Friday, 23 February 2018

Question Of The Day, Basic Physical Care
Q. Which scenario complies with Health Insurance Portability and Accountability Act of 1996 (HIPAA) regulations?

A. Two nurses in the cafeteria are discussing a client's condition.
B. The health care team is discussing a client's care during a formal care conference.
C. A nurse checks the computer for the laboratory results of a neighbor who has been admitted to another floor.
D. A nurse talks with her spouse about a client's condition.

Correct Answer: B

Explanation: To provide interdisciplinary continuity of care, nurses must share relevant information during client care conferences. Nurses discussing information in the cafeteria may be overheard; this indiscretion violates HIPAA regulations. Looking up laboratory results for a neighbor is a HIPAA violation, as is discussing a client's condition with one's spouse.

Thursday, 22 February 2018

Question Of The Day, Genitourinary Disorders
Q. After surgery for an ileal conduit, the nurse should closely assess the client for the occurrence of which of the following complications related to pelvic surgery?

A. Peritonitis.
B. Thrombophlebitis.
C. Ascites.
D. Inguinal hernia.


Correct Answer: B

Explanation: After pelvic surgery, there is an increased chance of thrombophlebitis owing to the pelvic manipulation that can interfere with circulation and promote venous stasis. Peritonitis is a potential complication of any abdominal surgery, not just pelvic surgery. Ascites is most frequently an indication of liver disease. Inguinal hernia may be caused by an increase in intra-abdominal pressure or a congenital weakness of the abdominal wall; ventral hernia occurs at the site of a previous abdominal incision.

Wednesday, 21 February 2018

Q. A nurse is conducting an initial assessment on a client with possible tuberculosis. Which assessment finding indicates a risk factor for tuberculosis?

A. The client sees his physician for a check-up yearly.
B. The client has never traveled outside of the country.
C. The client had a liver transplant 2 years ago.
D. The client works in a health care insurance office.

Correct Answer: C

Explanation: A history of immunocompromised status, such as that which occurs with liver transplantation, places the client at a higher risk for contracting tuberculosis. Other risk factors include inadequate health care, traveling to countries with high rates of tuberculosis (such as southeastern Asia, Africa, and Latin America), being a health care worker who performs procedures in which exposure to respiratory secretions is likely, and being institutionalized.


Thursday, 15 February 2018

Question Of The Day, Antepartum Period
Q. A multigravid client in labor at 38 weeks' gestation has been diagnosed with Rh sensitization and probable fetal hydrops and anemia. When the nurse observes the fetal heart rate pattern on the monitor, which of the following patterns is most likely?

A. Early deceleration pattern.
B. Sinusoidal pattern.
C. Variable deceleration pattern.
D. Late deceleration pattern.

Correct Answer: B

Explanation: The fetal heart rate of a multipara diagnosed with Rh sensitization and probable fetal hydrops and anemia will most likely demonstrate a sinusoidal pattern that resembles a sine wave. It has been hypothesized that this pattern reflects an absence of autonomic nervous control over the fetal heart rate resulting from severe hypoxia. This client will most likely require a cesarean delivery to improve the fetal outcome. Early decelerations are associated with head compression; variable decelerations are associated with cord compression; and late decelerations are associated with poor placental perfusion.

Wednesday, 14 February 2018

Question Of The Day, Psychotic Disorders
Q. The mother of a client with chronic undifferentiated schizophrenia calls the visiting nurse in the outpatient clinic to report that her daughter has not answered the phone in 10 days. "She was doing so well for months. I don't know what's wrong. I'm worried." Which of the following responses by the nurse is most appropriate?

A. "Maybe she's just mad at you. Did you have an argument?"
B. "She may have stopped taking her medications. I'll check on her."
C. "Don't worry about this. It happens sometimes."
D. "Go over to her apartment and see what's going on."

Correct Answer: B

Explanation: Noncompliance with medications is common in the client with chronic undifferentiated schizophrenia. The nurse has the responsibility to assess this situation. Asking the mother if they've argued or if the client is mad at the mother or telling the mother to go over to the apartment and see what's going on places the blame and responsibility on the mother and therefore is inappropriate. Telling the mother not to worry ignores the seriousness of the client's symptoms.


Tuesday, 13 February 2018

Q. A 40-year-old executive who was unexpectedly laid off from work 2 days earlier complains of fatigue and an inability to cope. He admits drinking excessively over the previous 48 hours. This behavior is an example of:

A. alcoholism.
B. a manic episode.
C. situational crisis.
D. depression.

Correct Answer: C

Explanation: A situational crisis results from a specific event in the life of a person who is overwhelmed by the situation and reacts emotionally. Fatigue, insomnia, and inability to make decisions are common signs and symptoms. The situational crisis may precipitate behavior that causes a crisis (alcohol or drug abuse). There isn't enough information to label this client an alcoholic. A manic episode is characterized by euphoria and labile affect. Symptoms of depression are usually present for 2 or more weeks.

Monday, 12 February 2018

Question Of The Day, Foundations of Psychiatric Nursing
Q. The family of an older adult wants their mother to have counseling for depression. During the initial nursing assessment, the client denies the need for counseling. Which of the following comments by the client supports the fact that the client may not need counseling?

A. "My doctor just put me on an antidepressant, and I'll be fine in a week or so."
B. "My daughter sent me here. She's mad because I don't have the energy to take care of my grandkids."
C. "Since I've gotten over the death of my husband, I've had more energy and been more active than before he died."
D. "My son got worried because I made this silly comment about wanting to be with my husband in heaven."

Correct Answer: C

Explanation: Resolving grief and having increased energy and activity convey good mental health, indicating that counseling is not necessary at this time. Taking an antidepressant or having less energy and involvement with grandchildren reflects possible depression and the need for counseling. Wanting to be with her dead husband suggests possible suicidal ideation that warrants serious further assessment and counseling.

Saturday, 10 February 2018

Question Of The Day, Infant
Q. A nurse is caring for a family whose infant has anencephaly. The most appropriate nursing intervention is to:

A. help the family prepare for the infant's imminent death.
B. implement measures to facilitate the attachment process.
C. provide emotional support so the family can adjust to the birth of an infant with health problems.
D. prepare the family for the extensive surgical procedures the infant will require.

Correct Answer: A

Explanation: Anencephaly is incompatible with life. The nurse should support family members as they prepare for the infant's imminent death. Facilitating the attachment process, helping the family to adjust to the infant's problems, and preparing the family for extensive surgical procedures are inappropriate because the infant can't survive.

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