FREE Adult-Gerontology Acute Care Nurse Practitioner Questions and Answers
Which of the following medical services can a teenager under the age of 18 receive or reject without their parents' knowledge or permission in the majority of states?
Explanation:
In every state in the US, a teen under the age of 18 can access or reject emergency contraception without their parents' knowledge or approval. Despite claims to the contrary in the product information, emergency contraception is accessible to younger adolescents because no identification is needed to purchase it. Most states require parental knowledge or consent of some form for teenage abortions (one parent, both parents). Transfusions and chemotherapy require parental approval, albeit the adolescent's perspective may be taken into account.
The NP aims to deploy a new technique in the provision of patient care, cognizant that the main obstacles to change are typically:
Explanation:
If an NP wants to modify how patient care is provided, they should be aware that staff opposition to change poses the biggest threat to implementation. Because of this, it's critical for the NP to secure "buy-in" as part of the planning process and to identify and hire key figures who are likely to persuade others to support change. Staff opposition can take a passive form (lack of enthusiasm, whining) or an active one (refusing to participate, undermining efforts).
A patient has septic (acute nongonococcal bacterial) knee arthritis. Antibiotics are a part of immediate care together with:
Explanation:
Antibiotics and joint drainage are used as urgent treatments for patients with acute nongonococcal bacterial (septic) arthritis of the knee. Broad-spectrum antibiotics are used as the first line of treatment until culture and sensitivity are restored. A drain is typically inserted into the joint during arthroscopic lavage and debridement to drain the joint. The majority of the time, symptoms are severe and include fever, chills, joint pain, edema, and heat. Active range-of-motion (ROM) exercises should be started by patients as soon as tolerated.
The following factors put patients who use urinary catheters for an extended period of time at risk for acquiring resistant infections:
Explanation:
Due to the formation of biofilms in the bladder, patients with long-term urinary catheters are at significant risk of getting resistant infections. Staphylococcus aureus is particularly harmful because it is virulent and capable of creating biofilms, which are enormous clusters of cells that stick to tissue and release a polysaccharide to shield the bacteria from antibiotics. Because the bacteria develop resistance and disperse, biofilms are very challenging to treat. Only when absolutely essential and for the smallest amount of time should urinary catheters be used.
A patient with a T-6 spinal cord injury lays flat on their back in bed when all of a sudden, they have blurred vision, a terrible headache, a piloerection with pallor below the lesion and flushing above it, as well as noticeably raised blood pressure of 280/160. The first thing to do is:
Explanation:
The head of the bed should be raised to a 45° angle as the first step. The patient's garments should be relaxed, their bowels should be examined, and the bladder should be checked for distension or the catheter should be examined for kinks. An alpha-adrenergic blocker or vasodilator, such as nifedipine, may be necessary for the patient if symptoms persist even after the stimulus has been identified and eliminated.
The NP is concerned that a stroke victim with chronic dysphagia and a coughing fit might aspirate. Which of the following recommendations is ideal?
Explanation:
The best person to refer to if a stroke victim exhibits persistent dysphagia and cough and the NP fears that the patient might aspirate is a speech therapist. The strength of the mouth, comprising the lips, tongue, palate, and jaw, can be evaluated by a speech pathologist. The speech therapist may recommend preventive measures, such as adjustments to positioning and food, and may also recommend exercises, neurological stimulation, or thermostimulation.
The NP reports that one nurse on the team frequently avoids caring for elderly patients and occasionally speaks poorly about the elderly. The NP should respond in the following manner to:
Explanation:
The best course of action is for the NP to talk with the nurse about views around aging. People who are ageists frequently worry about their own aging and might not even be aware of their prejudice. The NP must stress that older patients must receive the same high standard of care as younger patients and that disparaging remarks about the elderly are improper.