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: C

Rationale: In this scenario, the patient who has had a cervical diskectomy is experiencing severe pain with a sudden onset, which can be indicative of a complication such as bleeding, infection, or nerve impingement. The nurse's most appropriate action is to call the surgeon immediately to report the patient's pain. The surgeon needs to be informed promptly so that a further assessment can be made and appropriate interventions can be initiated to address the cause of the sudden pain. Palpating the surgical site or removing the dressing without consulting the surgeon first may worsen the situation or increase the risk of complications. Administering an NSAID is not appropriate in this situation without further evaluation and guidance from the surgeon. It is essential to prioritize patient safety and ensure that the patient receives timely and appropriate care by involving the surgeon in the decision-making process.

Correct Answer: A

Rationale: The most appropriate information for the nurse to tell the patient is option A, which states that this condition puts her at a higher risk for cervical cancer; therefore, she should have a Papanicolaou (Pap) test annually. Condylomata acuminata, or genital warts, is caused by the human papillomavirus (HPV). Certain strains of HPV, specifically types 16 and 18, are considered high-risk strains that can lead to cervical cancer in women. Therefore, regular Pap tests are crucial for early detection of any cervical changes that could indicate pre-cancerous or cancerous lesions. It is important for the patient to be informed about this risk and the importance of regular screening to monitor her cervical health.

Correct Answer: D

Rationale: Nocturnal penile tumescence tests are used to assess erectile dysfunction in men who are unable to engage in sexual activity. It measures the frequency and strength of erections that occur during sleep, which can provide valuable information about a man's erectile function and whether there may be underlying physiological causes for his inability to engage in sexual activity. This test can help determine if the patient's erectile dysfunction is due to physical or psychological factors. A sperm count, ejaculation capacity tests, and engorgement tests are not typically ordered to assess sexual functioning in this case.

Correct Answer: C

Rationale: Patients with Meniere's disease are often advised to limit their intake of salt as excess salt can worsen symptoms such as dizziness and vertigo. Shellfish tend to be high in sodium, so patients with Meniere's disease should be instructed to avoid or limit their consumption of shellfish to help manage their condition. It is important for the nurse to provide comprehensive diet education to the patient to help them minimize symptoms and improve their overall quality of life.