In developing a discharge plan for a patient requiring home-care services, what is important to assess?

Correct Answer: B

Rationale: In the context of developing a discharge plan for a patient requiring home-care services, assessing the availability of needed community services (Option B) is crucial. This is because ensuring the patient has access to necessary support services in the community is essential for their successful transition from hospital to home. By assessing the availability of these services, healthcare providers can coordinate appropriate care, such as home health aides, physical therapy, or meal delivery services, to meet the patient's needs and promote their recovery and well-being. Options A, C, and D are incorrect in this scenario. While the patient's nursing diagnosis (Option A) is important for guiding care planning, it does not directly address the practical aspect of coordinating community services for home care. Assessing the patient's functional abilities (Option C) is essential but focuses more on the individual patient's physical capabilities rather than the external support services needed for home care. Similarly, evaluating the patient's family dynamics (Option D) is important for understanding the social support available, but it does not directly address the logistical aspect of arranging community services. In an educational context, understanding the importance of assessing the availability of community services when developing a discharge plan reinforces the holistic approach to patient care. It emphasizes the need for comprehensive planning that considers not only the patient's medical condition but also the practical support services required for a successful transition to home care. This knowledge is essential for nursing students and healthcare professionals to ensure quality patient-centered care and promote positive health outcomes.

Correct Answer: D

Rationale: In this scenario, the correct answer is option D: Elevation in temperature is consistent with normal postoperative recovery. Postoperative patients commonly experience a temporary elevation in temperature due to the body's natural response to surgery, known as the inflammatory phase of wound healing. This transient increase in temperature is a normal part of the healing process and does not necessarily indicate an infection. Option A is incorrect because a decrease in blood pressure alone does not always indicate imminent shock. Shock is a complex physiological state involving inadequate tissue perfusion, which may present with other signs and symptoms beyond just a decrease in blood pressure. Option B is incorrect because an elevated temperature in the immediate postoperative period is more likely related to the body's response to tissue trauma rather than a wound infection. Wound infections typically manifest with localized signs such as redness, swelling, warmth, and purulent drainage. Option C is incorrect as a decrease in blood pressure postoperatively is not consistent with hypertension, which is characterized by persistently elevated blood pressure readings. Educationally, understanding the normal physiological responses to surgery and differentiating between expected postoperative changes and signs of complications is crucial for nurses and healthcare providers to provide appropriate care and interventions for postoperative patients. It is essential to monitor vital signs closely, interpret them accurately, and respond appropriately to ensure optimal patient outcomes.

Correct Answer: A

Rationale: In the context of pharmacology and nursing care, the most appropriate nursing action for Mr. Jones' persistent productive cough would be to increase intake of warm liquids (Option A). This is because warm liquids can help soothe the throat and facilitate the loosening of mucus, making it easier for Mr. Jones to expectorate and alleviate his cough. Option B, administering narcotic cough medication, is not the most appropriate initial nursing action for a productive cough, as it may suppress the cough reflex and hinder the body's natural mechanism of clearing the airways of mucus. Monitoring the amount of sputum produced each day (Option C) is relevant in assessing the effectiveness of interventions, but it is not the most immediate nursing action to address Mr. Jones' current symptom of a persistent productive cough. Placing the patient on strict bed rest (Option D) may not directly address the cough itself and could potentially lead to complications such as pneumonia or deconditioning. In an educational context, understanding the rationale behind selecting the most appropriate nursing action for a specific symptom like a persistent productive cough is essential for providing safe and effective patient care. Nurses need to prioritize interventions based on evidence-based practices to promote optimal patient outcomes.

Correct Answer: B

Rationale: In this scenario, the most appropriate response to Mr. Brown suspecting tuberculosis is option B: "Have you ever had a skin test for tuberculosis?" This response is correct because a skin test, such as the Mantoux test, is a common diagnostic tool for tuberculosis. A positive result would indicate exposure to the bacteria that causes tuberculosis and further testing and treatment would be necessary. Option A is incorrect because tuberculosis can be asymptomatic in some individuals, especially in the early stages of infection. Waiting for symptoms to appear before considering tuberculosis could delay diagnosis and treatment. Option C is incorrect because while a chest x-ray can show signs of tuberculosis like lung involvement, it is not the primary diagnostic tool for detecting the infection itself. Option D is incorrect because even if Mr. Brown's neighbor has been following a treatment regimen, it does not guarantee that Mr. Brown could not be infected. Tuberculosis is an infectious disease that can spread through the air, and contact with an infected individual can still pose a risk. In an educational context, it is crucial for healthcare providers to understand the appropriate diagnostic procedures for tuberculosis, including the use of skin tests and other confirmatory tests like sputum cultures. Early detection and treatment of tuberculosis are essential to prevent the spread of the disease and improve patient outcomes.

Correct Answer: D

Rationale: In the context of pharmacology, understanding the principles of respiratory care and the use of suction devices is crucial for nursing practice. In this scenario, the correct answer is D) The patient's lung has reexpanded. When there is no bubbling in the suction control chamber, it indicates that the negative pressure is not being generated, which in turn suggests that the lung has reexpanded and there is no air leak or obstruction in the system. Option A) Excessive negative pressure (suction) is incorrect because if there was excessive negative pressure, it would likely cause bubbling in the suction control chamber, not the absence of bubbling. Option B) A leak somewhere in the drainage system, as within the patient, is incorrect as well because a leak would lead to air bubbling in the chamber. Option C) A kink or plug in the drainage tubing is also incorrect as it would obstruct the flow and possibly cause bubbling. Educationally, this question highlights the importance of understanding the principles of chest tube management and how to interpret the findings in the suction control chamber. It emphasizes the need for nurses to be able to assess and troubleshoot issues related to chest tubes and drainage systems to ensure optimal patient care.