The nurse has just received a change of shift report on four patients. Which patient will the nurse assess first?

A post-operative patient after thyroid surgery preparing for discharge with a new medication

A patient diagnosed with Cushing's disease after insertion of a nasogastric tube

A patient scheduled for a chest radiograph who is anxious about their treatment

A patient with chronic obstructive pulmonary disease who requested a breathing treatment during the previous shift

Answer and Explanation

The Correct Answer is D

Choice A reason: While a post-operative patient preparing for discharge is important, they are stable enough to be considered for discharge and do not require immediate assessment.

Choice B reason: A patient with Cushing's disease after insertion of a nasogastric tube may need monitoring, but this is not as urgent as a patient with potential respiratory distress.

Choice C reason: A patient scheduled for a chest radiograph who is anxious about their treatment does not require immediate intervention compared to a patient experiencing respiratory issues.

Choice D reason: A patient with chronic obstructive pulmonary disease who requested a breathing treatment during the previous shift may be experiencing respiratory distress and requires immediate assessment and intervention to prevent further complications.

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Correct Answer is C

Explanation

Choice A reason: Reminding the patient that they will be responsible for caring for the ileostomy after discharge may increase their anxiety and reluctance. It does not address the underlying concerns or feelings.

Choice B reason: Reassuring the patient that the procedure will be reversed in a few months is not always accurate and may provide false hope. Each patient's situation is unique, and not all ileostomies are temporary.

Choice C reason: Acknowledging the patient's reluctance and initiating a discussion to explore their feelings is the most appropriate response. This approach allows the nurse to understand the patient's concerns, provide emotional support, and offer practical solutions to help the patient feel more comfortable with ostomy care.

Choice D reason: Discussing the need for a psychiatric referral during interdisciplinary rounds is not the immediate step. The nurse should first address the patient's feelings and concerns directly and provide support.

A. "I will take this medication as needed during flares of joint pain." B. "I will avoid drinking alcohol while taking this medication." C. "I will call my provider if I develop a sore throat or fever." D. "I will use contraception while taking this medication."

Correct Answer is A

Explanation

Choice A reason: Methotrexate is a disease-modifying antirheumatic drug (DMARD) that must be taken regularly as prescribed, not just during flares of joint pain. It helps to prevent disease progression and joint damage. This statement indicates a misunderstanding of the medication regimen and requires further teaching.

Choice B reason: Avoiding drinking alcohol while taking methotrexate is important because alcohol can increase the risk of liver damage, a potential side effect of methotrexate. This statement indicates proper understanding.

Choice C reason: Calling the provider if a sore throat or fever develops is important because methotrexate can suppress the immune system, increasing the risk of infections. This statement indicates proper understanding.

Choice D reason: Using contraception while taking methotrexate is crucial because methotrexate can cause birth defects. This statement indicates proper understanding.

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The nurse has just received a change of shift report on four patients. Which patient will the nurse assess first?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is caring for a patient with inflammatory bowel disease who has been discharged with an ileostomy. The patient expresses reluctance to participate in aspects of ostomy care. What is the nurse's most appropriate response to this observation?

Correct Answer is C

Explanation

The nurse is providing discharge teaching to a patient with rheumatoid arthritis (RA) who has been prescribed methotrexate. Which patient statement indicates to the nurse a need for further teaching?

Correct Answer is A

Explanation

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