Mrs. Kwame is scheduled for a hysterectomy for stage III cancer of the cervix. What information will help her request appropriate p.r.n. pain medication?

Correct Answer: A

Rationale: In the context of a patient scheduled for a hysterectomy due to stage III cervical cancer, understanding the prescribed drug action (Option A) is crucial for Mrs. Kwame to request appropriate p.r.n. pain medication. Explanation of why Option A is correct: Understanding the prescribed drug action will help Mrs. Kwame know how the pain medication works, its potential side effects, and when it is appropriate to request it. This knowledge empowers her to make informed decisions about her pain management, ensuring she receives the most effective relief while minimizing risks. Explanation of why other options are wrong: - Option B (Support and reassurance from the nurse): While emotional support is essential in healthcare, it is not directly related to Mrs. Kwame's ability to request appropriate pain medication based on understanding drug action. - Option C (The nurse's beliefs and preferences regarding use of narcotics): Mrs. Kwame's pain management should be based on her medical needs and not the nurse's personal beliefs. - Option D (Prescribed medication should be administered freely during the first 24 hours postoperatively): This statement is not accurate as medication administration should be based on individualized assessment and prescription, not blanket administration policies. Educational context: Understanding the rationale behind selecting the correct answer helps students grasp the importance of patient education in pain management. By explaining the relevance of knowing the drug action, students learn the significance of informed decision-making in healthcare. This case emphasizes the need for patient-centered care and the role of education in empowering patients to actively participate in their treatment.

Correct Answer: B

Rationale: The correct answer is B) Family history of breast cancer. Educational Rationale: Family history of breast cancer is a well-established risk factor for developing the disease. Women with a first-degree relative (mother, sister, daughter) who has had breast cancer are at higher risk themselves. This is due to the presence of genetic mutations that can be passed down in families, increasing the likelihood of developing breast cancer. Option A) Older than 30 years of age is not a specific risk factor for breast cancer. While age is a factor as risk increases with age, it is not as significant as having a family history of the disease. Option C) African-American heritage is a factor that may influence the incidence and aggressiveness of breast cancer but is not a common risk factor that is typically highlighted in educational materials. Option D) Breast tenderness without any sensation is not a known risk factor for breast cancer. Breast tenderness can be due to various reasons, such as hormonal changes, but it is not directly linked to an increased risk of developing breast cancer. Educational Context: Educating women about the risk factors for breast cancer is crucial in promoting awareness, early detection, and prevention. By understanding the common risk factors like family history, individuals can take proactive steps such as regular screenings and lifestyle modifications to reduce their risk or detect the disease at an early, more treatable stage. It is essential for nurses and healthcare providers to provide accurate information to empower women in making informed decisions about their health.

Correct Answer: C

Rationale: In the context of prostate cancer risk factors, an inactive lifestyle, as mentioned in option C, is a significant contributor. Regular physical activity has been shown to reduce the risk of developing prostate cancer by helping to maintain a healthy weight, regulate hormone levels, and boost the immune system. Living an inactive lifestyle leads to obesity, which is associated with increased inflammation and higher levels of certain hormones that can contribute to cancer development. Options A, B, and D are incorrect because they do not directly impact prostate cancer risk. A low-fat diet, as in option A, is generally considered a healthy choice, but its direct link to prostate cancer risk is not as strong as the impact of physical activity. Alcohol and caffeine consumption, as in option B, may have some associations with certain health conditions, but they are not primary risk factors for prostate cancer. Smoking habits, as in option D, are more strongly associated with lung and other types of cancer, not specifically prostate cancer. In an educational context, it is crucial for students to understand the specific risk factors for various diseases, such as prostate cancer, to make informed decisions about their lifestyle choices. By learning about the impact of physical activity on cancer risk, students can prioritize regular exercise as part of a healthy lifestyle to reduce their chances of developing prostate cancer later in life. This knowledge empowers individuals to take proactive steps towards cancer prevention and overall well-being.

Correct Answer: A

Rationale: In this scenario, the best task to delegate to an experienced LPN is monitoring the client's dressing for any signs of bleeding (Option A). This task falls within the scope of practice for an LPN as it involves close observation and assessment of the surgical site without making any clinical judgments or decisions. LPNs are trained to recognize signs of bleeding or infection and can promptly report any concerns to the appropriate healthcare provider. Option B, documenting the initial assessment, requires critical thinking and clinical judgment, which is typically within the scope of practice for registered nurses. Option C, calling the client's status report to the charge nurse, involves communication and decision-making that are better suited for a registered nurse who has a broader scope of practice. Option D, teaching the client about the importance of using pain medication, involves patient education and assessment of understanding, which are roles typically performed by registered nurses or other healthcare providers with specialized training in patient education. From an educational perspective, it is important for healthcare providers to understand delegation principles based on scope of practice, competency, and patient safety. Understanding which tasks can be appropriately delegated to different members of the healthcare team ensures effective and efficient patient care delivery. Practice scenarios like this help reinforce these concepts and promote safe delegation practices in healthcare settings.

Correct Answer: B

Rationale: In this scenario, the correct answer is option B: Perineal pad saturated after the first 30 minutes. This is the most concerning assessment data because it indicates excessive bleeding following the D&C procedure. Post-D&C bleeding can lead to complications such as hemorrhage, hypovolemic shock, and the need for immediate intervention to stabilize the client's condition. Option A, a blood pressure of 162/90, while elevated, is not as concerning as active bleeding. Option C, an O2 saturation of 91%-95%, is also elevated but not as urgent as addressing bleeding. Option D, sharp, continuous, level 8/10 abdominal pain, could be expected postoperatively but does not pose an immediate threat to the client's life like uncontrolled bleeding does. From an educational standpoint, understanding the significance of assessing and managing postoperative bleeding is crucial for nurses working in perioperative and post-anesthesia care settings. Recognizing abnormal bleeding and taking prompt action to address it can prevent serious complications and ensure patient safety. Nurses must prioritize assessments based on the urgency of potential risks to provide timely and appropriate care to their patients.