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Virginia Evans - Kori Salcido - RN 4U~ Express Publishing Virginia Evans Kori Salcido - R.N ~ Express Publishing Published by Express Publishing Liberty House, Greenham Business Park, Newbury, Berkshire RG19 6HW Tel.: (0044) 1635 817 363 Fax: (0044) 1635 817463 e-mail: inquiries@expresspublishing.co.uk http://www.expresspublishing.co.uk © Express Publishing, 2011 Design © Express Publishing, 2011 First published 2011 Made in EU All rights reserved No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form, or by any means, electronic, photocopying, or otherwise, without the prior written permission of the publishers This book is not meant to be changed in any way ISBN 978-0-85777-839-0 Table of Contents Answer Key Audioscripts 12 82 Answer Key 14 Audioscripts 23 Answer Key 26 Audioscripts 36 Book Answer Key Unit Unit Suggested Answers Suggested Answers There are many types of jobs that people working in hospitals have From doctors and nurses to the cleaning and waiting staff that are needed to clean the public restrooms and run the hospital cafeteria I believe that nurses work with doctors most often They are most likely to take everyday orders from them and have to undertake specific responsibilities that doctors give them There are specific types of nurses for more specialized tasks C D B D F B E A G obstetrician Different hospital departments provide different services to patients depending on the exact nature of their illness For example, a cardiology department has staff that specialize in treating heart conditions Radiology departments provide services such as X-rays, MRI and CAT scans to identify and diagnose disease Pathology departments study and diagnose diseases by inspecting organs, tissues and bodily fluids Obstetrics provide care services to expectant mothers and their babies It seems to me that the emergency department needs nurses the most This might be because of the technical training that nurses need to be able to deal with emergency situations Also, because it is impossible to predict what type of service a patient who finds themselves in the emergency room will need, nurses need to be trained to deal with many different situations C general practitioner pediatrician You can pick up your medicine from Suzan Devlin, the Pharmacist in room 129 F F T F T pediatrics pharmacy nurse x-rays radiologist room number hospital nurse here B: Hello, Jane, What can I for you? A: I have these blood test results for Dr Cho's patient He wants Dr David to take a look at them B: The pediatrician? He is on the second floor somewhere A: Do you happen to know the actual room number? B: No but the nurse on the ward will A: Okay This hospital is so confusing! B: I know the feeling You'll get used to it A Answer Key emergencies B A B B Departments have moved temporarily because of construction work to update the facilities C A department construction cardiology basement appointment elevator Suggested Answer A: Excuse me, nurse? This is the B: Name: Dr Terry David Job Title: Pediatrician Job Duties: Children's Health pathology surgery receptionist Suggested Answer A: Excuse me, Dr Johnson? Hi I'm Jane, I'm a new Suggested Answers Name: Dr Jared Cho Job Title: General Practitioner Job Duties: General Medicine F A: B: A: B: A: B: obstetrics department, isn't it? Well, usually it is But the hospital is under construction right now, so some departments are in different places Oh So where can I find obstetrics? It's on the second now Next to pediatrics Oh good I don't want to miss my appointment with my obstetrician Do you need directions to get there? I think so Take the stairs up to the second floor Obstetrics is to the right Book Answer Key Suggested Answer Suggested Answers Location of clean gowns: first floor closet Where to refill oxygen tank: replacement tank, second floor What to with sharps container: dispose of it and get a replacement from room 102 The obstetrics department has moved to the second floor because of the construction project underway in the hospital To get there: take the stairs up to the second floor It is next to the pediatrics department Sorry for the inconvenience! Unit Unit Suggested Answers Suggested Answers Different types of equipment can be found in a hospital room For example, a call button, latex gloves, syringes, and hospital gowns A call button is pressed by a patient so that they can alert a nurse to the fact that they need some help Latex gloves are worn by doctors and nurses in order to safely and hygienically handle equipment, as well as to protect the patient and care giver from infection Syringes are used in order to remove fluid from a patient so that the liquid can be tested Hospital gowns are worn by patients on the ward or just after an operation The different parts of the body are: head, arms, legs and torso A nurse treats injuries to the body by using firs aid For external injuries, such as swelling or bleeding, the nurse uses bandages A nurse " also make an assessment of the cond ition of :ne patient by asking the patient questions D B D D F G C A 2 H T F F c E A elevate head B E pulse bone Suggested Answer sharps container gown B call button wheelchair D According to the guide, a nurse decides what treatment is appropriate for new patients by firstly checking how responsive and alert they are Then the nurse looks at the patient's body to look for evidence of external injuries such as swelling, bruises and bleeding Once this is done, they nurse feels for bumps on the arms, legs and extremities, if these are found they suggest an internal injury like a broken bone The legs must be lifted above the heart, in cases where the leg is swollen or the patient has fainted If there is a possibility that the patient has spinal injuries, it is essential that the nurse ensures the patient is not moved Finally, if there are any external injuries, such as cuts or bleeding, the nurse should apply first aid gauze Nurses must make sure drawers are stocked with latex gloves and gauze T F T find things clean gowns oxygen second sharps get a new one Suggested Answer A: Alice, can you help me with something? B: Sure! I know how hard it is to get used to things on your first day! A: Room 305 needs some clean gowns Where are those? B: In the first floor closet A: Great Also, where can I refill an oxygen tank? B: Don't refill them Just get a replacement tank on the second floor Anything else? A: Yeah The sharps container is full Should I dispose of it? B: Definitely And get a new one from room 102 T leg bump T F elevate arm wrist bruise Suggested Answer A: Hi, Mr Harris What seems to be wrong? B: I fell playing soccer My leg really hurts A: I'm checking for a break Tell me if it hurts when I touch your leg B: Okay Owl Right there Answer Key Book Answer Key A: Yeah, there's a bump and some swelling I'm going A: Exactly, you can donate to any blood type A, B, to elevate your legs B: My right shoulder hurts too Just below my neck A: Yes, there is some swelling beginning to show Is it too painful to move? B: No I can move it But it hurts when I AB - it doesn't matter But unfortunately, you can receive only your own blood type B: Well, hopefully I'll never need to! Suggested Answer Blood Donor Name: Mr Fisher Blood Type: Blood type Universal Donor? Yes Donated Before? Yes Patient Questions/Concerns: Patient wanted to know who he can donate his blood to Suggested Answer Patient name: Mr Harris Cause of injury: Fell down playing soccer Notes on Physical Assessment: Checked for a break, I noticed a bump and some swelling and a bruise so I have elevated his leg Unit Unit Suggested Answers Suggested Answers A person's circulatory system functions to circulate blood around the body It delivers oxygen which is vital to life and to every organ in the body The types of problems that people experience related to their circulatory system are linked to the blocking up of the tubes through which the heart pumps blood Donating blood is important because it saves people's lives It is used in operations and transfusions Donating and receiving blood can be made safer by using disposable syringes and bags to store the blood T F T circulatory atrium clots, platelets bleeding, universal donor plasm a, red blood cells D A B C B C E Suggested Answer C B donating nervous E D A A A G B Oxygen is distributed around the body through a complex process The process begins with blood lacking oxygen entering the right atrium of the heart The heart muscle pumps the blood through the valve into the right ventricle From there, it travels to the lungs and receives oxygen, blood now with oxygen travels back to the heart through the pulmonary veins The heart then pumps the blood through the capillaries delivering oxygen to the body A Type universal donor F Suggested Answer The most important blood type is TYPE O This is because this blood type is compatible with all others and therefore can be used by anyone A oxygen lungs aorta everyone receive Suggested Answer A: Thanks for coming to the blood drive Mr Fisher Is B: A: B: A: B: this your first time donating? It's not actually I've actually donated blood before That's great! And I see on your files that you have TYPE blood Yes, that's right Does it matter? Actually, its very good as it means that you're a universal donor So my blood type is compatible with everyone? Answer Key A D test results arrhythmia valves treatment how it goes comforting Suggested Answer A: Good afternoon, George I have your test results back B: What they say? A: Well, we're detecting an arrhythmia B: Oh really Could you explain what that means? Book Answer Key A: It means that your heart isn't pumping blood A: It also helps heal the damage to your lungs and through the atria properly, which might make it beat abnormally B: Is there any treatment for this? A: Yes There are various treatment options We're going to start you on medication for now Luckily, this form of arrhythmia isn't too serious B: Well, that's a huge relief bronchial tubes B: Well, I'll think about it Suggested Answer Dangers of smoking: lung cancer emphysema, and those around you developing asthma Benefits of quitting: heals damage to the lungs and bronchial tubes Suggested Answer Patient Name: George Test Results: Detecting an arrhythmia Seriousness: Not very serious Treatment Plan: Start the patient on medication and see how they respond UnitS Suggested Answers The functions of the digestive system are to ad the absorption of food The types of diseases which affect the diges: e system include ulcers, appendicitis anc gas:"' ::: cancer Unit Suggested Answers The respiratory system delivers oxygen to the lungs through the bronchial tubes and removes toxic carbon dioxide Common problems include asthma and lung cancer often caused by smoking B B D F D A G C E respiratory system carbon dioxide B T questions smoking T F stomach esophagus large intestine diarrhea small intestine colonoscopy appendicitis colon A colonoscopy should be performed to rule out damage to the colon asthma C A stomach ulcer appendicitis co!onoscopy intestine Suggested Answer A: Are you feeling any better Sally? B: The same I still have the stomach pain as before F lung cancer asthma feeling There are various conditions which can be attributed to smoking including emphysema, which destroys the alveoli and lung cancer F F cramping ulcer Suggested Answer A: I'm sorry to hear that lungs think about Suggested Answer A: Hi, Mrs Smith I have a few questions before the doctor sees you Are you still smoking? B: Yes, but not very much A: Still, you need to quit You understand the risks don't you? B: Of course I know it causes lung cancer and emphysema A: Yes Plus, people around you are at risk of developing asthma B: I know And I don't want my kids getting it But quitting is really hard B: Does the doctor know what's wrong yet? A: Well, he doesn't think its an ulcer He believes you might have appendicitis though B: Really? Isn't that really serious? A: It can be but its unlikely in your case He's also recommending a colonoscopy to make sure there's nothing wrong with your colon or intestines Is that okay with you? B: Yes I'm willing to whatever it takes Suggested Answer Pati ent name: Sally Reason for visit: The patient is experiencing stomach pains Answer Key Book Answer Key Examination notes: After examining the patient I find that it is a possible case of appendicitis Recommendations for treatment: I am ordering a colonoscopy Unit 10 Suggested Answers Common symptoms of cold and flu include: sneezing, runny nose, cough, temperature and feeling cold all the time It is important to recognize symptoms early because doing so might help prevent patients getting worse It is also a good indicator if something else is wrong, which is perhaps more serious Unit Suggested Answers During physical assessments nurses look for abnormalities on the skin and body, they check for pain in the abdomen and check the patients pulse It is hard to find any asymptomatic diseases and so nurses often also order blood tests B B D F B A C D E C A B B B D B E F A C cough moderate B F F alright good thing consent T demographic stomach below Suggested Answer A: Good morning, Mr Richards How are you feeling today? B: I'm alright But there's a dull ache in my side A: Okay Good thing you're getting a physical exam then Do I have your consent? B: Sure A: First, let me finish the demographic data What's your age? B: I'm 40 years old A: Great Next up is palpation of the area I'm going to touch your stomach and side Just tell me when it hurts B: Okay Yeah, it hurts right there Right below my ribs Suggested Answer Physical Assessment form Patient Name: Mr Richards Patient Age: 43 Patient Complaint: dull ache in his side Answer Key stuffy fatigue Suggested Answer It is difficult to distinguish between a cold and the flu because the symptoms of both are similar Suggested Answer A physical examination would not be conducted when the patient does not give their consent D T F sore throat coughing F stuffy nose headache aches fever Suggested Answer A: Good morning Henry Sorry you're not feeling well What are your symptoms? B: Well, I've got a stuffy nose and I keep coughing A: Any sneezing? Or a soar throat? B: No, not yet I have a headache A: Are you feeling tired? Any aches or pains? B: Yeah, I'm really tired And I feel hot A: That's likely a fever Henry, it sounds like you may have the flu B: Oh, really? I was hoping it was just a cold Suggested Answer Patient Report Patient Name: Henry Symptoms: aches and pains, headache, stuffy throat, coughing Diagnosis: Patient most likely has the flu Unit 11 Suggested Answers Some of the ways to deal with pain are taking medication and applying an ice pack Nurses need to understand people's pain because it indicates what is wrong Book A A unbearable shooting constant excruciating B T Medication, Dose, Times burning intermittent Frank Cline sedative (25mg) at pm sharp Ted Hurst distress antihistamines (250mg) at 10 am and pm impact Jack Singer antidepressant (1l5mg) daily at am intensity An occasionally stabbing pain might also be described as an intermittent sharp pain F Name throbbing Suggested Answer Answer Key A D B E C B B B A A Suggested Answer F Ed Parson has a problem with his bowel moveme ~ pain bending unbearable start to lift constant Suggested Answer A: We need to fill out this pain assessment sheet, okay, Karen? Now where are you feeling pain? B: In my shoulder It's worse when strech or lift something A: I see How much does it hurt? B: Pretty bad It can be excruciating A: And when did the pain start? B: When I was doing some gardening yesterday A: And is the pain there all the time, or just sometimes? B: It comes and goes Suggested Answer Patient Name: Karen Describe the location of the pain: in the shoulder What causes or increases the pain? stretching or lifting something Describe the intensity and frequency: excruciating an intermittent F T T patient medication you go it's time s irT' a:-:5 dose no~ go Suggested Answer A: Hi, Marcus Do you have the patient meC ICal c~ list? B: Yeah Here you go A: Thanks Looks like it's time to give Ms Neil her medication B: Erica Neil? But it's only l am A: Exactly It says he needs her first dose of antibiotics B: But Ms Neil is on anti-inflammatories Kate Ford receives antibiotics A: Uh oh There must be a mix-up on the list B: That's not good Let's change that immediately Suggested Answer NP Name: Marcus Erica Neil: anti-inflammatory (125mg) twice daily Bam and pm Unit 12 Suggested Answers Some common medications that people take are antihistamines, anti-inflammatories, painkillers, and antibiotics The benefits of medication are that they combat the symptoms of the illness and decrease discomfort The disadvantages of medication are that often it does not deal with the root cause of the problem Kate Ford: antibiotics (200mg) daily lam Unit 13 Suggested Answers The skills that a licensed practical nurse needs are to know how to administer injections and vaccines, and to organize electronic health records A licensed practical nurse's most important responsibility is to provide patients with the correct care A B A Answer Key Book Answer Key Unit A: It's okay I understand B: I can look into possibly getting you one or two more breaks during shifts Would that help? A: Yes Even that would be great B: Alright I can't make any promises But I'll see what I can Suggested Answers Some nurses find it necessary to work long hours so that they can subsidize their low wages by earning overtime Another explanation is that hospitals are short -staffed and so rely on nurses working long hours rather than on hiring much needed new staff There are many obvious dangers of nurses working too much They will not be able to take care of patients properly Also, they are likely to suffer from fatigue and stress which can be dangerous to their own health F T F D B G A E F part-time workload survey exhaustion overtime Unit The article proposes that financial incentives are provided to nurses so that they avoid early retirement It is also suggested that more pai1-time positions are created to reduce the stress of working long hours A I am writing to you because the working hours and schedules for nurses have become very difficult I am currently working overtime because there are not enough nurses to cover my extra shifts This has led to me feeling extremely tired and overworked As you can appreciate, this situation can negatively affect job performance and put patients at risk There are a number of solutions to this problem which I would like to suggest to you If there was an increase in the number of part time positions available, there would be less need for nurses to work long hours Also I suggest that workloads become lighter, this will prevent exhaustion on the job and errors C Suggested Answer Suggested Answer Suggested Answers Communication between doctors and patients is very important because it allows a better diagnosis to be made Misunderstandings between patients and doctors can arise if too much jargon is used and the patient doesn't understand instructions and does not ask for extra information It is often the case that patients not get the correct information if they have cultural differences These misunderstandings can mean that the patient doesn't understand their condition, or gets very anxious D on your mind exhaustion a little heavy sorry to hear cut my hours overtime Suggested Answer A: Excuse me, Bill Can I talk to you? B: Sure What's on your mind? A: I was wondering if another nurse could take over a couple of my shifts B: Why? Is everything okay? A: Yeah, I'm fine But I leave work feeling really exhausted on most days And the fatigue is starting to get to me B: So you're feeiing overworked? A: A bit My workload is a little heavy B: I'm sorry to hear that But unfortunately, I'm not sure I can much A: Oh May I ask why? B: Well, it's not that I don't want to help, but we're already short on nurses A: So there's no way to cut my hours? B: Not really It would mean giving the other nurses overtime And we just don't have the money 26 communication health trust improve confuse empathy jargon D C A F B E B A A C B C Patients may find medical jargon confusing B D history miscommunication jargon poor health literacy pretty nervous Answer Key j Book Suggested Answer Suggested Answer A: Well, she's complaining of constant stomach B: A: B: A: B: A: B: Answer Key aches I asked about her medical history, but she didn't say much Is it just a miscommunication? Maybe she doesn't know what you're asking for It's possible But I can't tell because she's barely speaking to me She might just be nervous It can be scary to feel terrible but not know why Yeah, she does seem pretty worried Did you use lots of jargon? In my experience, that makes things worse I might have I mean, I asked her if she thought it might be from stress or indigestion See, if she has poor health literacy, those terms might sound scarier than they are Suggested Answer These few tips will help you to improve communication with your patients, this is important to provide the best care possible Be aware that the patient might be feeling anxious or nervous about their health and they might be in pain Try to put them at ease by asking them a few general questions first; it will help them to relax When you are explaining what might be wrong, be sure to avoid jargon Sometimes we may not realize that using medical terms can actually confuse patients and often makes them feel that things are scarier than they really are Unit Suggested Answers Some people not seek medical treatment when ill because they believe that they wil! eventually get better It is dangerous to not seek medical treatment when ill because delaying treatment of acute conditions can cause the onset of chronic ones If you not catch an illness at its onset, there can be complications which can be far more dangerous Early intervention can save time, money and even your life In chronic conditions, early intervention is vital This is because insufficient treatment can actually result in the occurrence of a debilitating acute condition F F a bad cough pneumonia a severe case F gotten so bad acting up again chronic bronchitis Suggested Answer A: Good morning, Mr Hastings You're here because of a bad cough, yes? B: Yes It's been getting worse for a while now A: Well, the doctor believes it's a case of acute pneumonia B: Is that bad? A: It's not a severe case But we would have liked to treat it a little earlier B: Is it harder to treat now? A: A bit You'll have to be on antibiotics longer '10,', If we'd had some kind of intervention earlier It wouldn't have gotten so bad B: Yeah, I thought about coming in to the hospital as soon as the coughing became worse A: Is there a reason you didn't? B: Well, I thought maybe it was just my bronchitis acting up again A: Wait You have chronic bronchitis? B: Yes I've had it for almost ten years now A: Mr Hastings, are you aware that chronic bronchitis makes you more susceptible to infection? F B E F G A T D C F Chronic Acute osteoporosis hypertension endocarditis scarlet fever stroke pneumonia Suggested Answer If people leave chronic conditions untreated, they can often lead to acute ones For example, osteoporosis, if it is not carefully monitored and treated can lead to broken bones Similarly, chronic bronchitis that is not treated properly makes it more likely that the person suffers from respiratory conditions like pneumonia It is also the case that hypertension left unchecked can result in a stroke It is also important that those people who delay treating acute conditions can end up having chronic ones to deal with For example, not treating a fever early on can cause much more serious problems The good news is that visiting a doctor early on in an illness can help avoid these serious complications later on Answer Key 27 Book Answer Key Unit4 A: Not really It's the same idea as lOSing weight Eat more healthy food and less junk B: I should probably be eating healthy anyway Suggested Answers Diabetes can be treated by regulating glucose levels This is done using medications and insulin Diabetes can be prevented by making sure you have a healthy diet and regular exercise F amputations Type diabetes is the most common form of diabetes There are many risk factors that can cause type diabetes These are: genetics, race, a high BMI, inactivity, high blood pressure, high blood fat levels, gestational diabetes and a diet high in fat or alcohol Type diabetes causes blood flow around th~ body to be reduced This then causes problems With the nervous system, digestive system and other organs It can then cause heart attacks, strokes and amputations Diabetics should follow a general healthy eating plan They should eat lots of fruits and vegetables, low fat meat and whole grain pastas and bread F T type diabetes Suggested Answer Insulin gums blindness gestational diabetes cataract glaucoma 8MI type diabetes glucose Suggested Answer Gestational diabetes usually lasts for a short period of time After birth blood sugar usually returns to normal Suggested Answers C genetics age insulin shots lifestyle changes Unit There are many different types of cancers, the four most common of which are the following: breast cancer, colon cancer, lung cancer and prostate cancer Treatment for cancer has improved over the years as advances have been made in chemotherapy, radiation therapy, immunotherapy, photodynamic therapy, hormone therapy and targeted therapy These advances have been made as knowledge about cancer biology has improved Progress in the development of nanotechnology and robotic surgery has also improved cancer treatment control your portions healthy eating plan losing weight Suggested Answer A: Mr Rogers, did Dr Fraser explain your test results? 8: Yes, and I was shocked I can't believe I have type diabetes A: Is there a family history of diabetes? 8: No, none A: Well, there are many risk factors besides genetics 8: But I'm not even overweight A: You are approaching sixty-five, though Unfortunately, age is a factor : Not much I can about that So will I need insulin shots? A: No, not as long as you manage your diabetes by making some lifestyle changes Like monitoring your diet and sugar intake B: That's a relief But I heard that pasta is bad for diabetics That's my favorite food Do I have to give it up? A: So long as you control your portions, no You also might want to consider switching to a whole grain pasta B: Okay Is there a list of foods that I should eat? A: Of course, but it looks a lot like any other healthy eating plan 8: Really? I would have expected something pretty restrictive 28 Answer Key 2 C D A poison oncologist radiation therapy D C A x-ray outpatient chemotherapy Suggested Answer According to the webpage information, radiation therapy is most effective on cancer cells which split very quickly It obstructs the DNA of the cancer cells so they cannot multiply .I I X catheter feel a pinch side effects some other systems X I digestive system hair follicles go completely bald Book getting more exercise, stopping smoking and getting regular check-ups Suggested Answer A: Hello, Mrs Robinson, how are you feeling? B: Well, to be honest, I'm pretty anxious This is my first chemotherapy session A: That's totally natural Would it help if I explained what's going to happen? B: I believe so A: We're going to put a catheter in one of the veins in your arm, and get the chemo into your system that way B: Will it hurt? A: You'll feel a pinch B: And how about the side effects? A: Well the drugs are very strong, because we need to kill the cancer Unfortunately they harm some other systems too B: The doctor said I'll feel sick to my stomach, right? A: Yes Chemo affects the digestive system You'll probably lose your appetite and some weight B: And does that happen right away? A: Yes, probably within a day or two Did the doctor tell you about chemo's effect on hair follicles? B: He did What most patients do? A: It depends on the amount of hair loss Some just wear hats, others, if they go completely bald, wear wigs Answer Key several inactivity coronary artery disease reducing combat surgery stress, aspirin congenital heart disease, cholesterol heart failure, abdominal obesity A B A A B Suggested Answer According to the poster, heart failure can be treated with drugs which can help proper functioning and in some cases surgical procedures can be applied F T F test results coronary artery disease palpitations and dizziness nothing electrolyte imbalances lifestyle changes Suggested Answer Chemotherapy is a drug or a set of drugs which are used to kill cancer cells They can be administered orally in pill, liquid or injection form Chemotherapy can be received in the hospital or in the patient's own home Possible side effects of the treatment include: hair loss, nausea and fatigue Unit Suggested Answers There are a number of diseases which affect the heart Ischemic heart disease means that the heart doesn't pump well, it is also known as cardiomyopathy Congenital heart disease is a type of heart disease that a person is born having It can mean that there is a "hole" in the heart that never closes One final type of heart disease is an electrical problem, also called arrhythmia This means there is a confusion in the path of the electrical "signal" that tells the heart when and how to contract This confusion causes an abnormal heart rhythm The main factors which can decrease someone's chances of getting heart disease involve making dietary changes including reducing intake of red meat or becoming vegetarian, reducing stress, Suggested Answer A: Hi Mr Feliston How are you doing today? B: Fine I'm just anxious to get these test results back A: That's right Dr Peters thinks it could be coronary artery disease or arrhythmia, right? B: Yes, but shouldn't we be able to tell what I've got, just from my results? A: Well, they have the same warning signs: shortness of breath, palpitations and dizziness B: What can I expect as far as treatments go? A: It depends on your diagnosis If it's an arrhythmia, there may not be a need for treatment at all B: Really? Nothing? A: Well, some arrhythmias are just caused by simple things like electrolyte imbalances But if it's more serious than that, there are a few treatment options B: I see What kind of options? A: A combination of lifestyle changes and medication Possibly surgery Suggested Answer In order to avoid heart disease it is important to stop smoking, eat lots of fruit and vegetables, olive oil and to avoid foods high in salt and fats It is also important to exercise regularly, and visit your doctor frequently for check-ups There are various treatment options Answer Key 29 00 Answer Key for someone who already has heart disease These involve lowering blood pressure and cholesterol or surgical options care, so then I moved on to calculating how many resources he would need A: Okay And what did you determine? B: I figured that he would need an MD assessment and an x-ray Unit Suggested Answers Suggested Answer Triage systems are necessary in hospitals so that the severity of each case can be evaluated and priority cases can be seen to immediately Any patient who is in danger of dying immediately should be seen before any other ESI Level Patient Condition ESI1 patient is in danger of dying and needs immediate treatment ESI2 patient is not dying but needs immediate treatment ESI patient is not critically ill and needs no resources at all E B A D acuity fracture F moved on to C D B an MD assessment x-ray A E C F C ESI1 trauma resources According to the nursing guide a critically ill patient should be assigned to ESI level T F patient more serious fracture it was just a Unit8 Suggested Answers Nurses communicate with each other about a patient's care by recording all important information on records which are stored on the computer database and/or on record cards with the patient at all times These records should be comprehensive and concise but contain all important information regarding the patient's illness and treatment, especially their medication Problems can occur when nurses change shifts Sometimes errors happen because writing is not legible, the wrong abbreviation has been used, or something important has been omitted Suggested Answer The ESI triage system is a method by which nurses can quickly and efficiently decide the order in which patients need to be treated The system is based on nurses conducting an assessment of patients and then ranking them in order of priority ESI ranking means the patient needs life-saving treatment ESI means the patient is not critically ill but will need care quickly ESI patients will require multiple resources but can wait for care and ESI4 will only require one resource ESI patients will need no resources at all and are the least urgent cases document abbreviations an assessment Suggested Answer A: Hey, Alice Did you just send a patient into room 208? B: I did Was that wrong? A: No don't worry But we're pretty full, and we should only be admitting the more serious cases B: I used the ESI triage system Do you want to see how I assigned him a level? A: Sure What did the patient come to the ER for? B: He had a wrist fracture A: Was it a compound fracture? B: No, it was just a simple fracture A: What was the acuity of his condition? B: It wasn't very severe He didn't need immediate 30 Answer Key D B status plan of care adhere to Communication is important to staff when they change shift because a lack of communication puts patients at risk If nurses on duty are not properly informed of a patient's status mistakes could be made F F medical record full of abbreviations What sort of morphine T didn't even update chronological order comprehensive concise Book Suggested Answer A: Is something bothering you? B: Yes, it's this medical record I don't understand it at all A: What has happened? B: It's full of abbreviations that I don't understand A: What sort of abbreviations? B: It says the patient got 20 milligrams of M Does that M stand for morphine or magnesium? A: I don't know B: The nurse didn't even add this information There's no assessment of the patient's current status A: Let me have a look Yes, look, it's here It's just that the nurse didn't write it in chronological order B: Oh yes, so it is It isn't very comprehensive though It just says 'stable' A: Yes, I know we're supposed to be concise but this is really bad B: It is, and I can't find any details about the patient's plan of care either A: We should tell the head nurse Maybe she can talk to the other nurses Suggested Answer I thought that you should be informed that I have found some problems with the medical notes you gave me I have encountered some problems with the way medications have been abbreviated This is especially the case with the letter M, it is frequently used but it is not clear if it refers to magnesium or morphine I suggest that we refer to magnesium as Ma to avoid this confusion in the future Clearly it could be quite serious if these medications were confused, morphine is a much more powerful medication and without it those needing it would be in severe pain I hope that this info is helpful Unit Answer Key macrodrip IV pump infusion microdrip roller clamp Parenteral nutrition is nutrition given to a patient through an IV B A hypertonic saline milliliters Let me check checked at the wrong rate roller clamp you'd better check doctor Suggested Answer A: Hello lan? B: Hi, can I help you with something? A: I've been looking at Agatha Flogan's hypertonic saline IV, and it seems to be incorrect B: What you mean? A: The summary sayss he's supposed to be on an IV of thirty milliliters per hour, but it's currently on fifty B: Really? Let me check her records Maybe the doctor ordered it to be increased and we didn't hear about it A: I've already checked them There's nothing written down B: Perhaps someone hit the button by mistake and set it going at the wrong rate A: It could have happened Do you think we should switch over to a regular roller clamp to avoid giving her too much? B: Perhaps But you'd better check with the doctor before you change anything How is the patient doing? A: She hasn't returned to consciousness, but her heart rate and temperature are normal Suggested Answer Suggested Answers Patients have to go on IVs because they need liquids or medications to enter the body quickly and at a regular rate The equipment associated with IV care includes: roller clamps, microdrips and IV pumps T 3 saline, isotonic continuous, intermittent Hypertonic, parenteral direct, hypotonic T F This report refers to Agatha Flogan's IV, which has been set at the wrong rate I went to check on the patient who had been put in my ward after her heart bypass operation According to her records she should be on an IV of 30 milliliters but it is now on fifty milliliters I had to consider whether I would change the level or leave it as it was I decided that it was best to double check her records and then pass on this information to the doctor The doctor confirmed that the IV should be set to 30 milliliters and instructed me to change it to the correct level Answer Key 31 Book Answer Key Unit 10 A: I am sure Now, you have any allergies to latex or dyes? B: No, not that I'm aware of Suggested Answers Patients are prepared for surgery at least one hour before their scheduled surgery Firstly a physical examination is performed and they are given all the necessary paperwork to be signed They take an antiseptic bath which prepares the skin by disinfecting it and the area to be operated on is often removed of hairs The patient is given an ID bracelet and their personal items such as glasses and jewelry are put into storage Patients must be informed of the types of risks associated with the surgery These may include anesthesia complications, bleeding problems, deep vain thrombosis, and heart failure or death during surgery T F F C E A F B Suggested Answer A pre-op checklist is necessary to ensure that the patient is aware of the risks of surgery and to confirm that all the essential preparations have been made It should be completed at least one hour before surgery The attending nurse should make sure that the patient has not eaten or drunk anything at least 12 hours before going under anesthetic and confirm their postop room It is important that the nurse signs and dates the form to show that it has beerl completed Unit 11 Suggested Answers D NPO order EKG report chlorhexidine operative permit personal effects crash cart Suggested Answer According to the passage, the nurse must indicate the completion of the pre-op checklist by initialing each task on the left and signing and dating the form at the bottom A B this surgery over with pre-op checklist operative I sign eat or drink I'm aware of Suggested Answer A: Hello, Miss Felix How are you feeling? B: Okay I'm ready to get this surgery over with A: We're almost ready I just need to finish reviewing this pre-op checklist with you B: Ok, lets that then A: I have your signed anesthesia permit here But I still need you to sign the operative permit B: Alright Where I sign? A: Right here Ok that's done Now, did Dr Giuseppe give you an NPO order? B: Yes, he did I haven't had anything to eat or drink since about 11 pm yesterday I can't wait to eat again though, I am really hungry 32 Answer Key The most common types of infection which can occur in hospitals are MRSA, E Coli and Staph infection Nurses can minimize the spread of infections by encouraging regular hand disinfection and regular cleaning of communal areas 2 Use alcohol-based hand sanitizers Wash your hands with soap and water Use checklists Clean patients' mouth, gums and teeth Use quick diagnostic tests urinary catheter Ventilator-infected pneumonia vector vigilant sanitizer Pathogens MRSA nosocomial E Coli staph infection alcohol-based contamination Suggested Answer According to the information in the flyer staff in hospitals ensure bacteria levels are kept at a minimum by ensuring regular hand washing and by placing alcohol based hand sanitizers throughout the hospital F T outbreak infected patients contamination F alcohol-based sanitizers reported any symptoms diagnostic tests Book Suggested Answer A: I've noticed there has been a recent outbreak of C Diff on the ward B: Yes, that's correct We have all the infected patients in isolation now A: Have those patients received any visitors recently? B: Yes, we're making sure they wash their hands when they arrive and leave to avoid contamination A: Good Make sure they don't use those alcoholbased sanitizers You know they need to use soap and water B: Yes, we've made sure of that A: Excellent Have any of the visitors reported any symptoms? B: No, they haven't A: Okay, but make sure you monitor that What about the nurses? B: One nurse who was treating those patients has come down with something A: The same infection? B: We're not sure They're doing some diagnostic tests at the moment It might be MRSA Suggested Answer There has been an outbreak of C Diff on the ward therefore please take the following precautions to keep spreading to the minimum All nurses must remember to wash their hands with soap and water when they have come in contact with contaminated patients They must also ensure that they ask visitors to wash their hands upon arrival and upon leaving the ward They should contact the hospital if they experience any signs of infection Unit 12 A woman officially has menopause when she has not had a menstrual cycle for twelve months A That's a relief lately I've been entering perimenopause having another child fertility cutting down on A Suggested Answer A: Okay First, are you having regular menstrual cycles? B: Not exactly I've missed three in the last year A: Well, the good news is that you're definitely not in menopause - not until you've missed twelve consecutive cycles B: That's a relief But I've got some other symptoms, too A: Can you describe them? B: I'm not sleeping well, and lately I've been gett ing hot flashes A: All right It sounds to me like you're entering perimenopause It just means your hormones are starting to level off B: So can I still get pregnant? My husband and I still talk about having another child A: Yes, you can But I wouldn't wait too long, because perimenopause does lower fertility B: I see Is there anything we can about the other symptoms? A: Some added exercise will help the insomnia And drinking less alcohol should reduce the hot flashes Suggested Answer Suggested Answers Common issues that OB/GYN nurses must address concern contraception, prenatal care, labor, delivery, menopause and other women's health issues OB/GYN nursing is different from other nursing fields in that its focus is exclusively on women's _health issues F T T G E A D F C Answer Key hot flash hormone therapy gynecology Perimenopause means that hormones are beginning to level off This means that if you are considering having a child it is important to think about it seriously and not wait too long as fertility is lowered at this time The difference between the onset of the menopause and perimenopause, is that the menopause means that you have missed twelve consecutive cycles Symptoms of the changing hormones include hot flashes and insomnia The best ways to reduce these symptoms are to more exercise and reduce alcohol consumption B menstrual cycle progesterone Unit 13 Suggested Answers The elderly are most often affected by illnesses such as Alzheimers disease, hearing loss, immobility and incontinence Answer Key 33 Book Answer Key Nurses must provide special care for the elderly such as helping them with their medications, helping to prevent falls or strokes and providing specialist equipment to aid prevention of bed sores B D D C D F B A E immobility dizziness bed sores drug interaction hearing loss whereas assisted living facilities means that assistance is given as and when it is requested The level of care that is required is assessed at an interview with the elderly person and their family Nursing homes treat patients with a wide variety of problems from immobility and hearing loss to those suffering with Alzheimer's disease Unit 14 Suggested Answers Psychiatric nurses treat people suffering from mental illnesses such as schizophrenia, depression, alcohol and drug addictions and eating disorders, to name a few Psychiatric nurses face alternative challenges to other types of nurses Mentally ill patients in very severe cases often become ill-tempered and sometimes even abusive The nurse also faces the challenge of understanding the nature of the mental illness which is often unclear and so the symptoms may be unexpected Grace Nursing Home is different from other assisted living providers because it provides 24-hour supervision and assistance to patients T geriatric care assisted living levels of care around the clock T F incontinence getting around fairly independent Suggested Answer B: I'm looking into different geriatric care facilities for my mother Can you help me? A: Sure What kind of facility are you interested in? B: Either a nursing home or assisted living We're not sure which is best A: Well, they offer similar services But different levels of care B: How so? A: Nursing homes provide around the clock supervision With assisted living, you can ask for assistance when you need it B: Which you think would be best for my mum? A: Well, her overall health is fairly good But she does have some incontinence problems B: And some problems moving around A: Yes, there are some immobility issues How much assistance would you say she needs with daily activities? B: Not too much She occasionally needs help dressing herself A: But aside from that she's fairly independent, right? B: Yes A: Well, assisted living might be the best fit A A C A C E D B F Electroconvulsive therapy psychiatric nursing psychotherapy DSM-IV diverse rehabilitation Suggested Answer According to the article, psychiatric nurses can help patients to get well and to stay well by making sure that the patient takes their medication regularly / / X 7 psychiatric nursing bipolar disorder based in a hospital rehabilitation mental health interventions psychotherapy electroconvulsive therapy / X Suggested Answer A: Isobel, what exactly is psychiatric nursing? Suggested Answer This talk will be about nursing homes and assisted living Firstly it is important to distinguish between the two Nursing homes provide 24-hour supervision, 34 Answer Key B: Psychiatric Nurses care for people with mental illnesses, such as bipolar disorder and schizophrenia A: Are you based in a hospital? B: No, I most of my work at people's homes Book A: Really? B: Yes, my work involves the rehabilitation of people back into society A: People who have been previously hospitalized because of mental health issues, you mean? B: Yes, and also people with mental illnesses who have been in jail A: Fascinating And what does your work involve? B: I'm trained in a range of interventions I use many of the same skills as regular nurses But I'm also trained in psychotherapy A: And is electricity still used in psychiatric treatment? B: Electroconvulsive therapy? No, that's only used in a small number of cases I've never used it myself Suggested Answer As a psychiatric nurse I treat a wide range of mental illnesses Sometimes people with schizophrenia, other times people with dementia or depression I don't always work on the hospital ward as you would expect, more often than not, I visit people's homes to see how their rehabilitation program is getting on, that is how effectively they are coping with everyday life and to make sure that they are taking their medication To be a psychiatric nurse, you need special training in psychotherapy Unit 15 Suggested Answers T F F G E D A DNR order hospice life expectancy F C holding up increase your morphine drip feeling ready When the time comes I'll see that estimates on Suggested Answer A: Hi, Mr Jamerson How are you holding up today? B: Oh, as well as I can, I suppose How are you? A: I'm well, thanks for asking Are you feeling any pain right now? B: I am, actually It's my neck again A: Okay I'm going to increase your morphine drip just a bit Is there anything else I can right now? B: No, that's it, thank you Now, you have those forms today? A: Yes, I Are you feeling ready to go over them? B: I think so Let's start with the DNR ord~r A: All right Now, you understand what this means When the time comes, we won't provide any life saving measures B: That's right I feel ready, though A: I understand I'll see that this gets updated right away B: And you have the estimates on cremations? A: Yes On average, you're looking at about 1,500 dollars Suggested Answer Nurses can help patients who have no hope of recovering by making them more comfortable and by showing compassion Some of the difficulties with dealing with patients who are dying are dealing with the emotional distress surrounding this situation Although nurses are trained to cope with this it is often difficult nevertheless Answer Key B I have just met with Mr Jamerson He has terminal cancer He feels a lot of pain in his neck today and so I have increased the level of morphine on his drip to ease the pain After a discussion with the patient, he has decided that when the time comes he does not want to receive any life-saving treatment and he has signed his DNR order We also discussed the options for his remains, he has decided on cremation I have supplied him with all the information he needs on his funeral preparations Now that this has been done, it has made him and his family feel more prepared H terminal death certificate end of life care Knowing that their loved ones is comfortable and as prepared as possible can help the family of a person with a terminal disease B C Answer Key 35 Audioscripts Unit Unit3 Nurse (M): Excuse me, Janet Can I talk to you? Supervisor (F): Sure What's on your mind? Nurse: I was wondering if another nurse could take over Nurse (F): Good morning, Mr Arnold You're here a couple of my shifts Supervisor: Why? Is everything okay? Nurse: Yeah, I'm fine But I leave work feeling really tired on because of a bad cough, yes? Patient (M): Yes It's been getting worse for a while now Nurse: Well, the doctor believes it's a case of acute pneumonia most days And the exhaustion is starting to get to me Patient: Is that bad? Nurse: It's not a severe case But we would have liked Supervisor: So you're feeling overworked? Nurse: A bit My workload is a little heavy Supervisor: I'm sorry to hear that But unfortunately, I'm Patient: Is it harder to treat now? Nurse: A bit You'll have to be on antibiotics longer now not sure I can much Nurse: Oh May I ask why? Supervisor: Well, it's not that I don't want to help, but we're already short on nurses Nurse: So there's no way to cut my hours? Supervisor: Not really It would mean giving the other nurses overtime And that's just not in the budget Nurse: It's okay I understand Supervisor: I can look into possibly getting you one or two more breaks during shifts Would that help? Nurse: Yes Even that would be great Supervisor: Alright I can't make any promises But I'll see what I can Unit Nurse (M): Megan, you have a minute? Nurse (F): Sure What's up? Nurse 1: It's about a patient I'm having trouble communicating with her Nurse 2: What you mean? Nurse 1: Well, she's complaining of constant headaches I asked about her medical history, but she didn't say much Nurse 2: Is it just a miscommunication? Maybe she doesn't know what you're asking for Nurse 1: It's possible But I can't tell because she's barely speaking to me Nurse 2: She might just be anxious It can be scary to feel terrible but not know why Nurse 1: Yeah, she does seem pretty nervous Nurse 2: Did you use lots of jargon? In my experience, that makes things worse Nurse 1: I might have I mean, I asked her if she thought they might be migraines or cluster headaches Nurse 2: See, if she has poor health literacy, those terms might sound scarier than they are Nurse 1: Good point Maybe I'll ask her how often they happen instead Nurse 2: Also, make sure to establish a rapport Even just by asking about her day Nurse 1: Oh I didn't really that I just jumped in with my questions Nurse 2: It's important It really helps the patient relax 36 Answer Key to treat it a little earlier If we'd had some kind of intervention earlier, it wouldn't have gotten so bad Patient: Yeah, I thought about coming into the hospital as soon as the coughing became worse Nurse: Is there a reason you didn't? Patient: Well, I thought maybe it was just my bronchitis acting up again Nurse: Wait You have chronic bronchitis? Patient: Yes I've had it for almost ten years now Nurse: Mr Arnold, are you aware that chronic bronchitis makes you more susceptible to infection? Patient: I know But there's not much I can about that Nurse: You'd be surprised Just washing your hands more frequently and avoiding smoke could really help your condition Patient: Oh, well that I can Unit Nurse (F): Mr Finklestein, did Dr Lopez explain your test results? Patient (M): Yes, and I was shocked I can't believe I have type diabetes Nurse: Is there a family history of diabetes? Patient: No, none Nurse: Well, there are many risk factors besides genetics Patient: But I'm not even overweight Nurse: You are approaching sixty, though Unfortunately, age is a factor Patient: Not much I can about that So will I need insulin shots? Nurse: No, not as long as you manage your diabetes by making some lifestyle changes Like monitoring your diet Patient: That's a relief But I heard that pasta is bad for diabetics That's my favorite food Do I have to give it up? Nurse: So long as you control your portions, no You also might want to consider switching to a whole grain pasta Patient: Okay Is there a list of foods that I should eat? Nurse: Of course, but it looks a lot like any other healthy eating plan f Audioscripts Patient: Really? I would have expected something pretty restrictive Nurse: Not really It's the same idea as losing weight Eat more healthy food and less junk Patient: I should probably be eating healthy anyway Unit Nurse (M): Hello, Mrs Henderson, how are you feeling? Patient (F): Well, to be honest, I'm pretty nervous This is my first chemotherapy session Nurse: That's totally natural Would it help if I explained what's going to happen? Patient: I think so Nurse: We're going to put a catheter in one of the veins in your arm, and get the chemo into your system that way Patient: Will it hurt? Nurse: You'll feel a pinch Patient: And the side effects? Nurse: Well the drugs are very strong, because we need to kill the cancer Unfortunately they harm some other systems too Patient: The doctor said I'll feel sick to my stomach, right? Nurse: Yes Chemo affects the digestive system You'll probably lose your appetite and some weight Patient: And does that happen right away? Nurse: Yes, probably within a day or two Did the doctor tell you about chemo's effect on hair follicles? Patient: He did What most patients do? Nurse: It depends on the amount of hair loss Some just wear hats, others, if they go completely bald, wear wigs Patient: I suppose that's the least of my problems Shall we get started? Unit Nurse (F): Hi Mr Rodriguez How are you doing today? Patient (M): Fine I'm just anxious to get these test results back Nurse: That's right Dr Pitt thinks it could be coronary artery disease or arrhythmia, right? Patient: Yes, but shouldn't we be able to tell what I've got, just from my symptoms? Nurse: Well, they have the same warning signs: shortness of breath, palpitations and dizziness Patient: What can I expect as far as treatments go? Nurse: It depends on your diagnosis If it's an arrhythmia, there may not be a need for treatment at all Patient: Really? Nothing? Nurse: Well, some arrhythmias are just caused by simple things like electrolyte imbalances But if it's more serious than that, there are a few treatment options Patient: I see What kind of options? Nurse: A combination of lifestyle changes and medication Possibly surgery Patient: What about coronary artery disease? Nurse: That is also treated with lifestyle changes, drugs and surgery Patient: Okay I definitely want to avoid surgery if I can Nurse: That's understandable Now, remember, it may be neither of those things That's why we ran the tests Patient: Thanks for explaining all this Unit Nurse (M): Hey, Laura Did you just send a patient into room 114? Nurse (F): I did Was that wrong? Nurse 1: Not necessarily But we're pretty full , and we should only be admitting the more serious cases Nurse 2: I used the ESI triage system Do you want to see how I assigned him a level? Nurse 1: Sure What did the patient come to the ER for? Nurse 2: He had a leg fracture Nurse 1: Was it a compound fracture? Nurse 2: No, it was just a simple fracture Nurse 1: What was the acuity of his condition? Nurse 2: It wasn't very severe He didn't need immediate care, so then I moved on to calculating how many resources he would need Nurse 1: Okay And what did you determine? Nurse 2: I figured that he would need an MD assessment and an x-ray Nurse 1: So what ESI level did you assign him to? Nurse 2: I assigned him to ESI Because he wasn't very ill, but he needed multiple resources What you think? Nurse 1: You made the right choice He definitely needs a room Nurse 2: Oh good I was worried I'd made a mistake on my first day Unit Nurse (F): Anything wrong? Nurse (M): Yes, it's this medical record I don't understand it at all Nurse 1: What's the problem? Nurse 2: It's full of abbreviations that I don't understand Nurse 1: What sort of abbreviations? Nurse 2: It says the patient got 20 milligrams of M Does that M stand for morphine or magnesium? Nurse 1: I don't know Nurse 2: The nurse didn't even update it There's no assessment of the patient's current status Nurse 1: Let me have a look Yes, look, it's here It's just that the nurse didn't write it in chronological order Nurse 2: Oh yes, so it is It isn't very comprehensive though It just says 'recovering' Nurse 1: Yes, I know we're supposed to be concise but this is really bad Answer Key 37 Audioscripts Nurse 2: It is, and I can't find any details about the patient's plan of care either Nurse 1: We should tell the head nurse Maybe she can talk to the other nurses Nurse 2: Maybe But in the meantime, I need to get the right information about this patient Nurse 1: You could ask Joanne She was here during the last shift Nurse 2: Good idea, thanks Nurse: Great Now, before the bath, I'll need any personal effects such as watches or keys from you Patient: Alright, here you go Will they be locked up? Nurse: Of course I'll take good care of them Any other questions before we head to the surgery room? Patient: You mentioned something about a bath What's that all about? Nurse: The chlorhexidine bath? It's just a quick rinse to eliminate any harmful bacteria Don't worry about it Patient: Oh okay That doesn't sound too bad Unit9 Nurse (M): Hey, Kathy? Nurse (F): Yes? Nurse 1: I've been looking at Raymond Willis's hypertonic saline IV, and it seems to be off Nurse 2: What you mean? Nurse 1: The summary says he's supposed to be on an IV of fifty milliliters per hour, but it's currently on sixty Nurse 2: Is it? Let me check the records Maybe the doctor ordered it to be increased and we didn't hear about it Nurse 1: I've already checked them There's nothing written down Nurse 2: Perhaps someone accidentally hit the button and set it going at the wrong rate Nurse 1: It's possible Do you think we should switch over to a regular roller clamp to avoid giving him too much? Nurse 2: Maybe But you'd better check with the doctor before you change anything How is the patient doing? Nurse 1: He hasn't returned to consciousness, but his heart rate and temperature are normal Nurse 2: And are there any signs of infection? Nurse 1: No There's no swelling or redness Nurse 2: Good, it seems like there's no problem yet Give the doctor a call and I'm sure he'll clear everything up Nurse 1: Sure, I'll it right away Unit 10 Nurse (F): Hello, Mr Willis How are you feeling? Patient (M): Okay I'm ready to get this surgery over with Nurse: We're almost ready I just need to finish reviewing this pre-op checklist with you Patient: Sure Nurse: I have your signed anesthesia permit here But I still need you to sign the operative permit Patient: Alright Where I sign? Nurse: Right here Thanks Now, did Dr Martinez give you an NPO order? Patient: Yeah I haven't had anything to eat or drink since about 11 pm yesterday I can't wait to eat again Nurse: I can imagine Now, you have any allergies to latex or dyes? Patient: No, not that I'm aware of 38 Answer Key Unit 11 Doctor (F): I've noticed there has been a recent outbreak of C Diff on the ward Nurse (M): Yes, that's right We have all the infected patients in isolation now Doctor: Have those patients received any visitors recently? Nurse: Yes, we're making sure they wash their hands when they arrive and leave to avoid contamination Doctor: Good Make sure they don't use those alcoholbased sanitizers You know they need to use soap and water Nurse: Yes, we've made sure of that Doctor: Excellent Have any of the visitors reported any symptoms? Nurse: No, they haven't Doctor: Okay, but make sure you stay on top of that What about the nurses? Nurse: One nurse who was treating those patients has come down with something Doctor: The same infection? Nurse: We're not sure They're doing some diagnostic tests at the moment It might be E Coli Doctor: E Coli? That's bad We can't have two different nosocomial infections on the ward at the same time Nurse: I realize that Doctor: When you see your nurses today, make sure they're keeping an eye on hygiene We need to keep these infections to a minimum Nurse: Sure, I'll remind them Unit 12 Nurse (M): Good morning, Mrs Brooke You have some questions about menopause, yes? Patient (F): Exactly Basically, I'm worried that it's already started, and I'm only thirty-nine years old Nurse: Okay First, are you having regular menstrual cycles? Patient: Not exactly I've missed at least two in the last year Nurse: Well, the good news is that you're definitely not in menopause - not until you've missed twelve consecutive cycles Patient: That's a relief But I'm definitely showing some other symptoms, too Audioscripts Nurse: Can you describe those? Patient: I'm not sleeping well, and lately I've been getting hot flashes Nurse: All right It sounds to me like you're entering perimenopause It just means your hormones are starting to level off Patient: So can I still get pregnant? My husband and I still talk about having another child Nurse: Yes, you can But I wouldn't wait too long, because perimenopause does lower fertility Patient: I see Is there anything we can about the other symptoms? Nurse: Some added exercise will help the insomnia And cutting down on alcohol should reduce the hot flashes Unit 13 Nurse (M): Hello, Ms Hale What can I for you? Woman (F): I'm looking into different geriatric care facilities for my dad Can you help me? Nurse: Sure What kind of facility are you interested in? Woman: Either a nursing home or assisted living We're not sure which is best Nurse: Well, they offer similar services But different levels of care Woman: How so? Nurse: Nursing homes provide around the clock supervision With assisted living, you can ask for assistance when you need it Woman: Which you think would be best for my dad? Nurse: Well, his overall health is fairly good But he does have some incontinence problems Woman: And some problems getting around Nurse: Yes, there are some immobility issues How much assistance would you say he needs with daily activities? Woman: Not too much He occasionally needs help dressing himself Nurse: But aside from that he's fairly independent, right? Woman: Yes Nurse: Well, assisted living might be the best fit Unit 14 Interviewer (M): We have in the studio today Penny Hargreaves who has come to talk about her job as a psychiatric nurse Good morning Penny Nurse (F): Good morning Bob Interviewer: Penny, what exactly is psychiatric nursing? Nurse: Psychiatric nurses care for people with mental illnesses, such as bipolar disorder, dementia and so forth Interviewer: Are you based in a hospital? Nurse: Personally no I most of my work at people's homes Interviewer: Really? Nurse: Yes, my work involves the rehabilitation of people back into society Interviewer: People who have been previously hospitalized because of mental health issues, you mean? Nurse: Yes, and also people with mental illnesses who have been imprisoned Interviewer: Fascinating And what does your work involve? Nurse: I'm trained in a range of interventions I use many of the same skills as regular nurses But I'm also trained in psychotherapy Interviewer: And is electricity still used in psychiatric treatment? Nurse: Electroconvulsive therapy? No, that's only used in a small number of cases I've never used it myself Interviewer: So Penny, what would you say to anyone considering a career in psychiatric nursing? Nurse: I'd say it's hard work, but it's very rewarding Unit 15 Nurse (M): Hi, Ms Wilson How are you holding up today? Patient (F): Oh, as well as I can, I suppose How are you? Nurse: I'm well, thanks for asking Are you feeling any pain right now? Patient: I am, actually It's my back again Nurse: Okay I'm going to increase your morphine drip just a bit Is there anything else I can right now? Patient: No, that's it, thank you Now, you have those forms today? Nurse: Yes, I Are you feeling ready to go over them? Patient: I think so Let's start with the DNR order Nurse: All right Now, you understand what this means When the time comes, we won't provide any lifesaving measures Patient: That's right I feel ready, though Nurse: I understand I'll see that this gets updated right away , Patient: And you have the estimates on cremations? Nurse: Yes On average, you're looking at about 1,000 dollars Patient: That's pretty steep, isn't it? Nurse: Well, a burial can be five times more expensive Patient: I've always hated wasting money Let's look at the cremation details Answer Key 39 Career Paths English: Nursing is a new educational resource for nursing professionals Reviewed by licensed nurses, it incorporates career-specific vocabulary and contexts into lessons that build professionals' workplace English skills Each unit offers step-by-step instruction that immerses students in four language components: reading , listening, speaking, and writing Career Paths English: Nursing addresses topics including hospital departments, basic equipment, specific illnesses, nursing duties and career options The series is organized into three levels of difficulty and offers over 400 vocabulary terms and phrases Every unit includes a test of reading comprehension, vocabulary, and listening skills, and leads students through written and oral production Included Features: • A variety of realistic reading passages • Career-specific dialogues • 45 read ing and listening comprehension checks • Over 400 vocabulary terms and phrases • Guided speaking and writing exercises • Complete glossary of terms and phrases The Teacher's book contains a full answer key and audio scripts The audio COs contain all recorded material in American English and British English Books 1-3 of Career Paths English: Nursing are rated for the Common European Framework of Reference for Languages at A 1, A2 and B1 respectively Express Publishing ISBN 978-0-85777-839-0 111111111111111111111111 11 780857 778390