Thursday, 19 July 2018

Question Of The Day, Basic Psychosocial Needs
Q. The health care provider at a prenatal clinic has ordered multivitamins for a woman who is 3 months' pregnant. The client calls the nurse to report that she has gone to the pharmacy to fill her prescription but is unable to buy it as it costs too much. The nurse should refer the client to:

A. The charge nurse.
B. The hospital finance office.
C. Her hospital social worker.
D. Her insurance company.

Correct Answer: C

Explanation: The social worker is available to assist the client in finding services within the community to meet client needs. This individual is able to provide the names of pharmacies within the community that offer generic substitutes or others that utilize the client's insurance plan. The charge nurse of the unit would be able to refer the client to the social worker. The hospital finance office does not handle this type of situation and would refer the client back to the unit. The client's insurance company deals with payments for health care and would refer the client back to the local setting.

Wednesday, 18 July 2018

Q. As a nurse helps a client ambulate, the client says, "I had trouble sleeping last night." Which action should the nurse take first?

A. Recommending warm milk or a warm shower at bedtime
B. Gathering more information about the client's sleep problem
C. Determining whether the client is worried about something
D. Finding out whether the client is taking medication that may impede sleep

Correct Answer: B

Explanation: The nurse first should determine what the client means by "trouble sleeping." The nurse lacks sufficient information to recommend warm milk or a warm shower or to make inferences about the cause of the sleep problem, such as worries or medication use.

Tuesday, 17 July 2018

Q. The nurse is assessing the urine of a client who has had an ileal conduit and notes that the urine is yellow with a moderate amount of mucus. Based on these data, the nurse should?

A. Change the appliance bag.
B. Notify the physician.
C. Obtain a urine specimen for culture.
D. Encourage a high fluid intake.

Correct Answer: D

Explanation: Mucus is secreted by the intestinal segment used to create the conduit and is a normal occurrence. The client should be encouraged to maintain a large fluid intake to help flush the mucus out of the conduit. Because mucus in the urine is expected, it is not necessary to change the appliance bag or to notify the physician. The mucus is not an indication of an infection, so a urine culture is not necessary.

Monday, 16 July 2018

When asked on office visits if they would prefer to see the Nurse Practitioner vs. an MD, more people pick NPs.

Why do patients prefer NPs, and why are so many nurses choosing to go back to school to become NPs?

Here, three popular reasons:

1. NPs Can Be Autonomous Providers.

Nurses who are interested in becoming autonomous providers in healthcare delivery—such as primary care or in a specialty agency like women’s health, pediatrics, cardiology, pulmonary or endocrinology—should consider becoming a Nurse Practitioner. In many states, NPs can own their own practice with a collaborative agreement with a physician. Remember, NPs still have to technically be under the supervision of an MD but depending on the practice, the setting, the relationship between NP and MD, some NPs can find themselves working in a nearly autonomous setting.

2. NPs Are in Demand.

With the current changes in healthcare delivery, becoming an NP will prepare you for a unique opportunity for the future. As an NP, you will be one of the four types of advanced practice nurses who have prescriptive authority and can manage patients holistically.

Editor’s Note: Recent polls have shown that when people are asked if they would prefer to see the Nurse Practitioner versus an MD when they go to an office visit, the percentage of people who would prefer to see an NP has the majority. The reputation stands that NPs spend more time with their patients, form relationships, and care for the patient as opposed to just merely treating the illness. Of course this is all subjective but it is a common belief regarding the advanced practice nurse. And with the emergence of the title, MDs are hiring more and more NPs because having an NP can reduce their workload and is beneficial for the physician, making the advanced practice nurse a profession that is in demand.

3. Financial Aid Is Available.

Financial reimbursement for some percentage of the tuition for a graduate degree is generally available through a nurse’s work setting. There are also loan forgiveness programs through the federal government if an NP graduate works in a federally run community health clinic for two years post-graduation.

An NP’s salary and benefits can vary depending on the type of healthcare and geographic setting, but generally ranges from $75,000 to $110,000, with increased salary and bonuses if the NP owns her own clinic or is a partner in the agency. Benefits such as no weekend or holiday scheduling, extra salary for on-call work and more self-governance also tend to attract nurses to become NPs.
Q. A client hospitalized for treatment of a pulmonary embolism develops respiratory alkalosis. Which clinical findings commonly accompany respiratory alkalosis?

A. Nausea or vomiting
B. Abdominal pain or diarrhea
C. Hallucinations or tinnitus
D. Light-headedness or paresthesia

Correct Answer: D

Explanation: The client with respiratory alkalosis may complain of light-headedness or paresthesia (numbness and tingling in the arms and legs). Nausea, vomiting, abdominal pain, and diarrhea may accompany respiratory acidosis. Hallucinations and tinnitus rarely are associated with respiratory alkalosis or any other acid-base imbalance.

Saturday, 14 July 2018

Q. After surgery to treat a hip fracture, a client returns from the postanesthesia care unit to the medical-surgical unit. Postoperatively, how should the nurse position the client?

A. With the affected hip flexed acutely
B. With the leg on the affected side abducted
C. With the leg on the affected side adducted
D. With the affected hip rotated externally

Correct Answer: B

Explanation: The nurse must keep the leg on the affected side abducted at all times after hip surgery to prevent accidental dislodgment of the affected hip joint. Placing a pillow or an A-frame between the legs helps maintain abduction and reminds the client not to cross the legs. The nurse should avoid acutely flexing the client's affected hip (for example, by elevating the head of the bed excessively), adducting the leg on the affected side (such as by moving it toward the midline), or externally rotating the affected hip (such as by removing support along the outer side of the leg) because these positions may cause dislocation of the injured hip joint.

Friday, 13 July 2018

Question Of The Day, Endocrine and Metabolic Disorders
Q. A client is diagnosed with diabetes mellitus. Which assessment finding best supports a nursing diagnosis of Ineffective coping related to diabetes mellitus?

A. Recent weight gain of 20 lb (9.1 kg)
B. Failure to monitor blood glucose levels
C. Skipping insulin doses during illness
D. Crying whenever diabetes is mentioned

Correct Answer: D

Explanation: A client who cries whenever diabetes is mentioned is demonstrating ineffective coping. A recent weight gain and failure to monitor blood glucose levels would support a nursing diagnosis of Noncompliance: Failure to adhere to therapeutic regimen. Skipping insulin doses during illness would support a nursing diagnosis of Deficient knowledge related to treatment of diabetes mellitus.

Thursday, 12 July 2018

Q. A client with pernicious anemia is receiving parenteral vitamin B12 therapy. Which client statement indicates effective teaching about this therapy?

A. "I will receive parenteral vitamin B12 therapy until my signs and symptoms disappear."
B. "I will receive parenteral vitamin B12 therapy until my vitamin B12 level returns to normal."
C. "I will receive parenteral vitamin B12 therapy monthly for 6 months to a year."
D. "I will receive parenteral vitamin B12 therapy for the rest of my life."

Correct Answer: D

Explanation: Because a client with pernicious anemia lacks intrinsic factor, oral vitamin B12 can't be absorbed. Therefore, parenteral vitamin B12 therapy is recommended and required for life.




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