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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 patient presents with sudden-onset, severe eye pain, headache, nausea, and vomiting. On examination, the affected eye appears red, with a steamy cornea and mid-dilated, non-reactive pupil. Which of the following conditions is most likely responsible for this presentation?
- A. Acute angle-closure glaucoma
- B. Central retinal artery occlusion
- C. Optic neuritis
- D. Corneal ulcer
Correct Answer: A
Rationale: The presentation described is characteristic of acute angle-closure glaucoma. This condition typically presents with sudden-onset severe eye pain, headache, nausea, and vomiting. On examination, the affected eye may appear red due to conjunctival injection, and there may be a steamy cornea due to corneal edema. The mid-dilated, non-reactive pupil is a key finding in angle-closure glaucoma, as the iris bombe (forward movement of the peripheral iris) blocks the drainage angle, leading to increased intraocular pressure. If left untreated, acute angle-closure glaucoma can result in irreversible vision loss. Immediate intervention is crucial to lower the intraocular pressure and prevent further damage to the optic nerve. Prompt referral to an ophthalmologist for definitive treatment is necessary in cases of suspected acute angle-closure glaucoma.
A patient presents with crushing chest pain that lasts longer than 20 minutes, diaphoresis, and dyspnea. An electrocardiogram (ECG) shows ST-segment elevation in the anterior leads. Which cardiovascular disorder is most likely responsible for these symptoms?
- A. Stable angina
- B. Unstable angina
- C. Acute myocardial infarction
- D. Prinzmetal's angina
Correct Answer: C
Rationale: The patient is most likely experiencing an acute myocardial infarction (MI) based on the presentation of crushing chest pain lasting longer than 20 minutes, diaphoresis, dyspnea, and ST-segment elevation on the ECG. These symptoms are consistent with the classic presentation of an ST-segment elevation myocardial infarction (STEMI), which is a type of acute MI that is characterized by prolonged ischemia leading to myocardial cell death. In this case, the ST-segment elevation in the anterior leads indicates myocardial damage in the corresponding area of the heart supplied by the affected coronary artery. This is a medical emergency that requires urgent intervention to restore blood flow to the affected myocardium and prevent further complications.
You are a Drug Abuse Treatment and Rehabilitation Center Nurse. During the assessment of a newly admitted Person Who Uses Drugs (PWUDs) named Korino, which of the following is the MOST APPROPRIATE question to ask?
- A. Ask Korino how long he thought that he could take drugs without someone finding it.
- B. Ask Korino why he started taking illegal drugs.
- C. Not ask any questions for fear Korino will deny and may become assaultive.
- D. Ask Korino about the amount of drug used and its effect and how long he had been using.
Correct Answer: D
Rationale: The most appropriate question to ask during the assessment of a newly admitted Person Who Uses Drugs (PWUDs) like Korino is to ask about the amount of drug used, its effects, and how long he has been using. This question provides valuable information for treatment planning and understanding the extent of Korino's drug use. By asking about the specific details of his drug use, the nurse can assess the severity of the addiction, potential health risks, and the duration of substance abuse. This information is crucial for developing an individualized treatment plan and providing appropriate care for Korino's needs. Asking open-ended questions about drug use also helps build rapport and trust between the nurse and the patient, which is essential for effective treatment.
The ER nurse clarifies the doctor's prescription on the dose of the pain medication based on the pain scale assessment and patient's age. which ethical principle is applied?
- A. Fidelity
- B. Truthfulness
- C. Justice
- D. Non-maleficence
Correct Answer: D
Rationale: Non-maleficence is the ethical principle that emphasizes the obligation to avoid causing harm to patients. In this scenario, the ER nurse clarifies the doctor's prescription to ensure the correct dosage of the pain medication based on the pain scale assessment and the patient's age. By doing so, the nurse is ensuring that the medication is safe and effective for the patient, thus adhering to the principle of non-maleficence. This action demonstrates the nurse's commitment to preventing harm and promoting the well-being of the patient through proper medication management.
The patient asked Nurse Vera when is the best time to visit the clinic for her 1st prenatal care. Which should be the APPROPRIATE answer of the nurse?
- A. Second trimester
- B. Third trimester
- C. Before delivery
- D. First trimester
Correct Answer: D
Rationale: The best time to visit the clinic for the first prenatal care is during the first trimester of pregnancy, ideally before the 12th week. This is because early prenatal care is crucial for monitoring the health of both the mother and the developing baby, identifying any risk factors or complications early on, and initiating important interventions such as prenatal vitamins and screenings. By starting prenatal care early in the first trimester, potential issues can be identified and addressed promptly, leading to better pregnancy outcomes. It is important for pregnant women to seek early prenatal care to ensure a healthy pregnancy and delivery.