The nurse supervises the care of a patient with a temporary radioactive cervical implant. Which action by unlicensed assistive personnel (UAP), if observed by the nurse, would require immediate intervention?

The UAP stands by the patient's bed for 60 minutes talking with the patient.

The UAP gives the patient a saline mouthwash to use for oral care.

The UAP places the patient's bedding in the laundry container inside the clients room.

The UAP flushes the toilet twice after emptying the patient's bedpan.

Answer and Explanation

The Correct Answer is A

A) The UAP stands by the patient's bed for 60 minutes talking with the patient:
This action requires immediate intervention because of the potential radiation exposure to the UAP. A temporary radioactive cervical implant involves placing a radioactive source in or near the patient's cervix. This implant emits radiation, and safety precautions are essential to limit exposure to others, including healthcare workers. Prolonged close contact, such as standing by the patient's bed for 60 minutes, increases the risk of radiation exposure to the UAP.

B) The UAP gives the patient a saline mouthwash to use for oral care:
There are no specific contraindications to using a saline mouthwash for oral care in patients with a radioactive implant. Saline mouthwash is commonly recommended for patients undergoing radiation therapy to soothe the mouth and prevent dryness or irritation. As long as the UAP is following standard infection control and safety precautions.

C) The UAP places the patient's bedding in the laundry container inside the client's room:
Bedding and linens from a patient with a radioactive implant can usually be handled and disposed of according to hospital guidelines for radioactive waste. Often, these linens are not considered to pose a significant radiation hazard after removal from the patient’s immediate area, especially if the patient is not emitting radiation outside the prescribed safety guidelines.

D) The UAP flushes the toilet twice after emptying the patient's bedpan:
After the patient has a radioactive implant, any bodily waste (urine, stool) can potentially contain small amounts of radiation. Flushing the toilet twice helps to ensure that any radioactive materials are effectively cleared. However, the UAP should be instructed to wear gloves and take other precautions to prevent contamination while handling the bedpan and ensuring proper disposal of waste.

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Correct Answer is ["A"]

Explanation

A) Unilateral facial drooping:
Unilateral facial drooping is the hallmark sign of Bell's palsy, a condition that results from inflammation of the facial nerve (cranial nerve VII). This inflammation causes muscle weakness or paralysis on one side of the face, leading to drooping of the mouth, eyelid, and other facial features on the affected side. The facial drooping may worsen with smiling, closing the eyes, or other facial expressions, making this a key finding in Bell’s palsy.

B) Unilateral arm weakness:
Unilateral arm weakness is not typically associated with Bell's palsy, which specifically affects the facial muscles due to nerve damage. While weakness can occur in other parts of the body due to neurological conditions, it is not a characteristic symptom of Bell’s palsy, which is primarily a cranial nerve issue. Therefore, arm weakness would prompt consideration of other potential neurological causes.

C) Alopecia:
Alopecia, or hair loss, is not a common symptom of Bell's palsy. Although it can be seen in many different conditions, it is not typically linked with Bell's palsy, which is a disorder of the facial nerve. Bell’s palsy affects facial muscles, leading to symptoms like drooping or inability to close the eye, but it does not directly cause hair loss.

D) Difficulty swallowing:
Difficulty swallowing (dysphagia) can occur in Bell's palsy, especially if the facial nerve affects the ability to control the muscles involved in swallowing. This may lead to difficulty with chewing, swallowing, or speaking clearly. While not always severe, dysphagia is a potential complication due to the involvement of the facial nerve, which controls facial muscles essential for these functions.

E) Inability to close the affected eye:
The inability to close the affected eye is a common symptom of Bell's palsy due to paralysis of the orbicularis oculi muscle, which is controlled by the facial nerve. This can lead to dryness or irritation of the eye and a risk for corneal damage if the eye is not properly closed or protected. This inability to close the eye is one of the hallmark features of Bell's palsy.

A. "ALS is caused by excess chemicals in the brain. The symptoms can be controlled with medication." B. "The disease is progressive and will eventually lead to paralysis while maintaining cognitive function." C. "Before you lose cognitive function, you should consider creating an advanced directive." D. "Despite severe symptoms right now, most patients recover with treatment."

Correct Answer is B

Explanation

A) "ALS is caused by excess chemicals in the brain. The symptoms can be controlled with medication."
Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease that results in the progressive loss of motor neurons, which leads to muscle weakness, atrophy, and paralysis. It is not caused by "excess chemicals in the brain," and there are currently no medications that can cure ALS or completely control its symptoms. Medications such as riluzole can slow the progression slightly, but they do not stop or reverse the disease.

B) "The disease is progressive and will eventually lead to paralysis while maintaining cognitive function."
ALS is indeed a progressive neurodegenerative disease that leads to the gradual loss of muscle function due to the death of motor neurons. Over time, the patient will experience muscle weakness, atrophy, and paralysis, while the cognitive function typically remains intact until the later stages of the disease, although some patients may develop frontotemporal dementia. it is essential for the patient to understand that the disease will progressively impair their physical abilities while leaving cognitive functions largely unaffected in most cases.

C) "Before you lose cognitive function, you should consider creating an advanced directive."
While it is important for individuals with ALS to plan for the future, this statement is not entirely accurate. Cognitive function in ALS is often preserved throughout most of the disease, although there is a subset of patients who may develop frontotemporal dementia. It would be more appropriate to discuss advanced directives early in the disease, but it is not guaranteed that cognitive function will be lost before physical decline.

D) "Despite severe symptoms right now, most patients recover with treatment."
ALS is a progressive disease with no cure, and it does not typically result in recovery. While certain treatments can help manage symptoms or slow the progression of the disease, recovery is not a realistic expectation. Most patients with ALS experience gradual worsening of symptoms and ultimately may require assistance with daily activities as the disease progresses.

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The nurse supervises the care of a patient with a temporary radioactive cervical implant. Which action by unlicensed assistive personnel (UAP), if observed by the nurse, would require immediate intervention?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is assessing a client who has been recently diagnosed with Bell's palsy. Which of the following findings should the nurse expect? [Select all that apply.]

Correct Answer is ["A"]

Explanation

The nurse is educating a patient who is newly diagnosed with amyotrophic lateral sclerosis (ALS). Which statement would be the most appropriate for the nurse to include in education?

Correct Answer is B

Explanation

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The nurse supervises the care of a patient with a temporary radioactive cervical implant. Which action by unlicensed assistive personnel (UAP), if observed by the nurse, would require immediate intervention?

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