Nokea
You are caring for a patient with newly diagnosed multiple sclerosis. Discharge instructions will likely include all of the following EXCEPT:
- A. PT referral for development of a planned exercise program
- B. Avoidance of prolonged sun exposure
- C. Hot baths to promote muscle relaxation
- D. Instructions to evaluate the home environment to ensure safety
Correct Answer: C
Rationale: Discharge instructions for a patient with newly diagnosed multiple sclerosis should focus on promoting safety and minimizing exacerbations. Hot baths should be avoided as excessive heat can trigger acute symptoms. Therefore, instructions may include PT referral for an exercise program to maintain mobility, avoidance of prolonged sun exposure to prevent symptom exacerbation, and guidance to evaluate the home environment for safety as symptoms progress. Hot baths are not recommended due to the risk of exacerbating symptoms, making it the correct answer. Choices A, B, and D are appropriate for a patient with multiple sclerosis, as they address mobility, symptom management, and safety concerns, respectively.
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What is the purpose of performing quality control?
- A. Create a paper trail to show that the laboratory is compliant with OSHA standards for quality control.
- B. Improve the odds that the results reported for any given test are as accurate and reliable as possible.
- C. Be required by law to be part of a quality assurance program.
- D. All of the above
Correct Answer: B
Rationale: The primary purpose of performing quality control is to enhance the accuracy and reliability of test results. Quality controls are crucial for ensuring the reliability of each analyte tested. While quality control is not mandated by specific laws, accrediting bodies often require it to maintain accreditation. Creating a paper trail and legal requirements are not the primary objectives of quality control, making choices A and C incorrect. Therefore, the correct answer is to improve the accuracy and reliability of reported test results.
Choose the BEST answer. To ensure adequate protection for legal issues, offices should maintain patients' charts for:
- A. 10 years
- B. Forever
- C. Until the age of majority
- D. 2 years after the patient was last seen in the office
Correct Answer: B
Rationale: The correct answer is 'Forever.' Maintaining patients' charts indefinitely ensures comprehensive legal protection by having all relevant information available in case of litigation or if patient history needs to be referenced in the future. Choice A, '10 years,' may not be sufficient to cover the entire period within which legal issues may arise. Choice C, 'Until the age of majority,' is not ideal as legal matters may extend beyond this age limit. Choice D, '2 years after the patient was last seen in the office,' is inadequate as legal actions can occur beyond this timeframe, necessitating the need for long-term retention of patient charts.
Ruth is a 72-year-old patient who has been upset and crying all morning. When asked why she is upset, she turns toward the wall in silence. What collaborative process may be helpful in caring for this patient?
- A. Speak with the patient care technician
- B. Call the chaplain
- C. Call the social worker
- D. Call the patient's husband
Correct Answer: A
Rationale: Collaborating with the patient care technician is an appropriate approach in this scenario. Patient care technicians and nurses' aides often provide direct care to patients, developing a closer relationship with them. Patients may feel more comfortable sharing their feelings with these caregivers compared to other healthcare professionals. In this situation, Ruth's distress appears more emotional than spiritual, making it more suitable to speak with someone directly involved in her care. Calling the chaplain (Choice B) might not directly address Ruth's immediate emotional needs as it could focus more on spiritual support. Involving the social worker (Choice C) could help address underlying emotional or social issues, but speaking with the patient care technician is a more direct and immediate step to assess and provide initial support. Calling the patient's husband (Choice D) may not address Ruth's immediate emotional distress and may not be appropriate without understanding the root cause of her upset.
The nurse is speaking at a community meeting about personal responsibility for health promotion. A participant asks about chiropractic treatment for illnesses. What should be the focus of the nurse's response?
- A. Electrical energy fields
- B. Spinal column manipulation
- C. Mind-body balance
- D. Exercise of joints
Correct Answer: B
Rationale: The focus of the nurse's response should be on spinal column manipulation when discussing chiropractic treatment for illnesses. Chiropractic theory emphasizes that misalignment of the vertebrae can interfere with the transmission of mental impulses between the brain and body organs, leading to diseases. Manipulation is aimed at reducing such misalignments, known as subluxations. While mind-body balance and exercise of joints are important aspects of holistic health, in the context of chiropractic treatment, the key intervention is spinal column manipulation to address vertebral misalignments. Therefore, choices A, C, and D are incorrect as they do not directly address the primary focus of chiropractic treatment.
Which of the following screening tools have been found to have high diagnostic accuracy for screening for intimate partner violence?
- A. Hurt, Insult, Threaten, and Scream (HITS)
- B. Humiliation, Afraid, Rape, and Kick (HARK)
- C. Slapped, Threatened, and Thrown (STaT)
- D. All of the above
Correct Answer: D
Rationale: All of the above screening tools, including HITS, HARK, and STaT, have been found to have high diagnostic accuracy for screening intimate partner violence, as per the National Preventive Services Task Force. These tools are effective in identifying current or recent intimate partner violence. While the Partner Violence screen may have some predictive value for future intimate partner violence, the question specifically focuses on screening tools with high diagnostic accuracy, making 'All of the above' the correct choice. Choices A, B, and C are specific validated screening tools for intimate partner violence, each with its own set of questions that have been shown to be effective in identifying individuals experiencing intimate partner violence. Therefore, 'All of the above' is the most comprehensive and accurate choice for this question.