The Royal Marsden Hospital Manual of Clinical Nursing Procedures - Lisa Dougherty [356]
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Multiple choice questions
1 Why should healthcare professionals take extra care when washing and drying an elderly patient’s skin?
a As the older generation deserve more respect and tender loving care (TLC).
b As the skin of an elder person has reduced blood supply, is thinner, less elastic and has less natural oil. This means the skin is less resistant to shearing forces and wound healing can be delayed.
c All elderly people lose dexterity and struggle to wash effectively so they need support with personal hygiene.
d As elderly people cannot reach all areas of their body, it is essential to ensure all body areas are washed well so that the colonization of Gram-positive and negative micro-organisms on the skin is avoided.
2 What would you do if a patient with diabetes and peripheral neuropathy requires assistance cutting his toe nails?
a Document clearly the reason for not cutting his toe nails and refer him to a chiropodist.
b Document clearly the reason for not cutting his nails and ask the ward sister to do it.
c Have a go and if you run into trouble, stop and refer to the chiropodist.
d Speak to the patient’s GP to ask for referral to the chiropodist, but make a start while the patient is in hospital.
3 A patient is agitated and is unable to settle. She is also finding it difficult to sleep, reporting that she is in pain. What would you do at this point?
a Ask her to score her pain, describe its intensity, duration, the site, any relieving measures and what makes it worse, looking for non-verbal clues, so you can determine the appropriate method of pain management.
b Give her some sedatives so she goes to sleep.
c Calculate a pain score, suggest that she takes deep breaths, reposition her pillows, return in 5 minutes to gain a comparative pain score.
d Give her any analgesia she is due. If she hasn’t any, contact the doctor to get some prescribed. Also give her a warm milky drink and reposition her pillows. Document your action.
4 On which step of the WHO analgesic ladder would you place tramadol and codeine?
a Step 1: Non-Opioid Drugs.
b Step 2: Opioids for Mild to Moderate Pain.
c Step 3: Opioids