Exam 5 Sherpath
The nurse learns that a patient has been on a low protein high carbohydrate diet for about a year. Which finding does the nurse anticipate in the patient's laboratory reports? a. Increase in serum triglyceride levels b. Decrease in serum bilirubin levels c. Increase in low-density lipoprotein levels d. Decrease in serum creatinine levels
Answer: a A patient on a low-protein and high0carbohydrate diet would present with an increase in serum triglyceride levels. A low-protein, high-carbohydrate diet would not ahem a significant impact on liver function. Therefore the nurse does not expect to find decreased bilirubin levels in the patient's laboratory reports. A high-cholesterol diet, rather than a high-0carbohydrate diet, would lead to an increase in LDL levels. A low-protein, high-carbohydrate diet would not alter serum creatinine levels. the nurse may find decreased serum creatinine levels in the laboratory reports of a patient with muscular atrophy
A patient reports severe pain when the nurse palpates the radial pulse. Which sensory impairment would the nurse infer in this situation? a. Allodynia b. Dyesthesia c. Hyperalgesia d. Hyperpathia
Answer: a Allodynia is a type of sensory impairment in which a patient experiences pain even from a non-injurous stimulus, such as being touched. Dysesthesia is a type of impaired sensation in which the patient experiences unpleasant and abnormal sensation to touch. Hyperalgesia and hyperpathia are impaired sensations in which the patient experiences an exaggerated intensity of pain from painful stimuli.
The nurse is caring for a patient whose your analysis shows glucosuria. After reviewing the blood results, which finding listeners to believe the patient may have Lane autoimmune diabetes mellitus? a. Increased C-reactive protein levels b. Increased troponin I levels c. Increased blood glucose levels d. Increased homocysteine levels
Answer: a C-reactive protein appears in the blood and responsive tissue damage and information. Elevated levels of C-reactive protein indicate auto immune disorder such as lead autoimmune diabetes mellitus. Elevated troponins one levels indicate cardiac injury in the patient, not autoimmune disorder. A patient with Layton autoimmune diabetes lightest may have increased blood glucose levels, but this does not indicate that the disease is autoimmune in nature. Elevated homocysteine levels indicate vitamin deficiencies, not autoimmune disorders.
The nurse monitors the patient's response to a pain management regimen and revises the plan to reduce the pain. Which principle is the nurse showing? a. Fidelity b. Advocacy c. Responsibility d. Accountability
Answer: a Fidelity refers to the agreement to keep promises. The nurse assesses the patient needs and performs interventions to fulfill them. If the interventions are not found to be effective, the nurse still follows through all the actions and modifies the care plan to reduce the pain. Advocacy, responsibility, and accountability are principles of the codes of ethics. Advocacy is when the nurse speaks up for patient rights. Responsibility refers to a willingness to respect one's professional obligations and follow through on promises. Accountability is when the nurse agrees to be answerable for one's actions
When a nurse assesses a patient repeated offers a plan to manage the pain, which principle is used to encourage the nurse to monitor the patient's response to the pain? a. Fidelity b. Beneficence c. Nonmaleficence d. Respect for Autonomy
Answer: a Requiring a return to the patient to evaluate the effectiveness of an intervention exemplifies keeping a promise, a concrete example of the Delery. Nurses demonstrate beneficence by acting on behalf of others and placing a priority on the needs of others rather than on personal thoughts and feelings. Nonmaleficence requires only the avoidance of harm. Autonomy, or self-determination, is the freedom to make decisions supported by knowledge and self-confidence.
When a patient has severe pain due to muscle cramps, which types of pain is the patient experiencing? a. Somatic pain b. Visceral pain c. Referred pain d. Radiating pain
Answer: a Somatic pain refers to the localized pain caused by the activation of nociceptors. Therefore, muscle cramps can be categorized as somatic pain. Viscera refers to the soft internal organs of the body, such as those in the digestive, respiratory, urogenital, endocrine, and cardiovascular systems. The pain caused in these organs is known as visceral pain. If a patient has an injury at a particular site, but the pain is exhibited at another site, it is called referred pain. If a patient has pain at the site that extends to adjacent areas, it is called radiating pain.
Which enzyme level does the nurse monitor in a patient with bone disease? a. Alkaline phosphatase (ALP) b. Alanin aminotransferase (ALT) c. Aspartate aminotransferase (AST) d. Gamma-glutamyltransferase (GGT)
Answer: a The liver contains various enzymes, such as ALP, ALT, AST, and GGT. However, a small proportion of ALP is also present in the bones, placenta, intestines, and kidneys. Therefore the nurse monitors ALP levels in the patient with bone disease. ALT, AST, and GGT are not found in bone. ALT is found in the kidneys, the heart, and skeletal muscle. AST is present in the heart, liver, and muscle. GGT is found primarily in the liver and biliary tract.
Which outcome is being fulfilled when a nurse asked the patient for a return demonstration after explaining a surgery and its potential outcomes and demonstrating postoperative exercises? a. Improve the patient self advocacy b. It determines the patient's learning needs c. It increases the patient's motivation d. It improves the patient's attentiveness
Answer: a The nurse improves the patient's self-efficacy with the methods of demonstration and return demonstration. Teaching the patient postoperative exercises does not determine the learning needs of a patient or increase motivation. It also does not improve the attentiveness of the patient.
While caring for the patient, nurse finds that the patient is allergic to the medication. The nurse informed the primary healthcare provider, who prescribed a new medication. Which principle of Code of Ethics has the nurse followed? a. Advocacy b. Accountability c. Responsibility d. Confidentiality
Answer: a The nurse is it OK for the safety of the patient. Advocacy is related to the support of a particular clause. The nurse speaks on behalf of the patient to ensure that the patient's right to safety is respected. Accountability is used while answering about one's actions. The nurse is not trying to justify the actions; therefore the principle of accountability is not acceptable. Responsibility refers to a willingness to respect one's professional obligations and follow through and promises. However the principle of advocacy is the most applicable principal. Confidentiality is used to keep the patient's personal health information private. The nurse is not trying to protect any patient - related information; therefore the principle of confidentiality does not hold true.
Which factor with the nurse keep in mind when preparing a teaching plan on prevention of urinary tract infections? Select all that apply a. You should meet the patient's needs b. Teaching should be problem based c. Plan to provide necessary information only d. Teaching should be based on mutually exclusive experiences e. It's a prompt learn to engage in activities that lead to a desired change
Answer: a, b, c, e Before preparing a teaching plan, the nurse should understand the patient's needs. The nurse should consider the patient's problem and provide only necessary information. This will help prevent information overload on the patient. The objective of the teaching is to educate the patient about the prevention of urinary track infections. Therefore, the teaching should prop the patient to adopt preventative measures against contracting a urinary track infection. The teaching should be based on real life experiences rather than mutually exclusive ones
Document is included under advance directives? Select all that apply a. Living will b. Health Care Proxy c. Do not resuscitate order d. Durable Power of attorney e. Informed consent form
Answer: a, b, d Advance directives are legal documents I provide information about the patient decisions regarding end of life care. Advance directive include three documents: LivingWell, healthcare proxy, and durable power of attorney. The living will specifies the actions to be taken by the caregivers to retain the patient's health when he or she is unable to care for him or herself. Healthcare proxy is a document that permits the patient to appoint another caregiver when the primary caregiver is unable to execute healthcare decisions. Durable power of attorney is a document that allows the patient to give authority to another person to make his or her healthcare decisions. Some patients with life-threatening illnesses or their healthcare proxies may decide to limit treatment in the event of natural death. The nurse document this as a do not resuscitate order. I do not resuscitate order is not an advance directive. An informed consent form is a document that indicates the patient's willingness to undergo a given treatment or surgery.
Characteristic is associated with the discussion method of the cognitive domain of learning? Select all that apply a. It allows peer support b. It involves both the nurse and the patients c. It involves presentation of procedures or skills by the nurse d. It helps the patient learn from others' experiences e. It allows patients to assume responsibility for completing learning activities at their own pace
Answer: a, b, d The discussion method involves interaction between both the nurse and the patients. This method allows peer involvement and also helps the patient learn from others experiences. Demonstration is the teaching method that involves presentation of procedures or skills by the nurse. Unlike the role-play method, this method does not allow the patient to assume responsibility for completing learning activities at his or her own pace.
Which action with the nurse perform to meet the American nursing association (ANA) code of ethics? Select all that apply. a. consider the patient his or her primary commitment b. Strive to protect the health and rights of the patient c. Consider personal and professional growth a priority d. Contribute to nursing practice and knowledge development e. Ignore other health care professionals and perform his or her own duties
Answer: a, b, d The nurses primary commitment to the patient, where that is an individual, family, group, or community for the ANA code of ethics, a nurse should promote, advocate for, and strive to protect the health, safety, and rights of the patient. The nurse should contribute to nursing practice and knowledge development and does participate in the advancement of the profession. The professional growth of the nurse should continue alongside the patient care, but it is not an ethical responsibility. The nurse should collaborate with other healthcare professionals, not just perform his or her own duties.
While obtaining a blood sample from a patient's vein, the nurse uses a blood collection tube with a gray stopper. Which test does the nurse perform using this blood sample? Select all that apply. a. Glucose b. Lactic acid levels c. Prothrombin time d. Blood alcohol levels e. Partial thromboplastin time
Answer: a, b, d The tube with a gray stopper contains potassium oxalate and sodium fluoride as additives. The nurse can use the sample to determine glucose levels, blood alcohol levels, and lactic acid levels. The nurse uses a light blue stopper tube, which has sodium citrate as an additive, to collect a blood sample for determining coagulation factors such as prothrombin time and partial thromboplastin time.
Is reading a living will be patient. Which information does the nurse obtain from this document? Select all that apply. a. Desire for organ donation b. Consent for performing an autopsy c. Do not resuscitate order d. Designation of a healthcare proxy e. Preferences regarding the termination of ventilator treatment
Answer: a, b, e A living will is an advance directive that specifies the details of treatment a patient wants to receive when he or she is not in a position to make decisions. The patient can include his or her desire for organ donation in the living will, so that the caregiver or the nurse would arrange with the same after the death of the patient. The patient also include consent for performing an autopsy if necessary. A living will may indicate when a person wants to have extraordinary measures terminated, such as ventilator treatment. They do not resuscitate order is not part of a LivingWell because it is not an advance directive. It specifies the patients or the family's decision to limit the treatment during end of life situations. A durable power of attorney for healthcare is called a healthcare proxy, it is not part of the living will.
For which side effect would the nurse monitor potential development of when a patient received dezocine? Select all that apply. a. Itching b. Nausea c. Anxiety d. Drowsiness e. Hypertension
Answer: a, b, e Dezocine is an agonist-antagonist analgesic useful in treating moderate to severe pain. Side effects include itching, nausea, drowsiness, dizziness vomiting, and respiratory depression. During intravenous administration of dezocine, histamines are released at the site of administration that result in itching. Dezocine slows down CNS function and causes nausea and drowsiness. Anxiety and hypertension are symptoms of withdrawal from opioid drugs, not dezocine.
The nurse is caring for a patient who abuses alcohol. While reviewing the urinalysis reports, the nurse finds that the specific gravity of the patient's urine is 1.040. Which finding might the nurse observe in the patient's blood reports? Select all that apply. a. Increased liver enzyme levels b. Decreased serum creatinine levels c. Increased blood urea nitrogen levels d. Increased serum ketone levels e. Decreased antidiuretic hormone levels
Answer: a, c The normal range or urine specific gravity is 1.005 tot 1.030. A patient who abuses alcohol may have increased specific gravity of urine due to liver damage, leading to increased levels of liver enzymes in the blood. Liver damage may also alter the metabolic processes in the body, resulting in increased blood urea nitrogen levels. Alcohol and liver damage will not significantly alter the creatinine levels in the patient. A patient with muscular atrophy may have decreased serum creatinine levels. A patient who abuses alcohol may have increased ketone levels in the urine but not in the blood. Decreased antidiuretic hormone may increase the specific gravity of urine. However, alcohol will not alter the antidiuretic hormone levels of the patient.
Which patient information, if not Charlie, can lead to malpractice lawsuits? Select all that apply a. Drug allergies b. Number of patient siblings c. Discontinued medications d. History of cancer e. Illegible writing
Answer: a, c, d, e Documentation error such as Felix record drug allergies, information on discontinue medication, or history of cancer can result in serious treatment errors and negative outcomes. This results in malpractice lawsuit. Recording information with incomprehensible writing also leads to errors and consequent lawsuits. Failing to record the number of siblings of the patient does not reflect the health status of the patient; it does not affect the treatment delivered
A nurse is explaining the physiology of sleep to student nurses. Which information with the nurse include in the explanation? Select all that apply. a. During sleep, the core body temperature start to decrease between 2 and 4 AM b. During sleep, cortisol levels increase around 2 AM in peak around 4 AM c. The major sleep center, is located in the hypothalamus d. The reticular activating system (RAS) regulates sleep e. Melatonin is the hormone believe to induce sleep in humans
Answer: a, c, d, e Sleep involves a sequence of physiologic states maintained by central nervous system activity. Core body temperature, which typically is coupled closely with activity rhythm, starts to increase after the minimum core temperature level is reached between 2 and 4 AM, in anticipation of activity. The major sleep center in the body is located in the hypothalamus. Sleep is a complex process regulated by the RAS and neurotransmitter interactions. Melatonin is the hormone believe to induce sleep in humans. In anticipation of daytime activity, cortisol levels increase around 4 AM and peak around 6 AM
The nurse is gathering a sleep history from a patient who is being evaluated for obstructive sleep apnea. Which common symptoms does the patient most likely report? Select all that apply. a. Headache b. Early wakening c. Excessive daytime sleepiness d. Difficulty falling asleep e. Snoring
Answer: a, c, e Colin systems for obstructive sleep apnea include headache, storing, and excessive daytime sleepiness caused by poor sleep during the night. Early awakening could be related to stress, circadian rhythm disorder, and parasomnias. Insomnia is the most common dyssomnia and is characterized by difficulty and falling asleep or staying asleep. They are not related to obstructive sleep apnea.
Which sleep-related complication would the nurse expect to find in a patient who is on beta blockers? Select all that apply. a. Insomnia b. Irritability c. Drowsiness d. Nightmares e. Restlessness
Answer: a, d Beta blockers inhibit the effects of the adrenaline hormone and also inhibit nighttime secretion of melatonin, a hormone involved in regulating both sleep in the body circadian clock. Reduced secretions of melatonin result in insomnia and nightmares. Irritability occurs due to sleep deprivation. Drowsiness and restlessness occur due to overusage of medication such as barbiturates, amphetamines, and antidepressants
A picture of ports in Aiken, crushing, stabbing, nutmeg, burning, shooting, and tingling sensation. The healthcare provider would prescribe a combination of which drug classification to treat the patient's condition? Select all that apply? a. Anticonvulsant drugs b. Antihistamine drugs c. Local anesthetic drugs d. Antidepressant drugs e. Nonsteroidal anti-inflammatory drug
Answer: a, d Burning and stabbing stations indicate neuropathic pain, which is caused by neuronal hyperexcitability and can be reduced by the action of anticonvulsants. Antidepressants are also occasionally used to relieve neuropathic pain and patience with the psychological disorders. Antihistamine medication's are used as a coat and I'll Jessica medication and are used in conjunction with morphine to really bitching. Local anesthetic drugs and nonsteroidal anti-inflammatory drugs help relieve nociceptive pain in different areas of the body; these do not specifically treat neuropathic pain
Which aspect of affective learning will help when a nurse is facilitating a discussion about depression with a group of patients? Select all that apply a. It will allow patients to receive support from other patients in the group b. It will allow patience to expressed concerns c. It will allow patience to discuss personal and sensitive things d. It will help patients learn from others' experiences e. It will help promote responsiveness, value, and organization
Answer: a, d, e Affective learning recognize the emotional component of integrating new knowledge. If patients with depression sit in a group and interact with other patients who have similar symptoms, they receive support from other patients in the group. The group discussion helps them learn from the experiences of others and also promotes responsiveness, value, and organization. Affective learning does not address patient's concerns. Many patients may not open up about their concerns, much less talk about sensitive topics within a group setting. The nurse may need to schedule a one on one conversation at a later date
Which inhibitory neurotransmitter reduces pain perception in the brain? Select all that apply. a. Enkephalins b. Histamines c. Substance P d. Beta endorphins e. Dynorphins
Answer: a, d, e Once pain is recognized, the brain can change the perception of pain by sending inhibitory input to the spinal cord to impede the transmission through a process called "modulation". The brainstem activates descending nerve fibers to send the signal back to the spinal cord. This triggers the release of natural analgesic neurotransmitters called "endogenous opioids" (enkephalins, beta endorphins, and dynorphins). Histamine is released by mast cells and plays a major role in the inflammatory process. Substance P transmits pain impulses from periphery to higher brain centers.
Which condition is associated with an increased serum bilirubin level? Select all that apply. a. Hepatitis b. Cholesystitis c. Bone tumors d. Anemia conditions e. Biliary obstruction
Answer: a, d, e The conditions associated with raised serum bilirubin and hepatobiliary disorders, certain anemias (hemolytic anemia), and obstructive conditions of the bile duct. In hemolytic anemia, there is an increased destruction of red blood cells, leading to free hemoglobin. This hemoglobin on breakdown raises the bilirubin levels. Hepatobiliary disorders and bile duct obstructions prevent excretion of bilirubin from the GI tract, leading to an increase in bilirubin levels in the blood. Cholecystitis is not associated with raised serum bilirubin, as it is an inflammation; however, serum amylase levels increase with this condition. In bone tumors there will be an increase in serum alkaline phosphatase due to increased turnover of the bone
Which neurotransmitter levels are elevated during non-rapid eye movement (NREM) sleep? Select all that apply a. Serotonin b. Melatonin c. Acetylcholine d. Norepinephrine e. Gamma aminobutyric acid (GABA)
Answer: a, e Sleep consist of two phases: rapid eye-movement (REM) sleep and and NREM sleep. Serotonin and GABA are Neuro transmitters that induce AND REM sleep; therefore one can find high levels of these Neuro transmitters during AND REM sleep. Melatonin is a horror mode, not a neural transmitter, and its levels generally increase at night. The levels of neural transmitters such as acetylcholine and no rip in it for an increase during REM sleep.
For the patient experiencing pain due to osteoarthritis, the nurse finds the patient has a below normal blood pressure and pulse rate. Which nursing documentation reflects the assessment findings? a. The patient has acute pain b. The patient has chronic pain c. The patient has visceral pain d. The patient has referred pain
Answer: b Osteoarthritis is a degenerative disorder caused by joint information causing pain that is a cute in the beginning but chronic if left untreated. A decrease in systolic blood pressure and pulse rate below normal indicate that the patient has chronic pain. Acute pain of quick answer and is caused by a new occurrence. A patient who has increased blood pressure and pulse rate may have a cute pain. Visceral pain refers to the pain in the smooth internal organs, such as the heart, lungs, kidneys, and gallbladder. Because bone is a somatic peripheral Oregon, the pain can be reported as somatic and not this role. Referred pain occurs when the pain is felt in a different location from the area affected.
In discussions with her coworkers, nurse spreads a false rumor that her manager is addicted to opioids my pain medication it has been pulled for them from the supply. Which offense has the nurse committed? a. Libel b. Slander c. Malpractice d. Unintentional Tort
Answer: b Slander spoken defamation of character. The nurse is verbally spreading defamatory rumors and is this committing slander. Written defamation of character is libel. The nurses verbalizing the accusation but not documenting it; therefore the nurse has not committed liable. Malpractice is negligence at a professional level; this nurses behavior does not constitute negligence. Unintentional torts are acts that can cause harm to the patient. The nurse's accusations will not directly harm patients. Slander = Spoken
`The nurse is caring for a patient diagnosed with anxiety and improper sleep patterns. Which medication does the nurse expect to be prescribed to the patient? a. Zaleplon b. Doxepin c. Zolpidem d. Modafinil
Answer: b Sleep disorders are common in patients with depression. Depressive thoughts in the daytime build up stress and cause emotional arousal during rapid eye movement sleep, thus affecting the patient's sleep patterns. A tricyclic antidepressant such as dose-in elevates the mood of a depressed person by increasing the levels of neurotransmitters such as serotonin, norepinephrine, acetylcholine, and histamine, thereby inducing sleep. Zaleplon induces sleep but may also arouse suicidal thoughts in patients with depression. Zolpidem may cause depression and is thus contraindicated. Modafinil is a wake-promoting drug that is sed in the treatment of narcolepsy.
Child immunization may cause discomfort during ministration, but the benefits of protection from disease, before the individual and society, outweigh the temporary discomfort. Which principle is involved in the situation? a. Fidelity b. Beneficence c. Nonmaleficence d. Respect for autonomy
Answer: b The musician is a clear effort to provide benefit. Beneficence refers to "doing good". Fidelity refers more to keeping promises. Non-maleficence refers to the commitment to avoid harm. Respect for autonomy refers to the commitment to include patients in the decision-making process regarding healthcare plans.
While reviewing the blood test of an infant, the nurse finds that the mean corpuscular hemoglobin concentration (MCHC) is 38 g/dL. Which inference does the nurse make from this finding? a. The infant has aplastic anemia b. The infant has a normal lab value c. The infant has signs of lead poisoning d. The infant has iron-deficiency anemia
Answer: b The normal MCHC level is 32-36 g/dL. However, an increased MCHC during infancy is a normal finding. This may be due to the higher metabolic rate and increased oxygen demand in infants. A MCHC of 38 g/dL in infants does not indicate aplastic anemia. Instead, a decreased WBC count in he body may indicate aplastic anemia. A MCHC below the normal range may indicate lead poisoning or ion-deficiency anemia in an infant.
A nurse is practicing according to the professional nursing go to bed text which action with the nurse performing accordance with the stairs of responsibility? Select all that apply a. Protecting the patient's right to privacy b. Trying to remain competent to practice c. Being responsible for delegated tasks d. Being willing to respect professional obligations e. Supporting health, safety, and rights of the patients
Answer: b, c, d To perform responsibility, nurses should strive to remain competent to practice. All nursing interventions are the responsibility of the nurse, including those that he or she has delegated. The standards of practice involving responsibility include the nurses willingness to respect professional applications and keep promises to patients. When a nurse protects a patient's right to privacy, and support the health, safety, and rights of a patient, he or she is guided by standards of advocacy, not responsibility.
Which result does the nurse expect to find in the laboratory report of a patient who has a biliary tract obstruction? Select all that apply. a. Increased albumin levels b. Increased bilirubin levels c. Increased serum creatinine levels d. Increased serum alkaline phosphate levels e. Increased serum alanine aminotransferase levels
Answer: b, d, e When a patient has a biliary tract obstruction, the liver function laboratory values will increase. This includes the serum bilirubin, serum alkaline phosphate, and serum alanine aminotransferase levels. A biliary tract obstruction does not alter the protein levels in the blood; however, a patient with dehydration will have increased serum albumin levels. The nurse may find increased serum creatinine levels in a patient who has renal failure, not a biliary obstruction.
Which time will the nurse caring for a patient scheduled for a coronary artery bypass grafting surgery select to teach breathing exercises and coffin techniques to prevent respiratory complications? a. During discharge b. After the surgery c. Before the surgery d. At the next follow-up visit
Answer: c Deep breathing and coughing exercise or talk to the patient to prevent respiratory complications after surgery. They should be taught preoperatively so that the patient learned the techniques and can perform them properly after surgery. The patient needs to start doing these exercises immediately after surgery. Due to physical discomfort and fatigue after surgery, the patient might not be able to learn the exercises properly. Teaching breathing exercises at discharge or at the follow up visit would not benefit this patient.
In which stage of non-rapid eye movement (NREM) sleep does enuresis occur? a. Stage 1 b. Stage 2 c. Stage 3 d. Stage 4
Answer: c NREM has four stages. Enuresis occurs in stage 3 of NREM of the sleep cycle. Stage 3 lasts for approximately 15 to 30 minutes. It is the deepest stage of sleep. Enuresis dose not occur in stages 1 or 2. There is not a Stage 4 of NREM.
Which assessment finding indicates the presence of pneumothorax? a. Absence of lung sounds on the affected side b. Inability to auscultate tracheal breath sounds c. Pleuritic pain that worries on inspiration d. Pursed-lip breathing
Answer: c Pneumothorax is caused by rapid accumulation of air in the pleural space, causing severely high intrapleural pressure. The patient may have pain as the atmospheric air irritates the pleura. The pain is greater on inspiration. Absence of lung sounds may be found in atelectasis. Inability to auscultate tracheal breath. sounds and pursed-lip breathing are associated with chronic lung diseases.
The nurse is caring for a patient who is restless leg syndrome. Which medication does the nurse expect in the patient's prescription? a. Zaleplon b. Modafinil c. Ropinirole d. Eszopiclone
Answer: c Restless leg syndrome is a neurological disorder characterized by tingling and crawling sensations in the legs and urge to move in. The sensation is uncomfortable and disturbed sleep. Ropinirole restores the imbalance in the dopamine levels in the brain; it may improve sleep by decreasing these unpleasant feelings in the legs. Zaleplon is a short term medication for insomnia. Modafinil is used in treating narcolepsy. Eszopiclone is used for the long-term treatment of insomnia
And most ethical dilemmas in healthcare, the solution to the dilemma requires negotiation about members of the healthcare team. Which reason describes why the nurses point of view as valuable? a. Nurses understand the principle of autonomy to guide respect for patient self-worth. b. Nurses have a scope of practice that encourages their presence during ethical discussions c. Nurses develop a relationship to the patient that is unique among all professional healthcare providers d. The nurses code of ethics recommends that a nurse be present at any ethical discussion about patient care
Answer: c The point of the question is to build confidence and even pride in the value of the special body of knowledge that a nurse requires about patients, the result of a unique relationship with them. Autonomy guides respect for the patient self-worth but does not mean a relationship has been established. The nurse is scope of practice and code of ethics encourages his or her presence during ethical discussions but does not mean that the nurse has a unique relationship with the patient.
While reviewing a patient's laboratory results, the nurse finds a blood urea nitrogen level of 30 mg/dL. Which complication does the nurse anticipate in the patient? Select all that apply. a. Liver failure b. Alcohol abuse c. Severe dehydration d. Congestive heart failure e. Acute glomerulonephritis
Answer: c, d, e A normal BUN level is between 10 and 20 mg/dL. Therefore the patient has increased BUN levels. Severe dehydration may increase the concentration of urine in the BUN level. Congestive heart failure may decrease blood flow to the kidneys and may decrease globular permeability, which may then reduce the excretion of nitrogenous compounds, resulting in increased BUN levels. A patient with acute glomerulonephritis well have increased BUN levels due to altered globular function. Liver failure and alcohol abuse will not increase BUN levels. These conditions actually decrease the levels due to malnutrition. Decreased ability of the liver to metabolize proteins in a patient with liver failure will decrease the BUN levels. Alcohol abuse causes liver damage, resulting in decrease BUN levels.
Senior nurse is discussing ethical dilemmas with colleagues. Which statement is true about ethical dilemmas? Select all that apply. a. Nurses should consider personal views while processing ethical dilemmas b. Resolving ethical dilemmas includes discussions without any contradictions c. Ethical dilemmas should be processed carefully to reduce distress and controversy d. An ethical dilemma cannot be resolved solely through scientific data e. Resolving ethical dilemmas is similar to the nursing process
Answer: c, d, e Ethical dilemmas can cause distress and controversy; to reduce that, they should be processed carefully and deliberately. And ethical dilemma cannot be resolved solely through scientific data; it requires negotiations of differences of opinions. Resolving ethical dilemmas is similar to the nursing process; it follows a methodical approach to come to a conclusion. The nurse should try to put personal views aside when working through an ethical dilemma. Resolving ethical dilemmas includes discussions and negotiation of differences of opin
Which factor with the nurse identify as likely to affect the ability of a to learn optimally? Select all that apply a. Behavior b. Health Beliefs c. Physical Strength d. Hearing Deficit e Shortness of breath
Answer: c, d, e The patient should have the required physical strength to complete the task to be learned. Hearing deficit would affect the teaching process as the patient would not fully understand what is being taught by the teacher. Physical discomfort like shortness of breath will prevent the patient from focusing on the teaching process. Behavior and health leaves are factors that affect the motivation of the patient to learn.
A patient's laboratory reports indicate that the red blood cell count is 3.8 cells/mm3. The nurse finds that the patient's anemia is due to hemolysis. Which laboratory finding is consistent with the nurse's conclusion? a. Increased ketone levels b. Increased glucose levels c. Increased creatinine levels d. Increased urobilinogen levels
Answer: d Hemolysis, or increased destruction of erythrocytes, results in hemolytic anemia. The patient may have increased urobilinogen levels due to the increased destruction of red blood cells. Hemolytic anemia will not increased ketone or glucose levels. Increased glucose levels, or hyperglycemia, indicate diabetes mellitus. Increased red blood cell destruction does not increase creatinine levels in the blood. Creatinine levels may increase in a patient with acute glomerulonephritis.
the nurse is caring for a patient who reports chronic insomnia. Which drug does the nurse expect to be prescribed to the patient? a. Zaleplon b. Zolpidem c. Modafinil d. Eszopiclone
Answer: d Insomnia for a month or longer is known as chronic insomnia. Eszopliclone is useful for the long-term treatment of insomnia. Zaleplon and zol[idem are short-term medications that are useful in inducing sleep. Modafinil is useful in treating narcolepsy
When teaching a group about nociception, which participant's statement indicates effective learning? a. "The C-fibesr are small and unmyelinated, and they cause sharp and acute pain." b. "The A-delta fibers are large and myelinated, and they care long-lasting pain." c. "Beta endorphins influence pain perception as well as emotional aspects" d. "Pain impulses move form the dorsal root ganglia to the spinal dorsal horn."
Answer: d Nociception refers to sensory stimuli that are transmitted from peripheral to the central nervous system. The tissue carries impulses from the peripheral organs to the cluster of nerve fibers that live below the spinal cord called the dorsal route ganglion. These impulses then moved the dorsal end of the spinal cord, which is known as a spinal dorsal horn. The impulses further move through the spinothalamic tract and thalamus and then reach the cerebral cortex. C-fibers are small and unmyelinated , and they cause diffuse, dull, and long lasting pain, not sharp, acute pain. A-delta fibers are large and myelinated, and they cause acute, sharp pain, not long lasting pain.Beta endorphins act on the peripheral and central nervous system to reduce pain, whereas enkephalins influence the perception of pain and the emotional aspect of how the pain is felt
A patient experiencing severe pain is diaphoretic after standing severe injuries in a motor vehicle accident. On assessment, the patient's heart rate is increased, people are dilated, and blood pressure is decreased. Which finding is caused by the stimulation of the parasympathetic nervous system? a. Diaphoresis b. Dilation of pupils c. Increased heart rate d. Decreased bloop pressure
Answer: d Superficial pain or mild to moderate pain stimulates the sympathetic nervous system. The parasympathetic nervous system is stimulated by continuous, deep, or severe pain involving visceral organs. Stimulation of the parasympathetic nervous system has an inhibitory effect on the body systems and causes a decrease in blood pressure. The sympathetic nervous system prepares the body for a fight or flight response. Diaphoresis, dilation of pupils, and increased heart rate are caused by the stimulation of the sympathetic system.
Upon reviewing a patient's urinalysis report, the nurse notes proteinuria. Which condition would the nurse anticipate from these findings? a. Alcoholic cirrhosis b. Trauma to the kidneys c. Acute tubular necrosis d. Glomerulonephritis
Answer: d The presence of protein the urine is known as proteinuria. This may happen as a result of reduced protein absorption by the glomerulus, which is part of the nephron. Therefore, the nurse anticipates that the patient has glomerulonephritis. Cirrhosis is a liver disorder that is associated with the presence of bilirubin in the urine. Renal trauma and acute tubular necrosis are associated with the presence of red blood cells, not protein, in the urine.
