FREE Adult Health Clinical Nurse Specialist Questions and Answers
A 68-year-old patient is seen with a history of palpitations, weakness, paroxysmal nocturnal dyspnea, and dyspnea upon exertion. Atrial fibrillation, right ventricular hypertrophy, and right axis deviation can all be seen on the patient's electrocardiogram. The clinical nurse specialist in adult health is looking for a differential diagnosis of:
Explanation:
The reported symptoms of dyspnea on exertion, paroxysmal nocturnal dyspnea, weakness, and palpitations, along with the electrocardiogram findings of atrial fibrillation, right ventricular hypertrophy, and right axis deviation, suggest that the patient may have heart failure with preserved ejection fraction (HFpEF) or pulmonary hypertension.
A 39-year-old married woman with cervical cancer had a complete hysterectomy and salpingo-oophorectomy. Surgery to induce menopause causes little discomfort for the patient. The clinical nurse specialist for adult health will talk about:
Explanation:
A total hysterectomy and salpingo-oophorectomy involve the removal of the uterus, fallopian tubes, and ovaries, which results in surgical menopause. Surgical menopause can cause various symptoms, including hot flashes, vaginal dryness, and reduced libido.
A healthcare facility chooses to work with an outside consultant to assist with reorganization because they can:
Explanation:
Hiring an external consultant can benefit a healthcare organization for various reasons, including their ability to operate independently from the power structure. Consultants are often employed for their expertise in a specific area or their ability to provide an unbiased perspective. By bringing in an external consultant, healthcare organizations can benefit from their specialized knowledge and experience without the potential bias within the organization.
A preliminary investigation is made into the emotional reactions of the relatives of patients in the intensive care unit. Of the 52 participants, 44.2% had completed high school, and 40.4% had finished college. 94.2% of the subjects were white, and 86.5% were married. The participants kept daily diaries of their emotions and practical actions. The study's authors concluded that the participants went through a wide spectrum of intense feelings while hospitalized. The following is a significant study limitation:
Explanation:
The major limitation of the exploratory study on the emotional responses of family members of patients in the intensive care unit is that the subjects do not represent a diverse population sample. The study sample only included 52 subjects from similar demographic backgrounds, with 94.2% being white, 86.5% being married, 44.2% having completed high school, and 40.4% having finished college. The study results may not generalize to a more diverse population.
A patient population with a variety of ethnic backgrounds can benefit from learning by:
Explanation:
An effective way of incorporating learning into a culturally diverse patient population is to allow a patient's culture to become a part of the educational process. Recognizing that cultural beliefs, values, and practices can significantly impact a patient's health beliefs and behaviors is important. Healthcare providers should aim to understand and respect their patients' cultural backgrounds and tailor their educational interventions to meet each patient's unique needs and preferences.
The proximal and distal interphalangeal joints of the 52-year-old patient are stiff and painfully swollen, and the condition worsens during the day. The following pathologic findings are anticipated in this patient:
Explanation:
The reported symptoms of stiffness and painful swelling of the proximal and distal interphalangeal joints that worsen as the day progresses are suggestive of rheumatoid arthritis (RA). The expected pathologic findings in patients with RA include inflammation of the synovial lining of the joints, which can lead to damage to the articular cartilage and bone erosion.
Chronic inflammation and the resulting immune response in RA can cause damage to the synovial membrane, which lines the joint capsule, and the adjacent articular cartilage. The inflammation can also lead to bone erosion and deformities due to the formation of pannus tissue, an abnormal growth of tissue that invades and destroys the surrounding joint tissue.
Therefore, the expected pathologic findings in a 52-year-old patient with symptoms of RA include erosions of the articular cartilage, synovial inflammation, and bone erosions.
A clinical nurse specialist at a university health center cares for a student with a chronic illness. During the semester break, the student travels back to their home state. Because of their rapport, the student emails the clinical nurse specialist with a question while on vacation. The clinical nurse specialist's main concerns while dealing with this patient are:
Explanation:
The clinical nurse specialist should be most concerned about the legality of providing health advice across state lines when responding to a patient who is located in another state. The clinical nurse specialist is licensed to practice nursing in the state where they work, but their license may not allow them to practice nursing in other states. Providing health advice across state lines may violate state laws and regulations, which can result in disciplinary action against the nurse's license.