You are caring for a 50-year-old man diagnosed with multiple myeloma; he has just been told by the care team that his prognosis is poor. He is tearful and trying to express his feelings, but he is having difficulty. What should you do first?

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Question 1 of 9

You are caring for a 50-year-old man diagnosed with multiple myeloma; he has just been told by the care team that his prognosis is poor. He is tearful and trying to express his feelings, but he is having difficulty. What should you do first?

Correct Answer: A

Rationale: The correct answer is A: Ask if he would like you to sit with him while he collects his thoughts. Rationale: 1. Active listening: By offering to sit with him, you show empathy and support his emotional expression. 2. Respect his autonomy: Asking if he would like you to sit allows him to make a choice about what support he needs. 3. Nonjudgmental approach: Sitting with him creates a safe space for him to share his feelings without feeling rushed or judged. Summary: B: Leaving abruptly may make him feel abandoned in a vulnerable moment. C: While spiritual support can be beneficial, it may not address his immediate emotional needs. D: Reassurance is important but may not be as effective as actively listening and offering support in this context.

Question 2 of 9

A child goes to the school nurse and complains of not being able to hear the teacher. What test could the school nurse perform that would preliminarily indicate hearing loss?

Correct Answer: C

Rationale: The correct answer is C: Whisper test. The nurse can perform a whisper test by whispering a series of numbers or words at a distance from the child to see if they can repeat them accurately. If the child struggles to hear and repeat the whispered words, it could indicate hearing loss. Rationale: A: Audiometry is a comprehensive hearing test that measures the range and sensitivity of hearing, not suitable for a quick preliminary assessment. B: Rinne test and D: Weber test are both tuning fork tests used to assess conductive and sensorineural hearing loss, not ideal for a quick initial screening of hearing loss. Summary: The Whisper test is the most suitable choice as it provides a quick and simple way to preliminarily assess hearing loss by evaluating the child's ability to hear and repeat whispered sounds accurately.

Question 3 of 9

After contributing to the care of several patients who died in the hospital, the nurse has identified some lapses in the care that many of these patients received toward the end of their lives. What have research studies identified as a potential deficiency in the care of the dying in hospital settings?

Correct Answer: A

Rationale: The correct answer is A. Research studies have consistently shown that families' needs for information and support often go unmet in hospital settings when caring for dying patients. This is a crucial deficiency as effective communication and support for families can greatly impact the quality of care provided to the dying patient. When families are not adequately informed and supported, it can lead to increased stress, confusion, and dissatisfaction with the care provided. Choices B, C, and D are incorrect because they do not address the specific deficiency identified in research studies. While pain control, communication, and attention from caregivers are important aspects of end-of-life care, the primary focus in this scenario is on the unmet needs of families for information and support. Ignoring families' needs can have significant negative consequences on the overall care provided to the dying patient.

Question 4 of 9

A nurse is developing a plan to reduce data entryerrors and maintain confidentiality. Which guidelines should the nurse include? (Select all that apply.)

Correct Answer: B

Rationale: The correct answer is B: Implement an automatic sign-off. This guideline helps reduce data entry errors by ensuring that all entries are completed and saved before exiting the system, thus maintaining confidentiality. Bypassing the firewall (A) would compromise data security. Creating a password with just letters (C) may not be secure enough. Using a programmed speed-dial key when faxing (D) is unrelated to reducing data entry errors or maintaining confidentiality.

Question 5 of 9

A patient presents to the emergency department with paraphimosis. The physician is able to compress the glans and manually reduce the edema. Once the inflammation and edema subside, what is usually indicated?

Correct Answer: B

Rationale: The correct answer is B: Circumcision. Paraphimosis occurs when the foreskin is retracted behind the glans and cannot be returned to its original position. Once the inflammation and edema subside, circumcision is typically indicated to prevent recurrence. This procedure removes the foreskin, reducing the risk of future paraphimosis episodes. Needle aspiration of the corpus cavernosum (A) is not indicated for paraphimosis. Abstinence from sexual activity for 6 weeks (C) is not a standard treatment for paraphimosis. Administration of vardenafil (D) is used for erectile dysfunction and not indicated for paraphimosis.

Question 6 of 9

The nurse is assessing a patient for nutritional status. Which action will the nurse take?

Correct Answer: D

Rationale: The correct answer is D, combining multiple objective measures with subjective measures. This approach provides a comprehensive assessment of the patient's nutritional status by incorporating both quantitative data (objective measures) such as weight, BMI, and laboratory values, as well as qualitative information (subjective measures) like dietary history and appetite changes. By combining these measures, the nurse can obtain a more holistic view of the patient's nutritional status, allowing for better identification of nutritional deficiencies or excesses. This method enhances the accuracy and reliability of the assessment compared to relying solely on one type of measure. Choice A is incorrect because nutritional assessment is crucial even in the presence of chronic disease to address potential malnutrition risks. Choice B is incorrect as the Mini Nutritional Assessment is not intended for pediatric patients but for adults. Choice C is incorrect as using a single tool may not capture the full complexity of the patient's nutritional status.

Question 7 of 9

A patient has just died following urosepsis that progressed to septic shock. The patients spouse says, I knew this was coming, but I feel so numb and hollow inside. The nurse should know that these statements are characteristic of what?

Correct Answer: A

Rationale: The correct answer is A: Complicated grief and mourning. This is characterized by a sense of emotional numbness and feeling hollow inside, which the patient's spouse is experiencing after the patient's death. Complicated grief involves intense and prolonged mourning that may interfere with daily functioning. Other choices are incorrect because: B: Uncomplicated grief and mourning typically involves a range of emotions, including sadness and sorrow, but not the profound numbness and emptiness described. C: Depression stage of dying refers to a stage in the Kubler-Ross model, but the patient's spouse is not the one dying, so this does not apply. D: Acceptance stage of dying involves coming to terms with one's impending death, not the aftermath of losing a loved one to sepsis.

Question 8 of 9

One aspect of the nurses comprehensive assessment when caring for the terminally ill is the assessment of hope. The nurse is assessing a patient with liver failure for the presence of hope. What would the nurse identify as a hope-fostering category?

Correct Answer: A

Rationale: The correct answer is A: Uplifting memories. When assessing hope in a terminally ill patient, identifying uplifting memories can foster hope by providing emotional support, positive experiences, and a sense of purpose. Memories can inspire optimism and comfort in difficult times. B: Ignoring negative outcomes is incorrect as it does not address the patient's emotional needs or promote coping strategies. C: Envisioning one specific outcome is incorrect because hope should encompass a range of possibilities, not just one specific outcome. D: Avoiding an actual or potential threat is incorrect as it focuses on avoidance rather than on promoting positive emotions and psychological well-being.

Question 9 of 9

Which action indicates the nurse is meeting aprimary goal of cultural competent care for patients?

Correct Answer: C

Rationale: The correct answer is C because providing individualized care is a fundamental aspect of cultural competence. This means tailoring care to meet the unique cultural, social, and personal needs of each patient. It involves understanding and respecting a patient's beliefs, values, and practices. Explanation: A. Providing care to transgender patients is important, but it is not the primary goal of cultural competence. B. Restoring relationships is beneficial but may not directly address cultural competence. D. Providing care to surgical patients is a common nursing duty but does not specifically relate to cultural competence.

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