Midterm - TERM2 Proprac|QUESTIONS WITH 100% CORRECT ANSWERS|VERIFIED|49 PAGES

A patient requests a prescription for birth control pills to control severe abdominal cramping and headaches during her menstrual periods. Which action should the nurse take first? Determine whether the patient is sexually active. Teach about the side effects of oral contraceptives. Take the patient's personal and family health history. Suggest nonsteroidal antiinflammatory drugs (NSAIDs) ANSWER- Take the patient's personal and family health history. Feedback: Oral contraceptives may be appropriate to control this patient's symptoms,but the patient's health history may indicate contraindications to oral contraceptive use.Because the patient is requesting contraceptives for management of dysmenorrhea,whether she is sexually active is irrelevant. Because the patient is asking for birth control pills, responding that she should try NSAIDs is nontherapeutic. The patient doesn't need teaching about oral contraceptive side effects at this time. Which finding indicates a need to contact the health care provider before the nurseadministers metformin (Glucophage)? The patient's blood glucose level is 174 mg/dL. The patient is scheduled for a chest x-ray in an hour. The patient has gained 2 lb (0.9 kg) in the past 24 hours. The patient's estimated glomerular filtration rate is 42 mL/min. ANSWER- D. The patient's estimated glomerular filtration rate is 42 mL/min Feedback: The glomerular filtration rate indicates possible renal impairment, and metformin should not be used in patients with significant renal impairment. The other findings are not contraindications to the use of metformin. Which assessment data for a patient who has Guillain-Barré syndrome will require the nurse's most immediate action? The patient's sacral area skin is reddened. The patient reports severe pain in the feet. The patient is continuously drooling saliva. The patient's blood pressure (BP) is 150/82 mm Hg. ANSWER- C. The patient is continuously drooling saliva. Feedback: Drooling indicates decreased ability to swallow, which places the patient atrisk for aspiration and requires rapid nursing and collaborative actions such assuctioning and possible endotracheal intubation. The foot pain should be treated with appropriate analgesics, the BP requires ongoing monitoring, and the skin integrityrequires intervention, but these actions are not as urgently needed as maintenance ofrespiratory function. When a patient who takes metformin (Glucophage) to manage type 2 diabetes develops an allergic rash from an unknown cause, the health care provider prescribes prednisone. What should the nurse anticipate? The patient may need a diet higher in calories while receiving prednisone. The patient may develop acute hypoglycemia while taking the prednisone. The patient may require administration of insulin while taking prednisone. The patient may have rashes caused by metformin-prednisone interactions. ANSWER- C. The patient may require administration of insulin while taking prednisone. Feedback: Glucose levels increase when patients are taking corticosteroids, and insulinmay be required to control blood glucose. Hypoglycemia is not a side effect ofprednisone. Rashes are not an adverse effect caused by taking metformin andprednisone simultaneously. The patient may have an increased appetite when takingprednisone but will not need a diet that is higher in calories The nurse interviews a patient scheduled to undergo general anesthesia for a bilateralhernia repair. Which information is most important to communicate to the surgeon andanesthesiologist before surgery? The patient drinks 3 cups of coffee every day. The patient stopped taking aspirin 10 days ago. The patient's father died after general anesthesia for abdominal surgery. The patient drank 4 ounces of apple juice 6 hours before coming to the hospital. ANSWER- C. The patient's father died after general anesthesia for abdominal surgery. Feedback: The information about the patient's father suggests that there may be afamily history of malignant hyperthermia and that precautions may need to be taken toprevent this complication. Current research indicates that having clear liquids 3 hoursbefore surgery does not increase the risk for aspiration in most patients. Patients areinstructed to discontinue aspirin 1 to 2 weeks before surgery. The patient should beoffered caffeinated beverages postoperatively to prevent a caffeine-withdrawalheadache, but this does not have preoperative implications. infection prevention BEST Intervention ANSWER- Hand washing - BEFORE AND AFTER EVERYTHING PPE Gloves ANSWER- For touching blood, body fluids, secretions, excretions, contaminated items For touching mucous membranes and non-intact skin PPE Gown ANSWER- During procedures and patient care activities when contact of clothing/exposed skin with blood / body fluids, secretions, and excretions is anticipated PPE Mask, eye protection (goggles), face shield: ANSWER- During procedures and patient care activities likely to generate splashes or sprays of blood, body fluids, secretions, especially suctioning, endotracheal intubation Needles and other sharps ANSWER- Do not recap, bend, break or hand-manipulate used needles If recapping is required, use a one handed scoop technique or capping block Use safety features when available Place used sharps in puncture resistant container _____________________ and _____________________ are the most effective strategies for diseases of a chronic nature including HIV ANSWER- Primary prevention and health promotion Benefits of prevention ANSWER- Increase safer sexual practices Decreasing risks: Drug use Decreasing risks: Perinatal transmission Decreasing risk: Work HAI Patient Education ANSWER- Take only the antibiotics that are prescribes to you Wash your hands Follow medication direction Do not request an antibiotic for Flu or colds Finish Antibiotic DO NOT Take leftover antibiotic antiretroviral therapy ANSWER- ART can significantly slow HIV progression, but it Is complex Has side effects Does not work for everyone and Is expensive When do you start ART ANSWER- ART is recommended as soon as possible after diagnosis Patient readiness is most important concern Nurses can educate and provide support, including medication adherence counseling Adherence to drug regimens is critical to prevent x3 most important things ANSWER- Disease progression Opportunistic disease Viral drug resistance An individualized approach is best Which lab value would the nurse expect to see when a patient with a history of unsafe sexual practices reports chronic fatigue, diarrhea, difficulty swallowing, and consistent oral lesions with infection? Positive human immunodeficiency virus (HIV) antibody/antigen assay Detectable viral load Decreased CD4 cell count Increased white blood cell (WBC) count Decreased liver function tests Increased cholesterol and triglycerides ANSWER- Positive human immunodeficiency virus (HIV) antibody/antigen assay Increased cholesterol and triglycerides Detectable viral load Decreased CD4 cell count Which action would the nurse encourage in a patient with a negative human immunodeficiency virus (HIV)/antigen test to help address risk and prevention? Regularly schedule HIV testing. Use barrier protection whenever having sex with a new partner. Avoid sharing drug equipment. Increase social engagement and activities. ANSWER- Avoid sharing drug equipment Which information would the nurse provide regarding reducing risks for a patient who reports engaging in a new same-sex relationship and is concerned about possible human immunodeficiency virus (HIV) exposure?