Thursday, 14 November 2019

Question Of The Day, Mood, Adjustment, and Dementia Disorders
Q. A client with major depression sleeps 18 to 20 hours per day, shows no interest in activities he previously enjoyed and reports a 17-lb (7.7-kg) weight loss over the past month. Because this is the client's first hospitalization, the physician is most likely to order:

A. phenelzine (Nardil).
B. thiothixene (Navane).
C. nortriptyline (Pamelor).
D. trifluoperazine (Stelazine).

Correct Answer: C

Explanation: Nortriptyline, a tricyclic antidepressant, is used in first-time drug therapy because it causes few anticholinergic and sedative adverse effects. Phenelzine isn't ordered initially because it may cause many adverse effects and necessitates dietary restrictions. Thiothixene and trifluoperazine are antipsychotic agents and, therefore, inappropriate for clients with uncomplicated depression.

Wednesday, 13 November 2019

Question Of The Day, Anxiety Disorders
Q. A client who recently developed paralysis of the arms is diagnosed with conversion disorder after tests fail to uncover a physical cause for the paralysis. Which intervention should the nurse include in the care plan for this client?

A. Exercising the client's arms regularly
B. Insisting that the client eat without assistance
C. Working with the client rather than with the family
D. Teaching the client how to use nonpharmacologic pain-control methods

Correct Answer: A

Explanation: To maintain the integrity of the affected areas and prevent muscle wasting and contractures, the nurse should help the client perform regular passive range-of-motion exercises with his arms. The nurse shouldn't insist that the client use his arms to perform such functions as eating without assistance, because he can't consciously control his symptoms and move his arms; such insistence may anger the client and endanger the therapeutic relationship. The nurse should include family members in the client's care because they may be contributing to the client's stress or conflict and are essential to helping him regain function of his arms. The client isn't experiencing pain and, therefore, doesn't need education regarding pain management.
Attending nursing classes online can have a lot of benefits, like accommodating your current work schedule (hellllooooo night shift), allowing you to attend class in your pajamas, and fit in family life.

Nursing Responsibilities, Nursing Career, Nursing Degree, Nursing Certification,

But all that flexibility can also make online classes challenging. Without an in-person class to attend combined with the distractions of home life, it can be difficult to stay on-task and motivated. For many people, however, the good outweighs the bad, so if online nursing school is in your future, here are some tips for success.

1. Stay Ahead of Schedule

Julie Widzinski, a mom of three active boys and a current Family Nurse Practitioner student, advises anyone taking classes online to stay ahead of their classwork. She points out that most online class formats allow you to see the entire course schedule ahead of time, which can help you plan school work around your life and even work in advance.

“I try to get ahead as best as I can, so if something comes up with the kids, etc., I don’t have to be stuck doing work,” Widzinski explains. “, when the deadline is Wednesday, I usually try posting on Monday.”

2. Do NOT Clean Before You Do Your Homework

I know exactly what you’re thinking — you’re home, you have some time set aside to do your homework, but you’re just going to switch the laundry real quick. Oh, and maybe get dinner started in the crockpot so it can cook while you work. Well, next thing you know you’re making a grocery list and ordering groceries because you noticed you were out of something in the pantry and an hour has gone by and you’re still not working.

Housework of any kind has a way of sucking you in (it’s the “If You Give a Mouse a Cookie” scenario, except for adults), so if you have work that’s due or you’ve committed a time slot to study, you need to just sit your butt down, ignore the housework completely, and make sure you do your homework first. The dishes will be there when you’re done, but you might lose that precious time to work or burn up all of your energy if you try to clean first.

3. Leave Your Home

That being said, if you absolutely cannot avoid getting distracted at home, you may find you work better out of your house or apartment, so head to a local coffee shop, restaurant during a slow time (like late afternoon), or the library. (I’ve even been known to do my online work in a parking lot where the WiFi will still work #noshame). Getting some fresh scenery can also help you stay energized in a new way that staying home can’t.

4. Utilize Time-Blocking

If you’re not familiar with time-blocking, it’s a time-management strategy designed to help you be more productive with your time. Essentially, instead of switching from one task to another, you “block” off time for each specific task so your brain can be completely focused on one thing at a time. So, instead of studying, then looking something up, then trying to answer your online discussion board, you block off a certain amount of time for each task: 30 minutes to study, 30 minutes to research, and 10 to answer your discussion questions, for instance.

You can even use a time-blocking app, such as Toggl, to help you stay on task if you’re using the computer to work; the app will block other distractions, such as texts or calls, or even web browsing if you need that limited so you can stay completely focused.

5. Don’t Work with Any Other Screens On

Sure, it may be tempting to plop down on the couch with a little bit of your favorite show on in the background as you work, but trust me, you will be much more effective and efficient if you study or complete your assignments with no other distractions.

Research shows that you might be just fine — or even more on-task with some background noise, like chatter from your family or the background of a coffee house — but when it comes to other screens or visual distractions, our brains just can’t handle both tasks at once. Just say no to screens while studying.

6. Invest in Noise-Cancelling Headphones

In an ideal world, sure, you may only complete your work or studying in a tranquil environment with a fresh cup of coffee and the birds chirping in the background. But in the real world, especially if you have a family, you’ll be cramming for a test while your kids wrestle in the living room or your partner wanders in and out of the bedroom looking for that one item right in front of their face that they just “can’t find.”

So, for the days that you can’t get away from them or just can’t answer another question about what’s for dinner, put on your noise-canceling headphones and (literally) block them all out. You can pick up a pair for around $60 on Amazon and you should 100% ask your accountant if you can write those off as a job-related expense.

7. Get an Accountability Partner

If staying on task and motivated is a challenge for you, try linking up with an accountability partner from your class. Ask one of your classmates if you can be accountability partners and set a system of checking in with each other; you’ll be less likely to blow off studying if you know your partner is expecting a text from you. Even better, find an IRL partner so you have to stay committed.

If you don’t know anyone in “real life” from your nursing class or don’t feel comfortable asking them, find an accountability partner online — there are many different online nursing student support groups.

Alternatively, you could find an accountability partner who is working toward a different goal. For instance, you check in when it’s time to study and they have to check in when it’s time for them to hit the gym. That way, you both win!

8. Ask for Help

Don’t fall into the trap of thinking that just because you’re taking an online class that you’re on your own—your professor is still available to help you if you’re struggling. In fact, his or her “office hours” might be even more accessible than an in-person professor, so don’t be afraid to schedule time to chat, video conference, or speak on the phone if there are concepts you need additional assistance with.

9. Keep a Back-up Copy of Your Work

When I was attending a graduate school program, I can’t tell you how many times I typed a long, thought-out discussion into the online class board only to have the thing completely disappear in some kind of glitch. With a newborn and a toddler at home at the time, I had precious little time to work, so I quickly learned to type out my answers in a Word or Google doc first, save it, then transfer the work to the online submission forms—that way, there was no risk of losing it.

10. Know Thyself

It sounds simple, but it’s a strategy that can serve you well when taking classes online because ultimately, you’re in charge of your own success. If you know that you have more energy in the morning, schedule your most intense work during that time. Conversely, if you’re a night owl, make that your most productive time. Save less intense work, such as outlining or writing out your schedule, for your energy “downtimes.”

If you have a family, don’t let yourself feel guilty for using your high-energy times to work, even if it’s when the kids are clamoring for you, or your partner wants to spend time with you. School is a short time in your life and it’s important to understand what works best for you—and stick to that schedule so ultimately you can all benefit. 

Tuesday, 12 November 2019

Q. The nursing staff has finished restraining a client. In addition to determining whether anyone was injured, the staff is mandated to evaluate the incident to obtain which of the following ultimate outcomes?

A. Coordinate documentation of the incident.
B. Resolve negative feelings and attitudes.
C. Improve the use of restraint procedures.
D. Calm down before returning to the other clients.

Correct Answer: C

Explanation: Although coordinating documentation, resolving negative feelings, and calming down are goals of debriefing after a restraint, the ultimate outcome is to improve restraint procedures.

Saturday, 9 November 2019

Question Of The Day, Preschooler
Q. A 4-year-old boy presents to the emergency department. His father tearfully reports that he was in the driveway and had his son on his shoulders when the child began to fall. The father grabbed him by the leg, swinging him toward the grass to avoid landing on the pavement. As the father swung his son, the child hit his head on the driveway and twisted his right leg. After a complete examination, it is determined that the child has a skull fracture and a spiral fracture of the femur. Which of the following actions should the nurse take?

A. Restrict the father's visitation.
B. Notify the police immediately.
C. Refer the father for parenting classes.
D. Record the father's story in the chart.

Correct Answer: D

Explanation: The father's story is consistent with the injuries incurred by the child; therefore, the nurse should document the cause of injury. There is no need to restrict the father's visitation, because the injuries sustained by the child are consistent with the explanation given. The police need to be notified only if there is suspicion of child abuse. The injuries incurred by this child appear accidental. There is no need to refer the father for parenting classes. The father seems upset about the accident and will not likely repeat such reckless behavior. The nurse should educate the father, however, regarding child safety.

Friday, 8 November 2019

Q. A nurse should expect a 3-year-old child to be able to perform which action?

A. Ride a tricycle
B. Tie his shoelaces
C. Roller-skate
D. Jump rope

Correct Answer: A

Explanation: The nurse should expect the child to ride a tricycle because, at age 3, gross motor development and refinement in eye-hand coordination enable a child to perform such an action. The fine motor skills required to tie shoelaces and the gross motor skills required for roller-skating and jumping rope develop around age 5.

Thursday, 7 November 2019

Question Of The Day, Infant
Q. During assessment of a small infant admitted with a diagnosis of meningitis, the infant becomes less responsive to stimuli and exhibits bradycardia, slight hypertension, irregular respirations, and a temperature of 103.2° F (39.6° C). The infant's fontanel is more tense than at the last assessment. What should the nurse do first?

A. Ask another nurse to verify the findings.
B. Notify the primary care provider of the findings.
C. Raise the head of the bed.
D. Administer an antipyretic.

Correct Answer: C

Explanation: Signs such as a decrease in the level of consciousness, bradycardia, hypertension, irregular respirations, and a tense fontanel strongly suggest increased intracranial pressure. The first action should be to attempt to lower the pressure by raising the head of the bed, which should improve venous return and decrease the pressure. Asking another nurse to verify the findings is unnecessary because temperature, pulse, and respirations are fairly objective data and not subject to interpretation. Additionally, asking for verification would waste valuable time. After elevating the infant's head by raising the bed, the nurse can notify the primary care provider and administer the antipyretic.

Wednesday, 6 November 2019

Q. An 18-year-old high school senior wishes to obtain birth control through her parents' insurance but does not want the information disclosed. The nurse tells the client that under the Health Information Portability and Accountability Act (HIPAA) parents:

A. Have the right to review a minor's medical records until high school graduation.
B. Have the right to review a minor's medical record if they are responsible for the payment.
C. May not view the medical record, but may learn of the visit through the insurance bill.
D. May not view the minor's medical record or the insurance bill.

Correct Answer: C

Explanation: Under HIPAA, 18-year-olds have the right to medical privacy and their medical records may not be disclosed to their parents without their permission. However, the adolescent must be made aware of the fact that information is sent to third party payers for the purpose of reimbursement. Those payers send the primary insurer, in this case the parent, a statement of benefits. HIPAA protects the right to medical privacy of all 18-year-olds regardless of their educational status. Even if parents are responsible for payment, they may not view the patient's chart without the consent of the adolescent.

Monday, 4 November 2019

Question Of The Day, Medication and I.V. Administration
Q. The nurse administers an intradermal injection to a client. Proper technique has been used if the injection site demonstrates which of the following?

A. Minimal leaking.
B. No swelling.
C. Tissue pallor.
D. Evidence of a bleb or wheal.

Correct Answer: D

Explanation: A properly administered intradermal injection shows evidence of a bleb or wheal at the injection site. There should be no leaking of medication from the bleb; it needs to be absorbed into the tissue. Lack of swelling at the injection site means that the injection was given too deeply. The presence of tissue pallor does not indicate that the injection was given correctly.

Saturday, 2 November 2019

Q. A physician has ordered penicillin G potassium (Pfizerpen), I.V., for a client with a severe streptococcal infection. A nurse determines that the client may be allergic to penicillin. When considering best practice, what should the nurse's priority intervention be?

A. Holding the penicillin G potassium and charting that it was held because the client is allergic
B. Administering the penicillin G potassium and staying alert for any reaction
C. Holding the penicillin G potassium and notifying the physician that the client may have an allergy to penicillin
D. Administering the penicillin G potassium but notifying the pharmacist that the client might experience an allergic reaction

Correct Answer: C

Explanation: The nurse should hold the penicillin G potassium, even if the client isn't sure he's allergic to penicillin, and notify the physician so he may order a different antibiotic. Many clients can't act as their own advocates; they rely on nurses to protect their rights. An allergy to penicillin G potassium is suspected, but not comfirmed. Administering penicillin G potassium could cause a life-threatening reaction. Administering the medication, then watching for a reaction or notifying the pharmacist that a reaction might occur, isn't best practice. If a client is allergic to penicillin, a nurse should alert the pharmacist and label the client's chart appropriately.

Friday, 1 November 2019

A. client with chronic renal failure (CRF) has developed faulty red blood cell (RBC) production. The nurse should monitor this client for:

A. nausea and vomiting.
B. dyspnea and cyanosis.
C. fatigue and weakness.
D. thrush and circumoral pallor.

Correct Answer: C

Explanation: RBCs carry oxygen throughout the body. Decreased RBC production diminishes cellular oxygen, leading to fatigue and weakness. Nausea and vomiting may occur in CRF but don't result from faulty RBC production. Dyspnea and cyanosis are associated with fluid excess, not CRF. Thrush, which signals fungal infection, and circumoral pallor, which reflects decreased oxygenation, aren't signs of CRF.




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