Nokea
You notice that Miss Kate, a bread vendor, receives and changes money, then holds the bread without washing her hands. As a nurse, what should you say to Miss Kate?
- A. Miss, don't touch the bread, I'll be the one to pick it up.
- B. Miss, please wash your hands before you pick up the bread.
- C. Miss, use a pick-up forceps when picking up the bread.
- D. Miss, your hands are dirty, I guess I'll try another bread shop.
Correct Answer: B
Rationale: The correct answer is B, as it emphasizes the importance of hygiene in food handling, which is crucial to prevent the spread of germs and diseases. The other options do not address the root of the issue, which is the unhygienic handling of food. Option A avoids direct confrontation but does not educate the vendor on proper hygiene. Option C, although it suggests a hygienic method, may not be practical or available in all situations. Option D is an avoidance strategy rather than a way to address the problem.
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What is the purpose of a chest tube after a lobectomy procedure, as understood by the nurse?
- A. Prevent mediastinal shift
- B. Promote chest expansion of the remaining lung
- C. Drain fluids and blood accumulated post-operatively
- D. Remove the air in the lungs to promote lung expansion
Correct Answer: C
Rationale: After a lobectomy, a chest tube is typically inserted to drain fluids and blood that may have accumulated post-operatively. This tube helps to prevent complications, such as infections or pneumonia, and aids in patient recovery. While a chest tube may aid in preventing a mediastinal shift (Choice A), promoting chest expansion of the remaining lung (Choice B), and removing air in the lungs to promote lung expansion (Choice D), these are not the primary reasons for its use after a lobectomy. Therefore, Choices A, B, and D are incorrect.
Considering the statement that communication is most effective when barriers are first removed, which of the following is recognized as an inhibiting factor in communication?
- A. Avoidance of universally accepted abbreviations
- B. Usage of incorrect grammar
- C. Poor handwriting
- D. Advanced age of the client
Correct Answer: D
Rationale: The correct answer is 'D: Advanced age of the client.' Age can be a significant obstacle in communication due to factors such as hearing loss, cognitive decline, or memory issues, which all can hamper effective communication. Choices A, B, and C, while they may present challenges in communication, are not directly related to age and its influence on communication, making them incorrect. The issues presented by not using universally accepted abbreviations, incorrect grammar, and poor handwriting can be resolved through clarification, education, or the use of alternative communication methods, unlike the difficulties that can arise from advanced age.
During which phase of the therapeutic relationship should the nurse inform the patient about the termination of therapy?
- A. Pre-orientation
- B. Orientation
- C. Working
- D. Termination
Correct Answer: D
Rationale: The correct answer is 'Termination'. This phase of the therapeutic relationship is when the nurse informs the patient about the conclusion of therapy. It is during this phase that the nurse and the patient review the goals and progress made and also discuss the upcoming termination. The other phases are not the appropriate times for discussing termination. 'Pre-orientation' is the phase before the nurse-patient relationship is established; 'Orientation' is when the nurse and patient get to know each other and set goals; and 'Working' is when these goals are pursued. Therefore, choices A, B, and C are incorrect.
All of the following are instructions for proper foot care to be given to a client with peripheral vascular disease caused by diabetes. Which one is not?
- A. Trim nails using a nail clipper
- B. Apply cornstarch to the foot
- C. Always check the temperature of the water before bathing
- D. Use canvas shoes
Correct Answer: A
Rationale: The correct answer is 'A', which says trim nails using a nail clipper. This is incorrect because patients with peripheral vascular disease, particularly those caused by diabetes, should not trim their nails themselves due to the risk of injury, infection, and poor wound healing. The other options, 'B', 'C', and 'D', are correct advice for diabetic foot care. Applying cornstarch can help keep the feet dry and prevent fungal infections. Checking the water temperature before bathing can prevent burns, as patients with peripheral vascular disease often have decreased sensation in their feet. Wearing canvas shoes can improve foot ventilation and reduce the risk of foot ulcers and infections.
Where should a nurse auscultate the apex beat?
- A. At the fifth intercostal space, along the midclavicular line
- B. At the mid-sternum
- C. 2 inches to the left of the lower end of the sternum
- D. 1 inch to the left of the xiphoid process
Correct Answer: A
Rationale: The correct location to auscultate the apex beat is at the fifth intercostal space, along the midclavicular line. This is where the apical impulse, also known as the point of maximal impulse (PMI), can be best heard. Choices B, C, and D are incorrect anatomical locations for auscultating the apex beat, which makes them incorrect choices. Auscultating at the correct location allows healthcare providers to assess the heart's function and detect any abnormalities in heart sounds, which is crucial for comprehensive patient care.