Nursing Care for Surgical and Medical Patients

Questions and Answers

What role is primarily focused on high-level clinical expertise in a specialized area of nursing?

Clinical nurse specialist (correct)

Nurse practitioner

Nurse educator

Forensic nurse

Which action would best exemplify a nurse acting in the role of client advocate?

Reminding the patient they can change their mind at any point

Asking what the patient understands about the procedure (correct)

Assuring the patient everything will be fine post-surgery

Explaining the procedure to the patient as the doctor indicated

If a nurse insists on a procedure after a client has refused it, which legal issue is the nurse most likely to face?

Battery (correct)

Unintentional tort

Assault

Invasion of privacy

When a nurse identifies an unusually large medication dosage prescribed by a provider, what should the nurse do first?

Notify the prescriber about the dosage Signup and view all the answers

What is the most likely outcome regarding a client's success in suing a nurse for administering the wrong medication dosage without harm?

The client will lose as no harm occurred. Signup and view all the answers

Which nursing role specifically involves working in legal settings and may provide expert testimony?

Forensic nurse Signup and view all the answers

Which women made significant contributions to the nursing care of soldiers during the Civil War?

Dorothea Dix Signup and view all the answers

What is a key focus of academic progression in nursing education, beyond initial RN preparation?

Encouraging continuing education opportunities Signup and view all the answers

Which scenario best demonstrates the principle of foreseeability in nursing practice?

A nurse administers an antibiotic without confirming an allergy. Signup and view all the answers

Which entities influence the curricula for nursing education most significantly?

The National Council of State Boards of Nursing Signup and view all the answers

What is a noteworthy example of continuing education for nurses?

Completing a workshop on ethical aspects of nursing Signup and view all the answers

Which activity best exemplifies health promotion?

Administering immunizations Signup and view all the answers

Who were recognized as America's first two trained nurses?

Richards & Mahoney Signup and view all the answers

At which stage of Benner's nursing expertise is a nurse with 2-3 years of experience who can coordinate multiple complex nursing care demands?

Competent Signup and view all the answers

Which professional organization originated a code specifically for nursing students?

NSNA Signup and view all the answers

Which social force is anticipated to have a substantial influence on the future supply and demand for nurses?

Aging Signup and view all the answers

What potential side effect related to sexual functioning may occur from taking certain medications?

Decreased sexual desire Signup and view all the answers

Which is a common sexual side effect experienced by individuals taking antidepressants?

Retrograde ejaculation Signup and view all the answers

In a situation where a client reports dyspareunia, what inquiry should be prioritized?

Have you discussed this with your partner? Signup and view all the answers

When discussing sexual health history, which type of medication should prompt this inquiry?

Antihypertensives Signup and view all the answers

Which component of the PLISSIT model is represented by advising a pregnant client to avoid intercourse?

Specific suggestions (SS) Signup and view all the answers

What response is most appropriate for a client feeling less feminine after a hysterectomy?

Tell me more about your feelings and concerns. Signup and view all the answers

What nursing diagnosis might be relevant to a young male client discussing changes in sexual activity without discomfort?

Knowledge deficit regarding sexual development Signup and view all the answers

Which is the most accurate description of retrograde ejaculation?

Ejaculation occurring in reverse Signup and view all the answers

Which client condition warrants the most cautious preoperative assessment due to potential complications?

A client receiving a blood transfusion with a history of transfusion reactions Signup and view all the answers

For the 85-year-old client who has had a stroke and is unable to maintain position unaided, which temperature measurement sites are the least appropriate?

Oral Signup and view all the answers

Which finding would most strongly indicate a nursing diagnosis of Ineffective Peripheral Tissue Perfusion?

Absent posterior tibial and pedal pulses Signup and view all the answers

If a client expresses dyspnea when ambulating, which assessment finding would typically be observed?

Wheezing Signup and view all the answers

What physiological signal is most indicative of a client’s death?

When the extremities are cool and dark in color Signup and view all the answers

When assessing blood pressure, the nurse notes specific sounds; which would indicate a need to re-evaluate the recorded blood pressure?

Silence between sounds Signup and view all the answers

What is the most appropriate response by the nurse when a client notices a different colored pill than usual?

I will recheck your medication orders. Signup and view all the answers

Which nursing diagnosis best fits a client with a BMI of 35?

Obesity Signup and view all the answers

Which of the following actions is appropriate for a nursing intervention when managing a client who frequently experiences asthma attacks?

Instructing on the use of a peak flow meter Signup and view all the answers

Which action by the nurse best supports a client in dying with dignity?

Relieves the client of as much responsibility for self-care as is possible Signup and view all the answers

What recommendation would a nurse give to an adult who reports a daily diet consisting of 3 cups dairy, 2 cups fruit, 2 cups vegetables, 5 ounces grains, and 5 ounces meat?

Maintain the diet; the servings are adequate Signup and view all the answers

Which of these medications listed on a client's MAR requires reconfirmation due to potential safety concerns?

Medications prescribed with narrow therapeutic ranges Signup and view all the answers

Which item listed is NOT appropriate for a full liquid diet?

Hard candy Signup and view all the answers

Which of the following best describes family support resources available during a crisis?

Resources from friends or community support Signup and view all the answers

A client’s understanding of their injuries can impact what aspect of care?

The client’s emotional coping strategies Signup and view all the answers

Which statement reflects a misconception about the signs of death?

Gag reflex absence is a definitive sign of death Signup and view all the answers

Study Notes

Contributions to Nursing During the Civil War

Significant women included Harriet Tubman, Florence Nightingale, Dorothea Dix, and Sojourner Truth.
These individuals played crucial roles in providing care to soldiers.

Influences on Nursing Education Curriculum

Influences comprise professional nursing organizations, individual state boards of nursing, and the National Council of State Boards of Nursing.
Physician groups and hospital administrators also affect curriculum development.

Continuing Education for Nurses

An example of continuing education is completing a workshop on ethical aspects of nursing, enhancing professional knowledge and skills.
Attending the hospital's orientation program does not count as continuing education.

Health Promotion Activities

Health promotion is best represented by administering immunizations, focusing on preventive care rather than treatment.
Other activities like bathing or diagnostic procedures do not primarily aim at health promotion.

America's First Trained Nurses

The first trained nurses in America were Linda Richards and Mary Mahoney, paving the way for future nursing education.

Benner's Stages of Nursing Expertise

A nurse with 2-3 years of experience who can coordinate complex care is at the "competent" stage.

Nursing Student Code of Ethics

The National Student Nurses' Association (NSNA) developed a code of ethics specifically for nursing students.

Future Factors Impacting Nursing Supply and Demand

Key social forces include aging populations, economic trends, advancements in science/technology, and telecommunications.

Health Care Advocacy Role

Nurses advocating for those affected by violence may explore psychological support resources or promote family understanding of injuries and coping mechanisms.

Signs of Death

The most accurate indicator of death would be the absence of an apical pulse, while cool extremities or unmeasurable blood pressure may be misleading.

Assisting Dying Patients Dignified

Supporting a dying client involves allowing them to make care decisions and relieving them of self-care responsibilities.

Nursing Diagnoses and Client Health

A client with a BMI of 35 is diagnosed with obesity, highlighting the need for appropriate dietary recommendations.
Daily intake measurements suggest counseling on dietary serving adjustments.

Full Liquid Diet Acceptable Foods

Foods allowed on a full liquid diet include chocolate pudding, tomato juice, cream of wheat, oatmeal, and fruit smoothies; hard candy is not permitted.

Effective client advocacy includes confirming the patient's understanding of a procedure, asking, "What were you told about the procedure you are going to have?"

Legal Implications of Nursing Actions

Insisting on procedures against a client's wishes could lead to charges of battery, a form of assault without consent.
Correct administration and monitoring of medications are crucial to avoid professional negligence lawsuits.

Appropriate Temperature Sites Post-Stroke

After a stroke, the most suitable sites for temperature assessment include axillary, tympanic, and temporal artery due to difficulties with oral and rectal routes.

Assessing Respiratory Distress

Dyspnea upon ambulation typically indicates shortness of breath or shallow respirations, requiring further evaluation.

Blood Pressure Auscultation

Blood pressure readings can include phases, recorded as systolic over diastolic, noting various sounds during measurement.

Medication Verification

When clients express concerns about medication differences, verifying medication orders is essential before administration.

Addressing Clients' Emotional Concerns

When dealing with emotional distress post-hysterectomy, validating feelings by encouraging discussion is critical for supportive care.

Assessing Sexual Health in Context

Inquiries into dyspareunia should include partner communication and the history of discomfort to understand psychosocial aspects.

PLISSIT Model Application

The recommendation for abstaining from intercourse during late pregnancy illustrates the "permission giving" aspect of the PLISSIT model.

Communication in Brief Sexual Health Discussion

Engaging young clients in discussions about sexual health should be handled sensitively, ensuring comfort and appropriate language.

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Description

This quiz focuses on various scenarios involving patients preparing for elective surgeries, receiving blood transfusions, or managing chronic conditions like asthma and strokes. Assess your knowledge on nursing interventions and patient care strategies relevant to these clinical situations.