Which nursing intervention is an independent function of the professional nurse?

Correct Answer: A

Rationale: Administering oral analgesics is an independent function of the professional nurse. Independent nursing interventions are those that a nurse is licensed to initiate based on their knowledge and skills without needing an order from a healthcare provider. Nurses are educated and trained in medication administration, including oral analgesics, and can independently assess the need for and safely administer them within their scope of practice. While requesting diagnostic studies, teaching perineal care, and providing wound care are essential nursing interventions, they typically require some form of healthcare provider's order or supervision, making them more interdependent activities.

Correct Answer: D

Rationale: The correct nursing intervention that is written correctly is option D. The intervention "Assist to ambulate for 10 minutes at 8 AM, 2 PM, and 6 PM" is clear, specific, and provides a specific time frame for the activity. It is important in nursing documentation to be precise and clearly state the details of the intervention to ensure effective communication among healthcare team members. This intervention also specifies the frequency and duration of the ambulation activity, which helps in ensuring continuity of care and proper execution of the intervention for the patient.

Correct Answer: C

Rationale: In this scenario, the emergency department nurse would be most likely to suspect that the woman has been battered based on the presence of injuries on various parts of her body that are in different stages of healing. This pattern of injuries, known as the "battered woman syndrome," is a red flag for domestic violence. The varying stages of healing indicate that the injuries are not from a single accidental fall down the stairs but rather from repeated incidents of physical abuse. Additionally, the fact that the injuries are in different locations on the body further suggests that they are not the result of a single traumatic event. This situation warrants further investigation and intervention to ensure the safety and well-being of the pregnant woman and her unborn child.

Correct Answer: B

Rationale: B. Informing the patient about pro-choice support groups: It is important for the clinic nurse to provide patients with information about different support resources available, including pro-choice support groups, to ensure they have access to a variety of perspectives and guidance.

Correct Answer: B

Rationale: The correct statement by the patient that demonstrates understanding of the laparoscope-assisted vaginal hysterectomy procedure is "I'm relieved that I won't have any visible scars on my abdomen." This is a relevant and accurate statement as the procedure involves minimal scarring due to the use of small incisions in the abdomen rather than a large incision. It shows understanding of one of the benefits of this surgical approach. The other statements are not accurate or relevant to the procedure.

Correct Answer: D

Rationale: Tamoxifen is a hormonal medication that can be used in premenopausal patients without the concurrent use of ovarian suppression. It is a selective estrogen receptor modulator (SERM) that acts by blocking estrogen receptors in breast tissue, thereby inhibiting the growth of hormone-sensitive breast cancer cells. Tamoxifen is commonly prescribed for hormone receptor-positive breast cancer in both premenopausal and postmenopausal women. Unlike aromatase inhibitors (e.g., letrozole and exemestane) which require ovarian suppression in premenopausal patients, tamoxifen can be used as monotherapy in premenopausal patients due to its different mechanism of action. Elacestrant is a selective estrogen receptor degrader (SERD) and not commonly used in clinical practice for this indication.

Correct Answer: A

Rationale: When a patient has a urinary tract infection (UTI) they may have increased white blood cells (leukocytes) in their urine. White blood cells are a sign of inflammation and infection in the urinary tract. It is a common finding in patients with UTIs. Symptoms such as increased urination and pain with urination are classic signs of a UTI. Therefore, the nurse would expect to see white blood cells in the urine of a patient with a UTI.

Correct Answer: A

Rationale: Analysis is the step of the nursing process being used when the nurse decides whether an ethical dilemma exists. During the analysis step, the nurse gathers and interprets data to make sense of a clinical situation. In the case of ethical dilemmas, the nurse would assess the situation, gather relevant information, and analyze it to determine if there is a conflict in values, beliefs, or principles, which would classify it as an ethical dilemma. Once the nurse identifies the existence of an ethical dilemma through analysis, they can then move on to the planning phase to decide on a course of action.

Correct Answer: D

Rationale: In many Asian cultures, avoiding eye contact can be a sign of respect, modesty, or a way to show deference to authority figures. Making direct eye contact during a conversation, especially with someone in a position of authority like a healthcare provider, can be seen as disrespectful or confrontational. Understanding and respecting these cultural beliefs is crucial when providing care to patients from diverse backgrounds. It is important for healthcare providers to be aware of these cultural differences and adjust their communication styles accordingly to ensure effective and culturally sensitive care.