A little help please? Thanks

  1. hi fellow nurses, i am reviewing for nclex. my agency has provided me with practice exams without answer keys. i noted some pointers (with permission from my agency) on questions where i had such difficulty deciding as to which is the best answer. i hope you could also share to me your insights that might help me come up with the answer.

    the following questions are not the exact words from the test. besides, i definitely couldn't probably copy them word for word, and also to avoid violations on copyrights, and these do not come from the actual nclex. as i have said they are only pointers. you may find some questions lacking in details because as i have implied, they are not replica of the questions.

    so here they are: (i would appreciate it if you would quote the questions for convenience. thanks. the answer in red was my answer to it.)

    1.) a pt has bilateral cataracts. what question/statement is most appropriate to ask to assess visual impairment?
    a. " tell me the things that you can see."
    b. "tell me the things that you have difficulty seeing"
    c. how has your visual abilities changed
    d. .......(i couldn't remember....all i know is that the question was a bit far-out....-shrugs-)
    * i chose b because of the word "impairment"...gee, really dont know.


    2) a patient (already confined in the hospital and is under antibiotics for pneumonia) suddenly presents signs and symptoms of mi. what should the nurse do first?
    a. administer o2 at 4l via nasal cannula (is 4l enough?i was tempted to choose this though because of the pneumonia thing. idk)
    b. 12 lead ecg (it seems to always be the first thing to do in cases of mi. right? or wrong?)
    c. cardiac enzymes (i think this comes later. idk)
    d. ensure patent iv (i think this comes later too because even if this ensures route for administration of mi meds, mi has to be confirmed first)

    3) a patient, after learning of his diagnosis of lung cancer becomes extremely agitated, violent and starts throwing objects at the nurses and staff. what is the most important thing to do?
    a. tell the patient that hurting the staff is an unacceptable behavior (i don't know if this is appropriate. it just seems like the best answer. again, i don;t know)

    b. send the staff out of the room (although it ensures safety for others, it doesn't address the client's problem)

    c. give the pt an anti anxiety drug with a full glass of water (won't the glass with water in it also get airborne? i don't think the pt is cooperative enough at this point to succumb to any interventions especially po meds. idk. however gving water does seem to have a calming effect on some people.)

    d. notify the physician of the cllients signs and symptoms (the md can probably have a better suggestion what to do.)

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    About Superlost1984

    Joined: Jun '09; Posts: 43; Likes: 5

    4 Comments

  3. by   classicdame
    1. generally you assess what they can see, just like when you go to the eye doctor. This is also a way to determine any change in visual acuity.
    2. A heart attack is caused by oxygen not getting to the heart. I would start with O2. More than 4 liters may actually inhibit breathing.
    3. I agree with you. Of the answers provided this seems to be something to address what is going on NOW.

    I would like to hear what others say. I could be way off of course.
  4. by   netglow
    Hmmm. I thought...
    1. c. Gets patient to say what is different, changed from norm. Explain maybe what used to see but cannot anymore. These ? are hard as an eye exam would be done to test anyway.
  5. by   Daytonite
    i know i've suggested before that you post in the student forums because current students are more tuned in to the way these types of questions are answered. additionally, the wording of these questions is very important so while you do not remember the exact wording of these questions or the answer choices it may very well make the critical difference in regard to which answer is the correct one. one word in the stem or an answer choice of the question can make the difference between the correct answer and the wrong answer.

    for how to answer these kinds of questions see https://allnurses.com/general-nursin...ng-224581.html - looking for test taking strategies (in the general nursing student discussion forum)


    a patient (already confined in the hospital and is under antibiotics for pneumonia) suddenly presents signs and symptoms of mi. what should the nurse do first?
    a. administer o2 at 4l via nasal cannula
    b. 12 lead ecg
    c. cardiac enzymes
    d. ensure patent iv
    the signs and symptoms of an mi are chest pain, nausea, vomiting, some shortness of breath, anxiety and tachycardia. the first thing the doctor is going to tell you to do is get an ekg stat so that he can confirm that the chest pain is due to an mi and not something else.

    if this patient is already in the hospital and under treatment with antibiotics for pneumonia, its a good possibility he already has an iv and is probably on supplemental o2 as well.
    a patient, after learning of his diagnosis of lung cancer becomes extremely agitated, violent and starts throwing objects at the nurses and staff. what is the most important thing to do?
    a. tell the patient that hurting the staff is an unacceptable behavior
    b. send the staff out of the room
    c. give the pt an anti anxiety drug with a full glass of water
    d. notify the physician of the cllients signs and symptoms
    you always show respect to patients and endeavor to allow them to maintain their dignity. secondly, maintain the safety of the patient. thirdly, maintain the safety of the staff. "a" telling the patient that he is hurting the staff is unacceptable behavior by the staff at this point and does not take the patient's feelings over his situation into account. along the same vein, so is answer choice "c" because it does not allow for any assessment of the situation first and determination of the problem. when a patient gets violent one staff member needs to attempt to develop a therapeutic relationship with him by communicating their empathy, acknowledging the patient's feelings, encouraging him to express his anger verbally rather than by acting it out and being respectful of the patient's personal space. in light of respecting the patient's personal space as well as looking out for the safety of all concerned, do "b" and send the staff out of the room. if the patient does not respond to any of the above, does not calm down and continues to remain out of control, then the physician can be notified.
  6. by   Superlost1984
    Quote from daytonite
    i know i've suggested before that you post in the student forums because current students are more tuned in to the way these types of questions are answered. additionally, the wording of these questions is very important so while you do not remember the exact wording of these questions or the answer choices it may very well make the critical difference in regard to which answer is the correct one. one word in the stem or an answer choice of the question can make the difference between the correct answer and the wrong answer.

    for how to answer these kinds of questions see https://allnurses.com/general-nursin...ng-224581.html - looking for test taking strategies (in the general nursing student discussion forum)


    a patient (already confined in the hospital and is under antibiotics for pneumonia) suddenly presents signs and symptoms of mi. what should the nurse do first?
    a. administer o2 at 4l via nasal cannula
    b. 12 lead ecg
    c. cardiac enzymes
    d. ensure patent iv
    the signs and symptoms of an mi are chest pain, nausea, vomiting, some shortness of breath, anxiety and tachycardia. the first thing the doctor is going to tell you to do is get an ekg stat so that he can confirm that the chest pain is due to an mi and not something else.

    if this patient is already in the hospital and under treatment with antibiotics for pneumonia, its a good possibility he already has an iv and is probably on supplemental o2 as well.
    a patient, after learning of his diagnosis of lung cancer becomes extremely agitated, violent and starts throwing objects at the nurses and staff. what is the most important thing to do?
    a. tell the patient that hurting the staff is an unacceptable behavior
    b. send the staff out of the room
    c. give the pt an anti anxiety drug with a full glass of water
    d. notify the physician of the cllients signs and symptoms
    you always show respect to patients and endeavor to allow them to maintain their dignity. secondly, maintain the safety of the patient. thirdly, maintain the safety of the staff. "a" telling the patient that he is hurting the staff is unacceptable behavior by the staff at this point and does not take the patient's feelings over his situation into account. along the same vein, so is answer choice "c" because it does not allow for any assessment of the situation first and determination of the problem. when a patient gets violent one staff member needs to attempt to develop a therapeutic relationship with him by communicating their empathy, acknowledging the patient's feelings, encouraging him to express his anger verbally rather than by acting it out and being respectful of the patient's personal space. in light of respecting the patient's personal space as well as looking out for the safety of all concerned, do "b" and send the staff out of the room. if the patient does not respond to any of the above, does not calm down and continues to remain out of control, then the physician can be notified.
    hi daytonite, your responses have been really helpful. i do apologize for my mistake of putting it here. i was misled by the word general, and didn't know that there is a general student discussion until i tried to really explore. i am new here and because of my excitement of the information and help that i am getting here, i haven't set aside time to find my paths through this labyrinth and got stuck with the first things that i know.

    i will learn the ways of this site in no time. thanks

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