Nokea
A nurse is preparing to perform a continuous bladder irrigation (CBI) procedure for a patient following urological surgery. What action should the nurse prioritize to prevent complications during CBI?
- A. Adjusting the irrigation flow rate based on the patient's urine output
- B. Changing the irrigation solution every 24 hours to maintain sterility
- C. Using tap water for irrigation to prevent electrolyte imbalances
- D. Limiting the duration of CBI to minimize the risk of bladder distention
Correct Answer: A
Rationale: The nurse should prioritize adjusting the irrigation flow rate based on the patient's urine output to prevent complications during continuous bladder irrigation (CBI). Proper adjustment of the irrigation flow rate helps maintain adequate bladder drainage while preventing bladder distention, clot formation, and potential irrigation fluid overload. Monitoring the patient's urine output and adjusting the flow rate accordingly ensures optimal functioning of the CBI system and enhances patient safety. This proactive approach minimizes the risk of complications and promotes effective postoperative care following urological surgery.
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As nursing students were setting up a health screening at a local community center, they reviewed the need to screen for heart disease and cancer. One student asked, "But colon cancer is prevalent: why aren't we setting up for sigmoidoscopy?" How would Nurse Filomena reply?
- A. "Can find adequate privacy for a sigmoidoscopy?"
- B. "A sigmoidoscopy is expensive to perform and invasive".
- C. "Would you like to perform that test for the screening?".
- D. "What a great idea. Would you like to help arrange it?".
Correct Answer: B
Rationale: Performing a sigmoidoscopy, which is a procedure to examine the lower part of the colon and rectum, during a health screening event at a community center may not be practical for several reasons. Firstly, sigmoidoscopy is relatively invasive compared to other screening methods for colon cancer, such as fecal occult blood tests or colonoscopy. Secondly, it can be expensive to perform, especially in a community setting where cost-effectiveness is an important consideration. Therefore, Nurse Filomena would likely point out the invasiveness and cost factors to explain why a sigmoidoscopy may not be suitable for a health screening event at a local community center.
A patient with a history of type 2 diabetes mellitus is prescribed metformin therapy. Which adverse effect is associated with metformin use and requires immediate medical attention?
- A. Hypoglycemia
- B. Lactic acidosis
- C. Hyperkalemia
- D. Peripheral neuropathy
Correct Answer: B
Rationale: Metformin is a commonly prescribed medication for the treatment of type 2 diabetes mellitus. One of the rare but serious adverse effects associated with metformin use is lactic acidosis. Lactic acidosis results from the buildup of lactic acid in the bloodstream, leading to symptoms such as weakness, rapid breathing, abdominal pain, and muscle pain. Lactic acidosis can be life-threatening and requires immediate medical attention. It is important for patients taking metformin to be aware of the signs and symptoms of lactic acidosis and seek immediate medical help if they experience any of these symptoms. Regular monitoring of kidney function is crucial in patients taking metformin to reduce the risk of lactic acidosis.
Which of the following conditions is characterized by the presence of multiple fluid-filled sacs within the ovaries and is associated with menstrual irregularities and hyperandrogenism?
- A. Polycystic ovary syndrome (PCOS)
- B. Ovarian torsion
- C. Ovarian cyst rupture
- D. Ovarian cancer
Correct Answer: A
Rationale: Polycystic ovary syndrome (PCOS) is a common endocrine disorder in women of reproductive age. It is characterized by the presence of multiple fluid-filled sacs (cysts) within the ovaries, which can be visualized on ultrasound. Women with PCOS often experience menstrual irregularities such as irregular periods or no periods, as well as symptoms of hyperandrogenism like hirsutism (excessive hair growth) and acne. Other common features of PCOS include insulin resistance and obesity. It is important to note that not all women with PCOS will have ovarian cysts, but the presence of multiple cysts is a common finding in this condition.
Ms. Cruz is the supervisor of a hospital on night shift. Several nurses did not report due to Jeepney strike. When the supervisor is executing proper allocation of nurses to the PRIORITY wards to address this concern, she is observing what type of principle?
- A. Beneficence
- B. Justice
- C. Non-maleficence
- D. Fidelity
Correct Answer: B
Rationale: When the supervisor allocates nurses to the priority wards in response to the situation of several nurses not reporting due to the Jeepney strike, she is practicing the ethical principle of justice. Justice in healthcare pertains to the fair distribution of resources and the equitable treatment of individuals. By ensuring that nurses are allocated fairly and appropriately to address the urgent needs of the hospital and its patients, the supervisor is upholding the principle of justice. This decision aims to ensure that all patients receive the care they need despite the unexpected staffing shortage.
For a client having an episode of acute narrow-angle glaucoma, a nurse expects to give which of the following medications?
- A. Acetazolamide (Diamox )
- B. Furosemide (Lasix)
- C. Atropine
- D. Urokinase (Abbokinase)
Correct Answer: A
Rationale: Acute narrow-angle glaucoma is a medical emergency that requires timely intervention to reduce intraocular pressure. Acetazolamide (Diamox) is a medication commonly used to treat this condition as it works as a carbonic anhydrase inhibitor, reducing the production of aqueous humor in the eye. By reducing the production of aqueous humor, acetazolamide helps decrease intraocular pressure rapidly, which is crucial in managing acute narrow-angle glaucoma. Other options listed, such as Furosemide (Lasix), Atropine, and Urokinase (Abbokinase), are not typically used in the treatment of acute narrow-angle glaucoma.