for this presentation?
- A. Herpes simplex keratitis
- B. Bacterial keratitis
- C. Fungal keratitis
- D. Acanthamoeba keratitis
Correct Answer: C
Rationale: The described presentation of a yellowish-white spot on the cornea with a ring of inflammation, along with branching, filamentous opacities extending from the corneal lesion, is characteristic of fungal keratitis. Fungal keratitis typically presents with these specific features on clinical examination.
During surgery, the nurse notices a discrepancy between the surgical count and the number of instruments on the sterile field. What should the nurse do?
- A. Re-count the instruments on the sterile field
- B. Document the discrepancy in the surgical count log
- C. Continue with the procedure as planned
- D. Inform the surgical team and initiate a thorough search
Correct Answer: D
Rationale: If a nurse notices a discrepancy between the surgical count and the number of instruments on the sterile field during surgery, it is crucial to inform the surgical team immediately and initiate a thorough search. Patient safety is of utmost importance, and any missing instruments could potentially pose a risk to the patient. By informing the team and conducting a thorough search, the missing instrument can be located promptly to ensure it is not inadvertently left inside the patient's body. Continuing with the procedure or ignoring the discrepancy without further investigation could lead to serious consequences for the patient's well-being. It is always better to address any discrepancies or concerns during surgery proactively to maintain a high standard of patient care and safety.
On which occasion would a nurse can be charged with negligence?
- A. Giving the patient the wrong medication.
- B. Giving competent care.
- C. Following standards of care.
- D. Communicating with another health team.
Correct Answer: A
Rationale: A nurse can be charged with negligence when they give the patient the wrong medication. Negligence in healthcare typically refers to a situation where a healthcare provider fails to provide a standard level of care, resulting in harm to the patient. Giving the wrong medication can lead to serious consequences for the patient, including adverse reactions, worsening of the condition, or even death. It is a clear violation of the duty of care that a nurse owes to their patients, and such a mistake can have legal and professional repercussions for the nurse.