Wednesday, 3 June 2020

Q. A nurse is performing a baseline assessment of a client's skin integrity. What is the priority assessment parameter?

A. Family history of pressure ulcers
B. Presence of pressure ulcers on the client
C. Potential areas of pressure ulcer development
D. Overall risk of developing pressure ulcers

Correct Answer: D

Reason: When assessing skin integrity, the overall risk potential of developing pressure ulcers takes priority. Overall risk encompasses existing pressure ulcers as well as potential areas for development of pressure ulcers. Family history isn't important when assessing skin integrity.

Tuesday, 2 June 2020

Q. Prochlorperazine (Compazine) is prescribed postoperatively. The nurse should evaluate the drug's therapeutic effect when the client expresses relief from which of the following?

A. Nausea.
B. Dizziness.
C. Abdominal spasms.
D. Abdominal distention.

Correct Answer: A

Reason: Prochlorperazine is administered postoperatively to control nausea and vomiting. Prochlorperazine is also used in psychotherapy because of its effects on mood and behavior. It is not used to treat dizziness, abdominal spasms, or abdominal distention.

Monday, 1 June 2020

Question Of The Day, Oncologic Disorders
Q. A client received chemotherapy 24 hours ago. Which precautions are necessary when caring for the client?

A. Wear sterile gloves.
B. Place incontinence pads in the regular trash container.
C. Wear personal protective equipment when handling blood, body fluids, and feces.
D. Provide a urinal or bedpan to decrease the likelihood of soiling linens.

Correct Answer: C

Reason: Chemotherapy drugs are present in the waste and body fluids of clients for 48 hours after administration. The nurse should wear personal protective equipment when handling blood, body fluids, or feces. Gloves offer minimal protection against exposure. The nurse should wear a face shield, gown, and gloves when exposure to blood or body fluid is likely. Placing incontinence pads in the regular trash container and providing a urinal or bedpan don't protect the nurse caring for the client.

Saturday, 30 May 2020

Question Of The Day, The Neonate
Q. During the first feeding, the nurse observes that the neonate becomes cyanotic after gagging on mucus. Which of the following should the nurse do first?

A. Start mouth-to-mouth resuscitation.
B. Contact the neonatal resuscitation team.
C. Raise the neonate's head and pat the back gently.
D. Clear the neonate's airway with suction or gravity.

Correct Answer: D

Reason: If a neonate gags on mucus and becomes cyanotic during the first feeding, the airway is most likely closed. The nurse should clear the airway by gravity (by lowering the infant's head) or suction. Starting mouth-to-mouth resuscitation is not indicated unless the neonate remains cyanotic and lowering his head or suctioning doesn't clear his airway. Contacting the neonatal resuscitation team is not warranted unless the infant remains cyanotic even after measures to clear the airway. Raising the neonate's head and patting the back are not appropriate actions for removing mucus. Doing so allows the mucus to remain lodged causing further breathing difficulties.

Friday, 29 May 2020

Question Of The Day, Postpartum Period
Q. On the second postpartum day a gravida 6, para 5 complains of intermittent abdominal cramping. The nurse should assess for:

A. endometritis.
B. postpartum hemorrhage.
C. subinvolution.
D. afterpains.

Correct Answer: D

Reason: In a multiparous client, decreased uterine muscle tone causes alternating relaxation and contraction during uterine involution, which leads to afterpains. The client's symptoms don't suggest endometritis, hemorrhage, or subinvolution.

Thursday, 28 May 2020

Nurse Practitioners, Nursing Responsibilities, Nursing Job, Nursing Career

Nurse Practitioners have consistently been ranked as one of the top 5 best occupations in the United States, thanks to its high marks in categories such as work-life balance, low-stress levels, and salary.

And the streak for Nurse Practitioners (NPs) as a top 5 job has continued, ranking in at #5 out of all occupations in the U.S. News and World Report Best 100 Jobs Rankings for 2020. Nurse Practitioners also nabbed an impressive spot at #4 out of all healthcare jobs, and #5 in STEM jobs.

How Jobs Are Ranked 

In order to compile its jobs rankings, U.S. News and World Report reviewed the following categories of data for various industries and occupations, weighted in importance by their corresponding percentage:

◉ Median Salary
◉ Employment Rate
◉ 10-Year Growth Volume
◉ 10-Year Growth Percentage
◉ Job Prospects
◉ Stress Level
◉ Work-Life Balance

For nurse practitioners, upward mobility – or the ability to advance in terms of responsibility and salary – was categorized as average, the stress level was measured as below average, and flexibility ranked lower than average.

The lower-than-average flexibility is an interesting distinction and may be due to the hours that NPs typically keep in their positions. For instance, many NPs work in a hospital or office setting with set hours that don’t offer a lot of flexibility. However, NPs still report a high work-life balance and the lower-stress levels can help offset any limited flexibility.

NP Salary and Prospects

Why exactly do NPs rank so highly--and consistently--through the years? As the U.S. News and World Report highlights, NPs make a median salary of $107,030. The highest quarter of NPs made even more than that, at $125,440 per year, while even the lowest-paid NPs made over $90,760.

Combined with a low unemployment rate of only 1.2% and high projected growth, the stability and high salary of a NP position is a definite draw to make this a highly-ranked job. Some of the other high rankings for NPs include:

◉ Low-stress level. NPs have a below-average stress level ranking for on-the-job stress.
◉ Advancement opportunity. Opportunities for advancement and growth come in at average but are still available for NPs who wish to climb higher in their careers.

Out of all of the possible rankings, the role of NP received a 7.6 out of 10. And all in all, healthcare roles dominated the reports best jobs, with Physician Assistants taking the #3 spot in overall 100 Best Jobs, Physicians taking #7, and Registered Nurses coming in at #13.

Nurse Anesthetists and Nurse-Midwives

Certified Registered Nurse Anesthetists (CRNAs) and Certified Nurse Midwives (CNMs) are closely related to NPs in terms of education. Both roles require a Master’s in Nursing and are an Advanced Practice Registered Nursing (APRN) role.

And although they are similar to NPs in terms of education, there are wide variances in the salary earnings and job duties among NPs, CRNAs, and CNMs. For instance, CRNAs are generally the highest-paid APRNs in the United States – the median salary comes in at $167,950, with an unemployment rate that is literally non-existent (no danger of losing your job as a CRNA!).

CRNAs ranked in as #21 in all best jobs, #15 in healthcare jobs, and #11 in the category of best-paying jobs.

Meanwhile, nurse midwives ranked in at #23 in best healthcare jobs and #82 out of all 100 best jobs, with a mean salary of $103,770. They don’t have a lot of job flexibility, but the opportunity for growth is considered to be strong, and they rank as a below-average stress level on the job.

From these numbers, we can see that nurse practitioners generally earn slightly more than their CNM colleagues, but CRNAs hold a large advantage in terms of earning power. Having said that, Nurse Anesthetists’ training is more intensive, and they are required to complete significantly more clinical hours in order to achieve licensure to practice.

Primary Care: Enter the Nurse Practitioner

According to the American Academy of Family Physicians (AAFP), a “significant physician shortage” is projected to grip the U.S. by 2025. While the growth of the primary care physician workforce is earnestly called for by the AAFP, it is anecdotally difficult to recruit medical students into practicing primary care since medical specialties are so much more lucrative for new doctors who carry enormous educational debt and costly professional liability.

While some physician groups continue to push back regarding nurse practitioners’ increasing ability to practice autonomous primary care, there is growing evidence of the value of NPs in healthcare. For example, the American Association of Nurse Practitioners (AANP) states that research has proven that:

◉ NPs provide care that is safe, effective, patient-centered, timely, efficient, equitable, and evidenced-based.
◉ NP care is comparable to physician-provided care.
◉ Patients under the care of NPs have higher patient satisfaction, fewer unnecessary hospital readmissions, fewer potentially preventable hospitalizations and fewer unnecessary emergency room visits than patients under physician-directed care

The Future of Nurse Practitioners

Many people have encountered a Nurse Practitioner in the course of receiving healthcare. NPs abound in ambulatory surgical centers, physician group practices, community health centers, urgent care centers, and other clinical milieus. NPs are also found in various hospital-based roles--patients are increasingly likely to receive acute care from hospitalist nurse practitioners with specific training and qualifications.

With NPs ranking as the #5 job in the United States in 2020, more nurses will begin pursuing the achievable goal of a career as a nurse practitioner. And as more RNs go onto become NPs, everyone--insurance companies, hospitals, consumers, nurses, and patients alike– will be able to see the benefits. With high marks all around pursuing education and training as a Nurse Practitioner or other type of APRN is a solid career move for those interested in providing health care to a wide variety of patients across the lifespan.

As an NP, not only will you be able to work as a healthcare provider, but you will also be able to enjoy the benefits of a highly-ranked job, such as higher-than-average salary, positive work-life balance and low-stress levels.

From pregnant moms and newborns to the aged and the dying, nurse practitioners and advanced practice nurses provide necessary healthcare to those in need. And with NP’s autonomy of practice growing in both depth and breadth, opportunities are consistently expanding for the enterprising and savvy Nurse Practitioner.

Question Of The Day, Intrapartum Period
Q. Which nursing action is required before a client in labor receives epidural anesthesia?

A. Give a fluid bolus of 500 ml.
B. Check for maternal pupil dilation.
C. Assess maternal reflexes.
D. Assess maternal gait.

Correct Answer: A

Reason: One of the major adverse effects of epidural administration is hypotension. Therefore, a 500-ml fluid bolus is usually administered to prevent hypotension in the client who wishes to receive an epidural for pain relief. Assessing maternal reflexes, pupil response, and gait isn't necessary.

Wednesday, 27 May 2020

Question Of The Day, Antepartum Period
Q. A nurse is assessing the legs of a client who's 36 weeks pregnant. Which finding should the nurse expect?

A. Absent pedal pulses
B. Bilateral dependent edema
C. Sluggish capillary refill
D. Unilateral calf enlargement

Correct Answer: B

Reason: As the uterus grows heavier during pregnancy, femoral venous pressure rises, leading to bilateral dependent edema. Factors interfering with venous return, such as sitting or standing for long periods, contribute to edema. Absence of pedal pulses and sluggish capillary refill signal inadequate circulation to the legs — an unexpected finding during pregnancy. Unilateral calf enlargement, also an abnormal finding, may indicate thrombosis.



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