foundation of nursing practice questions

Correct Answer: B

Rationale: It is crucial for the nurse to monitor that all furniture remains in the same position in the hospitalized patient's room. For a patient with impaired vision who needs to create a mental picture of the room to mobilize independently and safely, any changes in the position of furniture can disrupt this mental map and potentially lead to accidents or falls. By ensuring that all furniture remains unchanged, the nurse supports the patient's ability to navigate the room confidently and without obstacles. This monitoring helps promote the patient's safety and independence during their stay in the hospital.

Correct Answer: B

Rationale: The nurse should prioritize educating the patient on the importance of keeping appointments for desensitization procedures. Immunotherapy involves gradually increasing exposure to allergens to build tolerance and reduce allergic reactions. Missing desensitization appointments can lead to interruptions in treatment and potentially decrease the effectiveness of the therapy. It is crucial for the patient to adhere to the scheduled appointments as prescribed by the healthcare provider to ensure the success of the immunotherapy treatment.

Correct Answer: B

Rationale: During the primary infection stage of HIV, the patient is newly infected with the virus. At this stage, the patient's immune system has not yet produced HIV-specific antibodies, making it difficult to detect HIV infection using standard antibody tests. Instead, the virus can be detected by testing for the presence of HIV RNA or p24 antigen. The primary infection stage is characterized by a high level of viral replication and rapid spread of the virus throughout the body. In this early stage, the patient may experience flu-like symptoms such as fever, sore throat, muscle aches, and swollen lymph nodes. The absence of HIV-specific antibodies means that the patient is highly infectious and can easily transmit the virus to others. As the infection progresses, the patient will eventually develop HIV-specific antibodies, which can be detected through antibody tests.

Correct Answer: A

Rationale: The most critical assessment parameter to include in the initial assessment of a patient with a brain tumor scheduled for surgery is the gag reflex. The gag reflex is a protective mechanism that prevents the entry of foreign objects into the airway and lungs. Patients undergoing brain tumor resection may be at risk for impaired gag reflex due to the effects of the tumor on cranial nerves or related structures. Identifying any impairment in the gag reflex is essential to prevent aspiration during and after the surgical procedure. Monitoring the gag reflex allows the healthcare team to take necessary precautions to protect the patient's airway and prevent complications. Therefore, assessing the gag reflex is crucial in the care of a patient with a brain tumor undergoing surgery.

Correct Answer: B

Rationale: One of the key advantages associated with a nursing clinical information system is the reduction of errors of omission. By using an electronic system that prompts for required data entry and ensures completeness of documentation, nurses are less likely to miss important information, leading to improved patient care and safety. This advantage helps in promoting efficient communication among healthcare providers and contributes to better decision-making processes.