Commission on Graduates of Foreign Nursing Schools Exam

Hyperthyroidism Management: When a patient is prescribed Methimazole (Tapazole) for hyperthyroidism, crucial patient education includes dietary modifications. Instruct the patient to consume two to three servings of iodine-rich foods daily. Contact the doctor immediately if a sore throat develops, a potential side effect. Adequate hydration is also important; encourage the patient to drink three liters of fluid daily. Good oral hygiene is essential; advise the patient to use a hard-bristled toothbrush for brushing teeth.

Patient Advocacy & Chemotherapy Decisions: Navigating difficult treatment decisions requires sensitive patient advocacy. When a patient wishes to discontinue chemotherapy due to complications and cancer recurrence, but her husband desires continued treatment, the best patient-advocate approach is to talk to the physician about the conflict. Other supportive actions include:

• Encouraging the patient to openly discuss her feelings.
• Offering to be present during conversations with her husband and doctor.

Combating Social Isolation in Depression: Addressing social isolation is key in depression management. Effective nursing interventions include:

• Assigning a psychiatric technician to monitor the patient's activity.
• Asking a more stable patient to accompany the patient to activities.
• Moving the patient to a room closer to the nurses' station to facilitate interaction.
• Avoiding statements that imply continued isolation will delay discharge.

Electroconvulsive Therapy (ECT) Patient Education: Accurate patient education is vital before ECT. Include the following in your teaching:

• The patient will remain awake and alert during the treatment.
• The patient will remain flat on his back for one hour after treatment.
• Minimal muscle twitching is expected during treatment.
• Restraints are not required following the treatment.

Diabetes & Pregnancy Diet: Providing dietary guidance to a newly diagnosed pregnant woman with diabetes and insulin requires a tailored approach. Emphasize the normalcy of pregnancy and that her pre-pregnancy diet will likely be suitable as a starting point. Explain that pregnancy increases the need for protein and calcium, but only minor dietary adjustments are initially needed. Crucially, confirm that dietary and insulin needs will vary throughout the pregnancy, necessitating close follow-up with her healthcare team. Avoid instructing her to self-regulate based on urine glucose tests.

Postpartum Attachment Concerns: Early observation is critical in postpartum care. Concerning signs of impaired maternal-infant attachment 48 hours after a healthy delivery include:

• Staring out the window while feeding the newborn.
• Hesitation in cleaning the newborn's umbilical cord.
• Expressing difficulty in finding a name for the newborn.

Apgar Score Interpretation: An Apgar score of 8 at one minute indicates excellent newborn condition. Expect the newborn to exhibit:

• Heart rate of 120 beats/min
• Lusty cry
• Acrocyanosis (blueness of extremities)
• Minimal flexion of the extremities