A patient with a new diagnosis of amyotrophic lateral sclerosis (ALS) is overwhelmed by his diagnosis and the known complications of the disease. How can the patient best make known his wishes for care as his disease progresses?

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Question 1 of 5

A patient with a new diagnosis of amyotrophic lateral sclerosis (ALS) is overwhelmed by his diagnosis and the known complications of the disease. How can the patient best make known his wishes for care as his disease progresses?

Correct Answer: A

Rationale: The correct answer is A: Prepare an advance directive. This allows the patient to document their healthcare preferences in advance, ensuring their wishes are known and honored as the disease progresses. It provides clear instructions for healthcare providers and family members, reducing potential conflicts and ensuring the patient's autonomy is respected. Choice B is incorrect as designating an MRP focuses on medical decision-making but may not capture the full range of the patient's care preferences. Choice C involves collaboration with an organization, which may not fully represent the patient's individual wishes. Choice D is incorrect as witnesses are not always necessary for providing instructions, and the presence of witnesses does not guarantee that the patient's wishes will be followed accurately.

Question 2 of 5

A nurse is assessing a patient who presented to the ED with priapism. The student nurse is aware that this condition is classified as a urologic emergency because of the potential for what?

Correct Answer: C

Rationale: The correct answer is C: Permanent vascular damage. Priapism is a prolonged erection that can lead to ischemia and damage to the penile tissue due to impaired blood flow, potentially resulting in permanent vascular damage. Urinary tract infection (A) is unrelated to priapism. Chronic pain (B) may occur but is not the primary concern. Future erectile dysfunction (D) can result from priapism but is not as immediate or severe as permanent vascular damage. Therefore, C is the most critical consequence to address in priapism.

Question 3 of 5

The public health nurse is addressing eye health and vision protection during an educational event. What statement by a participant best demonstrates an understanding of threats to vision?

Correct Answer: C

Rationale: The correct answer is C because reviewing current medications with a pharmacist is crucial in understanding potential threats to vision. Some medications can have side effects that impact eye health. This proactive approach shows an understanding of how medication can affect vision. Choice A is incorrect because while avoiding direct sunlight is important for eye health, it does not address other potential threats. Choice B is incorrect because regular exercise, while beneficial for overall health, does not directly relate to understanding threats to vision. Choice D is incorrect because monitoring blood pressure is important for cardiovascular health but does not specifically address threats to vision.

Question 4 of 5

The advanced practice nurse is attempting to examine the patients ear with an otoscope. Because of impacted cerumen, the tympanic membrane cannot be visualized. The nurse irrigates the patients ear with a solution of hydrogen peroxide and water to remove the impacted cerumen. What nursing intervention is most important to minimize nausea and vertigo during the procedure?

Correct Answer: A

Rationale: Correct Answer: A. Maintain the irrigation fluid at a warm temperature. Rationale: 1. Warm fluid helps prevent vertigo and nausea by minimizing stimulation of the vestibular system. 2. Cold fluid can cause dizziness and nausea due to the temperature effect on the inner ear. 3. Warm fluid promotes patient comfort and relaxation during the procedure. 4. Cold fluid can lead to vasoconstriction, potentially exacerbating ear discomfort. Summary of other choices: B. Instilling short, sharp bursts of fluid can be uncomfortable and increase the risk of vertigo and nausea. C. Following with a curette may not be necessary if the irrigation effectively removes the impacted cerumen. D. Having the patient stand can increase the risk of falling or losing balance due to potential dizziness from the procedure.

Question 5 of 5

A 35-year-old father of three tells the nurse that he wants information on a vasectomy. What would the nurse tell him about ejaculate after a vasectomy?

Correct Answer: B

Rationale: The correct answer is B: There is no noticeable decrease in the amount of ejaculate even though it contains no sperm. After a vasectomy, the vas deferens, the tube that carries sperm from the testicles, is cut or blocked. This prevents sperm from being ejaculated, but the seminal fluid produced by the prostate and other glands still makes up the majority of the ejaculate volume. Therefore, although the ejaculate does not contain sperm after a vasectomy, there is no significant change in the amount of fluid ejaculated. Choice A is incorrect because the absence of sperm does not impact the volume of ejaculate. Choice C is incorrect as there is no marked decrease in ejaculate volume. Choice D is incorrect as there is no evidence to suggest that the viscosity of ejaculate changes post-vasectomy.

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