The Royal Marsden Hospital Manual of Clinical Nursing Procedures - Lisa Dougherty [660]
Chapter 9 Patient comfort
1 The correct answer is 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.
2 The correct answer is a, Document clearly the reason for not cutting his toe nails and refer him to a chiropodist.
3 The correct answer is 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.
4 The correct answer is b, Step 2: Opioids for Mild to Moderate Pain.
5 The correct answer is a, A patient who has adequately controlled pain relief with short-lived exacerbation of pain, with a prescription that has no regular time of administration of analgesia.
6 The correct answer is c, Contact the pain team/anaesthetist to discuss the situation and suggest that the means of delivery are changed.
7 The correct answer is a, A wound dressing change for short-term pain relief or the removal of a chest drain for reduction of anxiety.
8 The correct answer is a, Respiratory rate, bowel movement record and pain assessment and score.
9 The correct answer is d, Potentially all of the above.
Chapter 10 Respiratory care
1 The correct answer is c, Observe the patient’s breathing for ease and comfort, rate and pattern.
2 The correct answer is c, The type of oxygen delivery system, inspired oxygen percentage and duration of the therapy.
3 The correct answer is b, Never insert the catheter for longer than 10–15 seconds.
4 The correct answer is d, Arterial blood gases measure both oxygen and carbon dioxide levels and therefore give an indication of both ventilation and oxygenation.
5 The correct answer is c, Higher rates can cause nasal mucosal drying and may lead to epistaxis.
6 The correct answer is a, Early defibrillation to restart the heart.
7 The correct answer is b, Oxygen is a dry gas which can cause evaporation of water from the respiratory tract and lead to thickened mucus in the airways, reduction of the movement of cilia and increased susceptibility to respiratory infection.
Chapter 11 Interpreting diagnostic tests
1 The correct answer is a, Double bag it, in a self-sealing bag, and wear gloves if handling the specimen.
2 The correct answer is c, Choosing a soft, bouncy vein that refills when depressed and is easily detected, and advising the patient to keep their arm straight whilst firm pressure is applied.
3 The correct answer is a, Collect at least 10 mL of blood.
4 The correct answer is a, Inoculate the aerobic culture first.
5 The correct answer is b, Temperature of 38.5°C, shivering, tachycardia and hypertensive.
6 The correct answer is a, Clean around the urethral meatus prior to sample collection and get a midstream/clean catch urine specimen.
7 The correct answer is b, Gastroscopy.
8 The correct answer is a, MRI.
9 The correct answer is a, Eat and drink as soon as sedation has worn off.
10 The correct answer is a, Inadvertent puncture of the pleura, a blood vessel or bile duct.
Chapter 12 Observations
1 The correct answer is a, When they are admitted or initially assessed. A plan should be clearly documented which identifies which observations should be taken and how frequently subsequent observations should be done.
2 The correct answer is b, The system provides an early accurate predictor of deterioration by identifying physiological criteria that alert the nursing staff to a patient at risk.
3 The correct answer is c, A full set of observations: blood pressure, respiratory rate, oxygen saturation and temperature. It is essential to perform a 12-lead ECG. The patient should then be reviewed by the doctor.
4 The correct answer is b, If the patient has a history of dizziness or syncope on changing position.
5 The correct answer