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A nurse is preparing to perform a bedside bronchoscopy procedure for a patient. What action should the nurse take to ensure patient safety during the procedure?
- A. Administering sedation to the patient before the bronchoscopy
- B. Obtaining informed consent from the patient or their legal representative
- C. Skipping the use of topical anesthesia to minimize patient discomfort
- D. Allowing the patient to eat or drink up to one hour before the procedure
Correct Answer: B
Rationale: The correct action for the nurse to ensure patient safety during a bedside bronchoscopy procedure is to obtain informed consent from the patient or their legal representative. Informed consent is a vital ethical and legal requirement before any medical procedure. It ensures that the patient understands the risks, benefits, and alternatives of the procedure, as well as gives the patient the authority to make decisions about their healthcare. By obtaining informed consent, the nurse ensures that the patient has been properly informed and agrees to undergo the bronchoscopy, which promotes patient autonomy and safety. Administering sedation, using topical anesthesia, and restricting food intake are also important aspects of bronchoscopy preparation, but obtaining informed consent is the primary action to prioritize patient safety.
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Who among the passengers will take PRIORITY for the rescue team to transport to the hospital?
- A. Student with Colle's fracture.
- B. Jay with lacerations
- C. Pregnant women
- D. Conductor with broken leg
Correct Answer: C
Rationale: In emergency situations, pregnant women are typically given priority when it comes to transportation to the hospital. This is because they have unique medical needs and potential complications that require immediate attention. It is important to ensure the well-being of both the mother and the unborn child. Additionally, the health and safety of the unborn child are critical considerations in determining priority for medical treatment and transport. Therefore, the pregnant woman should be the priority for the rescue team to transport to the hospital.
A nurse doubts that the physician has prescribed an unusually large dosage of a medication. The nurse ask the senior nurse on duty about the order if it is correct or wrong, the senior nurse tells the nurse that the order is correct. The nurse comply with the order and administer it to the patient. The patient eventually died. Who is liable for this situation.
- A. Physician
- B. Nurse
- C. Senior nurse
- D. Physician and nurse
Correct Answer: D
Rationale: The physician is ultimately responsible for prescribing the correct dosage of medication to the patient. However, the nurse also plays a critical role in ensuring patient safety by questioning any orders that appear to be unusual or incorrect. In this scenario, the nurse had doubts about the unusually large dosage but was reassured by the senior nurse that the order was correct. Both the physician and the nurse failed in their responsibilities, leading to the patient's unfortunate death. The senior nurse also shares liability as they provided incorrect guidance to the nurse administering the medication. Ultimately, the situation was a result of a breakdown in communication and adherence to proper procedures by both the physician and the nurse.
A patient admitted to the ICU develops delirium characterized by acute onset confusion and agitation. What intervention should the healthcare team prioritize to manage the patient's delirium?
- A. Administer antipsychotic medications to reduce agitation.
- B. Implement environmental modifications to promote orientation.
- C. Refer the patient to a psychiatrist for further evaluation.
- D. Prescribe benzodiazepines for sedation and calming effect.
Correct Answer: B
Rationale: The healthcare team should prioritize implementing environmental modifications to promote orientation in a patient with delirium. Delirium is a state of acute confusion and agitation that can be triggered by various factors such as medications, infections, or metabolic disturbances. Environmental modifications involve creating a calm, quiet, and well-lit environment for the patient. Promoting proper orientation through the use of clocks, calendars, and familiar objects can help reduce confusion and improve the patient's understanding of their surroundings. These interventions are non-pharmacological and aim to address the underlying causes of delirium while minimizing the need for additional medications that may have potential side effects. Antipsychotic medications and benzodiazepines should be used judiciously and under close supervision due to the risk of adverse effects in older adults and critically ill patients. Referring the patient to a psychiatrist may be considered if the delirium is complex or if there are underlying psychiatric issues contributing to the presentation.
A patient admitted to the ICU develops acute exacerbation of chronic heart failure (CHF) with pulmonary edema and respiratory distress. What intervention should the healthcare team prioritize to manage the patient's exacerbation?
- A. Administer intravenous loop diuretics for fluid removal.
- B. Initiate positive pressure ventilation for respiratory support.
- C. Perform emergent pericardiocentesis for tamponade relief.
- D. Recommend inotropic medications to improve myocardial contractility.
Correct Answer: B
Rationale: In this scenario, the patient is presenting with acute exacerbation of chronic heart failure (CHF) complicated by pulmonary edema and respiratory distress. The priority intervention for managing this exacerbation is to initiate positive pressure ventilation for respiratory support. Positive pressure ventilation, such as non-invasive positive pressure ventilation (NIPPV) or invasive mechanical ventilation, can help improve oxygenation and decrease the work of breathing for the patient. By providing adequate respiratory support, ventilation can reduce the negative effects of pulmonary edema and respiratory distress due to CHF exacerbation. Administering intravenous loop diuretics (Choice A) might be necessary to address fluid overload, but it is not the initial priority as ensuring adequate ventilation is crucial. Emergent pericardiocentesis (Choice C) is not indicated in this scenario as there is no mention of cardiac tamponade. Inotropic medications (Choice D) may be considered in managing acute exacerbation of CHF but
Which of the following is a common complication associated with benign prostatic hyperplasia (BPH)?
- A. Urinary retention
- B. Erectile dysfunction
- C. Urethral stricture
- D. Renal calculi
Correct Answer: A
Rationale: Benign prostatic hyperplasia (BPH) can lead to urinary retention, which is a common complication associated with this condition. As the prostate gland enlarges, it can obstruct the flow of urine from the bladder through the urethra. This obstruction can result in difficulty starting to urinate, weak urine flow, frequent urination, incomplete bladder emptying, and eventually urinary retention. If left untreated, urinary retention can lead to serious complications such as urinary tract infections, bladder damage, kidney damage, and even kidney stones. Therefore, urinary retention is an important complication to be aware of in patients with BPH.