The Royal Marsden Hospital Manual of Clinical Nursing Procedures - Lisa Dougherty [659]
Chapter 5 Communication
1 The correct answer is a, Listening, clarifying the concerns and feelings of the patient using open questions.
2 The correct answer is c, Tell the patient you are interested in what is concerning them and that you are available to listen.
3 The correct answer is c, Denial is a coping mechanism used by an individual with the intention of protecting themselves from painful or distressing information whereas collusion is the withholding of information from the patient with the intention of ‘protecting them’.
4 The correct answer is b, Anxiety has three aspects: physical – bodily sensations related to flight and fight response, behavioural – such as avoiding the situation, and cognitive (thinking) – such as imagining the worst.
5 The correct answer is a, Use short statements and closed questions in a well-lit, quiet, familiar environment.
Chapter 6 Elimination
1 The correct answer is a, Once other methods of continence management have failed.
2 The correct answer is b, The smallest size necessary.
3 The correct answer is c, Male and female patients require anaesthetic lubricating gel.
4 The correct answer is c, Exercise and drink 2–3 litres of fluid per day.
5 The correct answer is c, Below the level of the patient’s bladder to reduce backflow of urine.
6 The correct answer is d, Antiemetic or opioid medication.
7 The correct answer is d, Assessment, source isolation, universal precautions.
8 The correct answer is d, Cognitive ability, lifestyle, patient dexterity, position of stoma, state of peristomal skin, type of stoma, consistency of effluent, patient preference.
9 The correct answer is c, Encourage a varied diet as people can react differently.
10 The correct answer is a, That the patient can independently manage their stoma, and can get supplies.
Chapter 7 Moving and positioning
1 The correct answer is a, The skeleton provides a structural framework. This is moved by the muscles that contract or extend and in order to function, cross at least one joint and are attached to the articulating bones.
2 The correct answer is d, Social isolation, loss of independence, exacerbation of symptoms, rapid loss of strength in leg muscles, deconditioning of cardiovascular system leading to increased risk of chest infection, and pulmonary embolism.
3 The correct answer is c, The patient needs to be able to sit in a forward leaning position supported by pillows. They may also need access to a nebulizer and humidified oxygen so they must be in a position where this is accessible without being a risk to others.
4 The correct answer is c, Lying on his side with the area to be drained uppermost after the patient has had humidified air.
5 The correct answer is b, Try to diminish increased tone by avoiding extra stimulation by ensuring her foot doesn’t come into contact with the end of the bed; supporting, with a pillow, her left leg in side lying and keeping the knee flexed.
Chapter 8 Nutrition, fluid balance and blood transfusion
1 The correct answer is d, The fluid input has exceeded the output.
2 The correct answer is a, Blood glucose levels, full blood count, stoma site and bodyweight.
3 The correct answer is b, Offer the patient pain relief and either use bed scales or a hoist with scales built in.
4 The correct answer is b, Sip feeds.
5 The correct answer is a, The feed.
6 The correct answer is c, Feeding via a radiologically inserted gastrostomy (RIG).
7 The correct answer is b, Sit them at least at a 45° angle.
8 The correct answer is d, Drugs that can be absorbed via this route, can be crushed and given diluted or dissolved in 10–15 mL of water.
9 The correct answer is c, That the pH of gastric aspirate is <5.5, and the measurement on the NG tube is the same length as the time insertion.
10 The correct answer is b, Temperature, pulse, blood pressure