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A nurse is preparing to assist with a percutaneous endoscopic gastrostomy (PEG) tube insertion for a patient requiring long-term enteral feeding. What action should the nurse prioritize to ensure procedural success?
- A. Confirming the patient's fasting status before the PEG tube insertion
- B. Positioning the patient in a supine position with the head of the bed elevated
- C. Administering prophylactic antibiotics to prevent infection
- D. Coordinating with radiology or gastroenterology for procedural guidance Dermatology
Correct Answer: D
Rationale: Coordinating with radiology or gastroenterology for procedural guidance is crucial to ensure the success of a percutaneous endoscopic gastrostomy (PEG) tube insertion. This procedure is typically performed under endoscopic guidance to ensure proper placement of the tube into the stomach through the abdominal wall. Radiology or gastroenterology professionals are trained to perform and guide the insertion procedure, making their involvement essential for a successful outcome. Additionally, their expertise helps minimize the risk of complications during and after the PEG tube placement.
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A primigravida at 40 weeks gestation is in active labor. The nurse notes late decelerations on the fetal monitor tracing. What action should the nurse take first?
- A. Administer oxygen to the mother.
- B. Change the mother's position.
- C. Prepare for immediate delivery.
- D. Discontinue oxytocin infusion.
Correct Answer: D
Rationale: Late decelerations on the fetal monitor tracing indicate a potential uteroplacental insufficiency, which could be caused by decreased oxygen supply to the fetus. One common cause of late decelerations is uterine hyperstimulation due to excessive use of oxytocin. By discontinuing the oxytocin infusion, the nurse can help alleviate the stress on the fetus and decrease the likelihood of further late decelerations. This action should be prioritized before other interventions such as changing the mother's position or administering oxygen. Immediate delivery may be necessary if the fetus continues to show signs of distress despite discontinuing the oxytocin infusion.
The nurse assists a health care provider in performing a liver biopsy. After the biopsy, the nurse should place the client in which position?
- A. Prone
- B. Supine
- C. A left side-lying position with a small pillow or folded towel under the puncture site
- D. A right side-lying position with a small pillow or folded towel under the puncture site
Correct Answer: C
Rationale: Placing the client in a left side-lying position after a liver biopsy helps to promote pressure on the puncture site, which can reduce the risk of bleeding. Placing a small pillow or folded towel under the puncture site provides additional support and helps to maintain pressure on the area. This position also helps prevent the client from putting pressure on the abdomen, which could potentially affect the biopsy site and increase the risk of bleeding or complications. Overall, positioning the client on the left side with support under the puncture site is the most appropriate and safest option after a liver biopsy.
A patient with a history of chronic liver disease presents with jaundice, ascites, and spider angiomas. Laboratory tests reveal elevated serum bilirubin levels, prolonged prothrombin time, and hypoalbuminemia. Which condition is the patient most likely experiencing?
- A. Hepatic encephalopathy
- B. Hepatorenal syndrome
- C. Cirrhosis
- D. Acute liver failure
Correct Answer: C
Rationale: The patient's presentation of jaundice, ascites, spider angiomas, elevated serum bilirubin levels, prolonged prothrombin time, and hypoalbuminemia are all indicative of cirrhosis. Cirrhosis is a late stage of liver disease characterized by liver scarring and poor liver function. Jaundice, which is the yellowing of the skin and eyes due to elevated bilirubin levels, is a common manifestation of liver dysfunction seen in cirrhosis. Ascites, the accumulation of fluid in the abdomen, is also a common complication of cirrhosis. Spider angiomas, which are small blood vessels near the skin's surface, are a result of altered blood flow in the liver due to cirrhosis. Prolonged prothrombin time and hypoalbuminemia are consequences of reduced liver synthesis function in cirrhosis. Hepatic encephalopathy and hepatorenal syndrome
The type of epidemiologic study that is used to describe a group of persons enrolled in a study who share some characteristic of interest and who are followed over a period of time to observe some health outcome is a/an:
- A. Cross-sectional study
- B. Cohort study
- C. Experimental study
- D. Case control study
Correct Answer: B
Rationale: Cohort studies are types of epidemiological studies that involve a group of individuals who share a common characteristic or experience and are followed over time to observe the development of a particular health outcome. This type of study is useful in determining the incidence of a disease, identifying risk factors, and studying the natural history of a disease. Cohort studies allow researchers to investigate the relationship between exposure and outcome by following participants forward in time. It helps in establishing causality and is particularly useful for studying rare exposures or outcomes. In contrast, cross-sectional studies involve collecting data from a population at a single point in time, experimental studies involve interventions and control groups, and case-control studies involve comparing individuals with a particular health outcome (cases) to those without the outcome (controls) retrospectively.
Nursing programs that are based on needs assessment and needs analysis and should ne offered free is which of the following?
- A. Continuing Development Program
- B. In-service Training Program
- C. Nursing Education Program
- D. Post-graduate program
Correct Answer: C
Rationale: Nursing programs that are based on needs assessment and needs analysis are meant to provide education and training to current or aspiring nurses according to specific needs within the healthcare system. These programs are usually foundational education programs that are essential for producing competent and skilled nurses. Offering such programs for free ensures that individuals with a passion for nursing but limited financial resources can access quality education and training opportunities. This helps in bridging the gap in the healthcare workforce and ultimately contributes to the overall health and well-being of the population.