Nathaniel has severe pruritus due to having hepatitis B. What is the best intervention for his comfort?

Correct Answer: A

Rationale: The correct answer is A) Give tepid baths. In the context of pruritus (itching) due to hepatitis B, tepid baths can help alleviate discomfort by soothing the skin without causing further irritation. Tepid water helps to calm the skin and reduce itching sensations, providing relief to the patient. Avoiding lotions and creams (option B) is not the best intervention as these products can sometimes exacerbate itching or cause further skin irritation in individuals with pruritus, especially in the setting of hepatitis B. Using hot water to increase vasodilation (option C) may actually worsen pruritus by further irritating the skin and increasing blood flow, which can lead to more itching and discomfort. Using cold water to decrease itching (option D) is not recommended as it can cause vasoconstriction and may not provide the same soothing effect as tepid water. In the educational context, it is important for nurses to understand the underlying causes of pruritus and how different interventions can impact patient comfort. By choosing the appropriate intervention, such as giving tepid baths in this scenario, nurses can effectively manage symptoms and improve the overall well-being of patients with hepatitis B experiencing pruritus.

Correct Answer: D

Rationale: The correct answer is option D: "My family knows that if I get tired and start vomiting, I may be getting sick again." This statement indicates patient understanding because it shows awareness of the signs and symptoms of hepatitis B recurrence, emphasizing the importance of monitoring for early indications of illness. This reflects a proactive approach to managing the condition and seeking timely medical intervention if needed. Option A is incorrect because having had hepatitis B previously does not confer immunity from future infections or reinfections. Option B is incorrect as individuals with hepatitis B are typically deferred from donating blood due to the risk of transmitting the virus. Option C is also incorrect as ongoing liver damage can occur from alcohol consumption, especially in the context of hepatitis B. From an educational perspective, this question assesses the patient's understanding of hepatitis B management and self-care measures post-discharge. It highlights the importance of patient education in promoting self-awareness, early recognition of symptoms, and adherence to follow-up care to prevent disease progression and complications.

Correct Answer: A

Rationale: The correct answer is A) "You'll need to turn from side to side every 2 hours." This response is the best because it provides accurate postoperative care instructions for the patient undergoing a cholecystectomy. Turning from side to side every 2 hours helps prevent complications such as atelectasis, pneumonia, and pressure ulcers. This action also promotes circulation, aids in respiratory function, and reduces the risk of blood clots. Option B) "It's always a good idea to rest quietly after surgery," is incorrect as complete immobility can lead to complications and delays in recovery. Mobilization and turning are essential for postoperative patients to prevent complications and promote healing. Option C) "The doctor will probably order you to lie flat for 24 hours," is incorrect as prolonged immobility in the supine position can increase the risk of respiratory complications and venous thromboembolism. Option D) "Why don't you decide about activity after you return from the recovery room?" is incorrect because decisions regarding postoperative care should be based on evidence-based practices and healthcare provider recommendations rather than patient preferences, especially in terms of essential postoperative care activities like turning and mobilization. In a medical-surgical nursing context, it is crucial to educate patients on proper postoperative care to prevent complications and promote optimal recovery. Nurses play a vital role in ensuring that patients understand and adhere to these essential care instructions to enhance their outcomes and overall well-being.

Correct Answer: A

Rationale: Rationale: The correct answer is A) Encourage her to not worry about the future. This response is not appropriate because it dismisses the patient's valid concerns and emotions regarding her illness. As a nurse, it is essential to acknowledge and validate the patient's feelings, including anxiety about the duration of her recovery. By encouraging her not to worry, we are not addressing her emotional needs and may come across as dismissive. Option B) Encouraging the patient to express her feelings about the illness is appropriate because it promotes open communication and allows the patient to share her concerns, fears, and emotions, which can be therapeutic. Option C) Discussing the effects of hepatitis B on future health problems is also appropriate as it provides the patient with important information about the potential long-term implications of her condition, enabling her to make informed decisions about her health. Option D) Providing avenues for financial counseling if she expresses the need is also appropriate as hepatitis B treatment can be costly, and addressing financial concerns can help reduce stress and promote the patient's overall well-being. In an educational context, this question highlights the importance of therapeutic communication and addressing the holistic needs of patients beyond their physical symptoms. Nurses play a crucial role in providing emotional support, education, and resources to help patients cope with their illnesses and make informed decisions about their health.

Correct Answer: A

Rationale: The correct answer is A) Give diazepam in the I.V. port closest to the vein. This is the correct option because when administering medications intravenously, it is crucial to deliver them directly into the bloodstream to ensure rapid and accurate absorption. Placing the medication in the I.V. port closest to the vein allows for immediate entry into the circulation, promoting the desired therapeutic effect. Option B) Mix diazepam with 50 ml of dextrose 5% in water and give over 15 minutes is incorrect because diluting diazepam in a solution and administering it over a prolonged period can delay the onset of action and potentially reduce the drug's effectiveness. Option C) Give diazepam rapidly I.V. to prevent the bloodstream from diluting the drug mixture is incorrect as rapid administration of diazepam can lead to adverse effects such as respiratory depression and hypotension. It is essential to administer the medication at a safe and appropriate rate to prevent harm to the patient. Option D) Question the order because I.V. administration of diazepam is contraindicated is incorrect as diazepam can be administered intravenously when prescribed by a healthcare provider. However, the method of administration must follow proper guidelines to ensure patient safety. In an educational context, understanding the correct administration of intravenous medications is crucial for nurses, especially in a medical-surgical setting. Nurses must have a solid knowledge base of pharmacology and medication administration principles to provide safe and effective care to patients. Proper administration of medications like diazepam is essential to prevent adverse reactions and promote positive patient outcomes.