Friday 24 November 2017

Question Of The Day, Antepartum Period
Q. A client who's 7 weeks pregnant comes to the clinic for her first prenatal visit. She reports smoking 20 to 25 cigarettes per day. When planning the client's care, the nurse anticipates informing her that if she doesn't stop smoking, her fetus may be at risk for:

A. spina bifida.
B. tetralogy of Fallot.
C. low birth weight.
D. hydronephrosis.

Correct Answer: C

Explanation: The risk of intrauterine growth retardation may increase with the number of cigarettes a pregnant woman smokes. Neural tube defects (such as spina bifida), cardiac abnormalities (such as tetralogy of Fallot), and renal disorders (such as hydronephrosis) are associated with multifactorial genetic inheritance, not maternal cigarette smoking.

Thursday 23 November 2017

Q. Flumazenil (Romazicon) has been ordered for a client who has overdosed on oxazepam (Serax). Before administering the medication, the nurse should be prepared for which common adverse effect?

A. Seizures
C. Shivering
C. Anxiety
D. Chest pain

Correct Answer: A

Explanation: Seizures are the most common serious adverse effect of using flumazenil to reverse benzodiazepine overdose. The effect is magnified if the client has a combined tricyclic antidepressant and benzodiazepine overdose. Less common adverse effects include shivering, anxiety, and chest pain.

Monday 20 November 2017

Question Of The Day, Anxiety Disorders
Q. Which of the following should the nurse teach a client with generalized anxiety disorder to help the client cope with anxiety?

A. Cognitive and behavioral strategies.
B. Issue avoidance and denial of problems.
C. Rest and sleep.
D. Withdrawal from role expectations and role relationships.

Correct Answer: A

Explanation: A client with generalized anxiety disorder needs to learn cognitive and behavioral strategies to cope with anxiety appropriately. In doing so, the client's anxiety decreases and becomes more manageable. The client may need assertiveness training, reframing, and relaxation exercises to adaptively deal with anxiety.

Friday 17 November 2017

Question Of The Day, Preschooler
Q. A child diagnosed with tetralogy of Fallot becomes upset, crying and thrashing around when a blood specimen is obtained. The child's color becomes blue and the respiratory rate increases to 44 breaths/minute. Which of the following actions should the nurse do first?

A. Obtain an order for sedation for the child.
B. Assess for an irregular heart rate and rhythm.
C. Explain to the child that it will only hurt for a short time.
D. Place the child in a knee-to-chest position.

Correct Answer: D

Explanation: The child is experiencing a tet or hypoxic episode. Therefore the nurse should place the child in a knee-to-chest position. Flexing the legs reduces venous flow of blood from the lower extremities and reduces the volume of blood being shunted through the interventricular septal defect and the overriding aorta in the child with tetralogy of Fallot. As a result, the blood then entering the systemic circulation has a higher oxygen content, and dyspnea is reduced. Flexing the legs also increases vascular resistance and pressure in the left ventricle. An infant often assumes a knee-to-chest position in the crib, or the mother learns to put the infant over her shoulder while holding the child in a knee-to-chest position to relieve dyspnea. If this position is ineffective, then the child may need a sedative. Once the child is in the position, the nurse may assess for an irregular heart rate and rhythm. Explaining to the child that it will only hurt for a short time does nothing to alleviate the hypoxia.

Wednesday 15 November 2017

Question Of The Day, Infant
Q. An infant is hospitalized for treatment of inorganic failure to thrive. Which nursing action is most appropriate for this child?

A. Encouraging the infant to hold a bottle
B. Keeping the infant on bed rest to conserve energy
C. Rotating caregivers to provide more stimulation
D. Maintaining a consistent, structured environment

Correct Answer: D

Explanation: The nurse caring for an infant with inorganic failure to thrive should strive to maintain a consistent, structured environment because it reinforces a caring feeding environment. Encouraging the infant to hold a bottle would reinforce an uncaring feeding environment. The infant should receive social stimulation rather than be confined to bed rest. The number of caregivers should be minimized to promote consistency of care.
Communication through social media has become a way of life, especially for the younger generation, and will continue to increase. Although indiscriminate posting on social media by nurses hold a number of pitfalls, nurses should embrace this evolving technology in order to keep up with the changing needs and demands of contemporary society. The creative use of social media has limitless potential in nursing education, nursing management, and health care. It is still a vast, mostly unexplored territory.

Nursing Careers, Nursing Jobs, Nursing Tutorials and Materials, Nursing Exam

1. Nursing Education

Nursing students are skilled in the use of social media and will welcome their use in education. Online groups can be used very effectively to create interactive and self-directed learning opportunities. The educator can, for example, post links to web-based articles and YouTube videos for the students to read and watch in preparation for the next classroom session. Instead of the information being presented to the students by the teacher, classroom sessions can be used for clarification, group discussions, and role plays.

Groups can be created by which the educator can connect with their students to share interesting content related to their studies and to inform them of special lectures, test timetables, and other events. An account such as Twitter can even connect the educator with students who are on clinical practice assignments so that she can answer questions, provide guidance and support. There could also be a planned communication session every week at a particular time.

Students themselves can form study support groups through which they can exchange questions and explanations as well as support each other in general. They could also share interesting content related to the topic they are studying.

2. Personal development and support

Nurses can join any of countless nursing groups and pages on Facebook and other social media. These are either for nurses in general or for nurses specializing in a particular field. They serve to share information on developments and issues in nursing and health care and to network with other nurses locally or worldwide. These groups also enhance morale within the nursing profession – just think of the warm feeling you get from a meme or quote about how wonderful nurses are.

One of the most popular nursing groups on Facebook is SMYS that aims to unify the voices of nurses and other healthcare professionals.

The instantaneous and wide sharing of content is one of the major advantages of social media for professional development. This characteristic can be used to start a journal club, either for a special interest group or within an organization. Links to journal articles are posted to the group and, once members have read the article, there can be a discussion in the group about the content of the article, its value for nursing practice and whether and how the research can be implemented in the clinical situation.

Within a specific workplace, nurses can also have a dedicated group where they can ask questions, express feelings, reflect and provide general support for each other.

3. Nursing management

Nurse managers should become familiar with social media, using it to improve communication, obtain staff participation in management decisions and enhance staff morale.

A group for nurses in the workplace can be created with regular postings of the following:

◉ Reminders about continuing education programs and other educational opportunities
◉ Requests for input for or information about policy changes. Allowing nurses to participate in decisions by making use of a voting app can be a great morale booster
◉ Introducing newly appointed nurses with a photo and brief resume
◉ A nurse’s “face for the day” with a positive comment about the nurse’s contribution to the organization
◉ Recognition of achievements by nurses in the organization, including obtaining new qualifications, awards or promotions
◉ Updates on feedback received from patients for positive encouragement or to point out areas needing attention

Imagine the positive influence the above communication will have on staff engagement and cohesion among nurses, as well as on staff recruitment and the branding of the health care institution.

Nursing managers can also use a social media application, dedicated and always attended to, to provide nurses with advice and feedback about problems in real time.

To make effective use of social media in the workplace, nurse managers should also actively engage their staff in developing policy and new methods in information sharing, collaboration on projects, education and patient care.

4. Patient Care

Worldwide there are numerous developments and projects in using social media to enhance health care for patients and communities.

They can be used effectively in communication with patients and patient monitoring. A chat line can be made available for newly discharged patients where they can safely and discreetly communicate with a member of the nursing staff to confirm discharge instructions, enquire about symptoms they are experiencing which might indicate a complication, or even post images of their wounds so that the nurse can monitor the healing process. The nurse can even monitor a patient’s wound dressing technique or method of administering medication via a video. Other uses include medication reminders and confirming upcoming appointments.

Patients can be referred to social media groups which offer support and information for individuals with specific long-term conditions. A group can even be created by a health care institution for patients with specific long-term conditions, or even for new mothers, where they can provide each other with support. A nurse with specialized knowledge could form part of the group to give professional advice, patient education and information about events and new developments in treatments.

A number of mobile-based online applications, which interact with social media, have been developed for monitoring and assessing patient information. One such application, for teenage diabetics, prompts users to enter blood glucose data. Trends are tracked and remotely monitored by health care professionals.

Social media have also proved to be a powerful tool in public advocacy campaigns. They can be used effectively by nurses and organizations to advocate for change in local, regional and national nursing and health issues.

Nurses might feel anxious about using social media in health care but the profession should evolve with developments in the society which they serve. As long as the core ethical principles of nursing are kept in mind, new technology should be embraced for its potential benefits in nursing and health care.

Monday 13 November 2017

Question Of The Day, Basic Physical Assessment
Q. Crackles heard on lung auscultation indicate which of the following?

A. Cyanosis.
B. Bronchospasm.
C. Airway narrowing.
D. Fluid-filled alveoli.

Correct Answer: D

Explanation: Crackles are auscultated over fluid-filled alveoli. Crackles heard on lung auscultation do not have to be associated with cyanosis. Bronchospasm and airway narrowing generally are associated with wheezing sounds.

Friday 10 November 2017

Question Of The Day, Basic Physical Care
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.

Wednesday 8 November 2017

Question Of The Day, Respiratory Disorders
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.

Monday 6 November 2017

Question Of The Day, Musculoskeletal Disorders
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 3 November 2017

Question Of The Day, Gastrointestinal Disorders
Q. A client with cholecystitis is taking Propantheline bromide (Pro-Banthine). The expected outcome of this drug is:

A. Increased bile production.
B. Decreased biliary spasm.
C. Absence of infection.
D. Relief from nausea.

Correct Answer: B

Explanation: Propantheline bromide is an anticholinergic used to decrease biliary spasm. Decreasing biliary spasm helps to reduce pain in cholecystitis. Propantheline does not increase bile production or have an antiemetic effect, and it is not effective in treating infection.

Thursday 2 November 2017

Question Of The Day, Oncologic Disorders
Q. A nurse is caring for a client receiving chemotherapy. Which nursing action is most appropriate for handling chemotherapeutic agents?

A. Wear disposable gloves and protective clothing.
B. Break needles after the infusion is discontinued.
C. Disconnect I.V. tubing with gloved hands.
D. Throw I.V. tubing in the trash after the infusion is stopped.

Correct Answer: A

Explanation: A nurse must wear disposable gloves and protective clothing to prevent skin contact with chemotherapeutic agents. The nurse shouldn't recap or break needles. The nurse should use a sterile gauze pad when priming I.V. tubing, connecting and disconnecting tubing, inserting syringes into vials, breaking glass ampules, or other procedures in which chemotherapeutic agents are being handled. Contaminated needles, syringes, I.V. tubes, and other equipment must be disposed of in a leak-proof, puncture-resistant container.

Wednesday 1 November 2017

Question Of The Day, Cardiovascular Disorders
Q. In preparing the client and the family for a postoperative stay in the intensive care unit (ICU) after open heart surgery, the nurse should explain that:

A. The client will remain in the ICU for 5 days.
B. The client will sleep most of the time while in the ICU.
C. Noise and activity within the ICU are minimal.
D. The client will receive medication to relieve pain.

Correct Answer: D
Explanation: Management of postoperative pain is a priority for the client after surgery, including valve replacement surgery, according to the Agency for Health Care Policy and Research. The client and family should be informed that pain will be assessed by the nurse and medications will be given to relieve the pain. The client will stay in the ICU as long as monitoring and intensive care are needed. Sensory deprivation and overload, high noise levels, and disrupted sleep and rest patterns are some environmental factors that affect recovery from valve replacement surgery.



Popular Posts

Blog Archive

Total Pageviews