A patient with a history angina pectoris brought by to the Emergency Department complaining of severe chest pain. The patient informs the nurse that he did not take nitroglycerine tablet. Which of the following assessment findings must concern the nurses MOST before administering nitroglycerine?
Answer(s): D
Patient History: The patient has angina pectoris, which means they have episodes of chest pain due to reduced blood flow to the heart muscle. Nitroglycerin is a common medication used to relieve this pain by dilating blood vessels.Nitroglycerin Mechanism: Nitroglycerin works by relaxing and widening blood vessels, which decreases the workload on the heart and increases blood flow to the heart muscle. This process typically lowers blood pressure.Assessment Concerns:Heart rate of 90 bpm: This is within the normal range and does not typically contraindicate the use of nitroglycerin.Blood sugar of 12 mmol/L: Elevated blood sugar is concerning but not directly affected by nitroglycerin administration.Blood pressure of 190/110 mmHg: This is high and nitroglycerin can help reduce it. High blood pressure is often treated with nitroglycerin.Blood pressure of 80/60 mmHg: This is hypotension (low blood pressure). Since nitroglycerin lowers blood pressure further, administering it to a patient with already low blood pressure can lead to severe hypotension, which is life-threatening.Conclusion: The most concerning finding is the low blood pressure (80/60 mmHg) because administering nitroglycerin in this situation can further lower the blood pressure to dangerous levels.
NCLEX-RN review guides, pharmacology textbooks, clinical guidelines on the management of angina pectoris and nitroglycerin use.
A circulating nurse is caring for a patient who is undergoing to laparotomy under a general anesthesia in the Operating Room.What is the PRIORITY nursing diagnosis the circulating nurse would include in the care plan?
Answer(s): C
Role of Circulating Nurse: The circulating nurse manages the overall environment of the operating room, ensuring safety and coordination among the surgical team. They are responsible for maintaining patient safety, including correct positioning.Prioritizing Safety:Risk for anxiety: While relevant, managing anxiety is typically addressed preoperatively and postoperatively, not the immediate intraoperative period. Risk for bleeding: While bleeding is a concern, it is primarily monitored and managed by the surgical team.Risk for injury related to positioning: During surgery, improper positioning can lead to nerve damage, pressure sores, and musculoskeletal injuries. The circulating nurse must ensure that the patient is correctly positioned to avoid these injuries.Risk for infection: Preventing infection is crucial, but the sterile field and surgical techniques primarily address this risk.Conclusion: The highest priority for the circulating nurse is to ensure the patient is correctly positioned to prevent any injury related to positioning, as this is a direct and immediate responsibility during the surgical procedure.
Surgical nursing textbooks, NCLEX-RN review guides, AORN (Association of periOperative Registered Nurses) guidelines.
A nurse is providing health education and instructions to a woman who has been diagnosed with mastitis.Which of the following statements if made by the woman indicates a need for further teaching?
Answer(s): A
Understanding Mastitis: Mastitis is an infection of the breast tissue that results in breast pain,swelling, warmth, and redness. It often occurs in breastfeeding women.Appropriate Management:Continue Breastfeeding: It is generally recommended to continue breastfeeding or pumping to relieve milk stasis and prevent further complications. Analgesia: Pain relief medications (analgesia) can help manage discomfort associated with mastitis. Antibiotics: Antibiotics are often prescribed, and improvement is typically seen within 24-48 hours. Warm Compression: Applying warm compresses before breastfeeding can help alleviate pain and improve milk flow.Incorrect Belief: The statement "I need to stop breastfeeding until this condition resolves" indicates a misunderstanding. Stopping breastfeeding can worsen the condition due to milk stasis and increased engorgement.Conclusion: The statement indicates a need for further teaching as continuing breastfeeding is crucial for managing and resolving mastitis.
Maternal and child nursing textbooks, NCLEX-RN review guides, clinical guidelines on breastfeeding and mastitis management.
A nurse is preparing to collect a throat culture for a middle-aged male patient. The nurse is aware that the swabbing should be collected from:
Purpose of Throat Culture: A throat culture is performed to detect the presence of pathogens (like bacteria) that cause infections such as strep throat.Correct Technique:Uvula and Soft Palate: These are not the primary sites for collecting throat cultures. Any site of Oral Cavity Mucosa: This is too broad and non-specific. Tongue and Buccal Mucosa: These sites are not typically infected in throat infections and do not provide accurate culture results.Oropharynx and Tonsillar Region: The mucosa of the oropharynx and tonsillar region is the most common site of infection in throat infections, making it the appropriate site for swabbing. Procedure: The nurse should gently swab the oropharynx and tonsillar area, avoiding the tongue and other parts of the oral cavity to avoid contamination and ensure accurate results. Conclusion: The correct site for collecting a throat culture is the mucosa of the oropharynx and tonsillar region, ensuring the detection of the causative pathogens.
Clinical nursing skills textbooks, NCLEX-RN review guides, guidelines for throat culture collection.
The aim of outcome research in nursing is to:
Outcome research in nursing focuses on understanding the results of health care practices and interventions. It aims to evaluate how effective these practices are in improving patient outcomes. This type of research is crucial for ensuring that the care provided is evidence-based and leads to the best possible health results for patients.For example, if a new wound care protocol is introduced, outcome research would measure whether patients heal faster or have fewer infections compared to the previous method. This helps in determining the effectiveness of the new protocol.
Polit, D. F., & Beck, C. T. (2017). Nursing Research: Generating and Assessing Evidence for Nursing Practice. Wolters Kluwer Health.
A nurse is caring for an adult client with cancer who is complaining of acute pain.The MOST appropriate pain assessment would be:
The most appropriate way to assess pain is by asking the client to rate their pain. Pain is a subjective experience, meaning only the person experiencing it can accurately describe its intensity and quality. This is often done using a numerical scale (0-10) where the patient rates their pain, with 0 being no pain and 10 being the worst pain imaginable.Nonverbal cues and the nurse's impression can provide additional information, but they are not as reliable as the patient's self-report. Pain relief after interventions helps evaluate the effectiveness of the pain management but does not assess the initial pain level.
McCaffery, M., & Pasero, C. (1999). Pain: Clinical Manual. Mosby.
A client with schizophrenia is placed on chlorpromazine 50 mg PO bid, and Benztropine 2 mg PO bidPRN.Which of the following nursing assessment findings would indicate a need to administer Benztropine?
Chlorpromazine is an antipsychotic medication that can cause extrapyramidal symptoms (EPS), such as muscle spasms and tremors. Benztropine is an anticholinergic medication often prescribed to manage these side effects.If a client on chlorpromazine develops muscle spasms and tremors, it indicates EPS, and administering Benztropine would help alleviate these symptoms. The other options, such as severe agitation, sore throat, or suicidal thoughts, are not directly related to the need for Benztropine.
Stahl, S. M. (2013). Stahl's Essential Psychopharmacology: Neuroscientific Basis and Practical Applications. Cambridge University Press.
A nurse is visiting an Asian family and found that both parents have cardiac problems. The nurse is aware of Asian genetic predisposition to cardiovascular diseases. The nurse assessment falls below which of the following cultural assessment category?
When assessing the health of a family, considering their genetic predispositions to certain conditions falls under the category of bio-cultural factors. These factors include genetic traits, physical characteristics, and biological variations that can influence health. In this case, the nurse's awareness of the genetic predisposition of Asian individuals to cardiovascular diseases helps in understanding the family's health risks.
Spector, R. E. (2017). Cultural Diversity in Health and Illness. Pearson.
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