Reading Comprehension Flashcards

A clinical article on pain assessment reads: 'Self-report is the gold standard for pain measurement. Numeric Rating Scales (NRS), Visual Analogue Scales (VAS), and descriptive scales are commonly used. For non-verbal patients, behavioral observation tools such as CPOT (Critical-Care Pain Observation Tool) or FLACC are recommended.' Which approach is MOST appropriate for assessing pain in an intubated, sedated ICU patient?

Answer: Use a behavioral observation tool such as CPOT

CPOT is specifically validated for non-verbal, mechanically ventilated patients and is the recommended tool per the article.

A passage about therapeutic communication reads: 'Therapeutic communication techniques include active listening, open-ended questions, silence, and clarification. Non-therapeutic techniques such as false reassurance, giving advice, and changing the subject can hinder the nurse-patient relationship.' A patient says: 'I'm terrified about my surgery tomorrow.' The nurse responds: 'Don't worry — everything will be just fine!' What technique does this represent?

Answer: False reassurance

Telling a patient not to worry and that everything will be fine dismisses their feelings and offers unfounded guarantees — a classic example of false reassurance.

A nursing care plan for a patient with COPD includes: 'Administer oxygen at 1–2 L/min via nasal cannula; titrate to maintain SpO2 88–92%.' Why is the target SpO2 range lower than the standard 95–100% used for most patients?

Answer: COPD patients may rely on hypoxic drive to breathe and excessive oxygen can suppress respiratory effort

Some COPD patients with chronic CO2 retention rely on hypoxic drive; excessive supplemental oxygen can blunt this drive and cause respiratory depression.

A post-operative nursing note reads: 'Patient returned from OR at 1400 following laparoscopic appendectomy. SpO2 94% on 2L O2, BP 108/70, HR 102, RR 20. Patient is shivering and reports pain 7/10. Dressings dry and intact. Foley catheter draining clear yellow urine.' Which finding requires the MOST immediate nursing attention?

Answer: SpO2 of 94% on 2L O2

SpO2 of 94% on supplemental oxygen in a post-operative patient signals compromised oxygenation and warrants immediate assessment and intervention.

A chart note reads: 'Patient refuses blood transfusion on religious grounds. Patient is alert, oriented x3, and has demonstrated understanding of the risks including death from continued blood loss. Patient has signed a refusal of treatment form.' A family member demands the nurse give the blood anyway. What is the ethically and legally correct response?

Answer: Uphold the patient's documented informed refusal; the patient is competent to decide

A competent adult patient has the right to refuse any treatment, including life-saving blood transfusions; the documented informed refusal must be respected.

A pharmacology reference passage states: 'Opioid analgesics act on mu, kappa, and delta receptors in the CNS. Common adverse effects include respiratory depression, constipation, urinary retention, nausea, and sedation. Tolerance develops to most effects except constipation.' A patient on long-term opioid therapy for cancer pain asks why they still need laxatives even though their pain control has stabilized. What is the BEST explanation?

Answer: Constipation is an opioid side effect that does not resolve with tolerance

Unlike most opioid side effects, tolerance to opioid-induced constipation does not develop, so bowel regimens remain necessary for the duration of opioid therapy.

A nursing journal article about cultural competence states: 'Cultural humility is an ongoing process of self-reflection and learning that acknowledges the nurse's own cultural biases and power differences in the healthcare relationship. It differs from cultural competence in that it does not assume mastery of another culture.' A nurse assumes a patient from a particular culture will refuse pain medication based on a previous patient from that same background. Which concept does this reflect?

Answer: Cultural stereotyping that can compromise individualized care

Applying assumptions about one patient's behavior to another based solely on cultural background is stereotyping, which undermines individualized, patient-centered care.