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A patient became seriously ill after a nurse gave him the wrong medication. After his recovery , he filed a lawsuit. Who is MOST likely to be held liable?
- A. No one because it was an accident
- B. hospital
- C. nurse
- D. nurse and the hospital
Correct Answer: D
Rationale: In cases where a patient becomes seriously ill or is harmed due to receiving the wrong medication, both the nurse and the hospital are likely to be held liable. The nurse is responsible for administering the correct medication to the patient, and any error in this process can lead to harm. The hospital may also be held liable for the actions of its employees, including nurses, under the legal principle of vicarious liability. Additionally, the hospital has a duty to ensure that proper protocols are in place to prevent medication errors, and failure to do so can lead to liability. Therefore, in this scenario, both the nurse and the hospital are likely to share liability for the patient's harm.
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Which of the following is the PRIMARY purpose of pregnancy test?
- A. It allows for counseling on nutrition.
- B. It may help in a decision to stop working at home.
- C. It enables the husband to follow the desires of the wife.
- D. It allows for early initiation of care.
Correct Answer: D
Rationale: The primary purpose of a pregnancy test is to confirm whether a woman is pregnant or not. Once pregnancy is confirmed, it is crucial for the individual to begin prenatal care as early as possible to ensure a healthy pregnancy and delivery. Early initiation of care can help monitor the health of both the mother and the developing fetus, detect any potential issues or complications early on, and provide necessary interventions or treatments. Therefore, the main objective of a pregnancy test is to enable early initiation of care for the pregnant individual.
A patient presents with fatigue, weakness, and jaundice. Laboratory tests reveal hemolytic anemia, elevated LDH, decreased haptoglobin, and presence of schistocytes on peripheral blood smear. Which of the following conditions is most likely to cause these findings?
- A. Hereditary spherocytosis
- B. Glucose-6-phosphate dehydrogenase (G6PD) deficiency
- C. Autoimmune hemolytic anemia (AIHA)
- D. Thalassemia
Correct Answer: B
Rationale: Glucose-6-phosphate dehydrogenase (G6PD) deficiency is an X-linked recessive disorder that leads to hemolytic anemia in response to oxidative stress. The patient's presentation of fatigue, weakness, and jaundice along with laboratory findings of hemolytic anemia (evidenced by schistocytes), elevated LDH, and decreased haptoglobin are all characteristic of G6PD deficiency. The oxidative stress causes red blood cell destruction, resulting in the release of LDH and bilirubin, leading to jaundice. Decreased haptoglobin is seen due to its consumption in binding free hemoglobin released from the lysed red blood cells. Additionally, the presence of schistocytes on a peripheral blood smear is indicative of red blood cell fragmentation, a common finding in hemolytic anemias including G6PD deficiency
A patient with advanced dementia is no longer able to communicate verbally and displays signs of distress. What should the palliative nurse consider when assessing and managing the patient's distress?
- A. Focus solely on physical comfort measures to alleviate distress.
- B. Assume the patient's distress is solely related to physical discomfort.
- C. Explore non-verbal cues and behaviors to identify the underlying causes of distress.
- D. Administer sedative medications to manage the patient's agitation.
Correct Answer: C
Rationale: When assessing and managing distress in a patient with advanced dementia who is no longer able to communicate verbally, the palliative nurse should consider exploring non-verbal cues and behaviors to identify the underlying causes of distress. Since the patient cannot communicate through words, it is essential to pay close attention to their non-verbal cues such as facial expressions, body language, and changes in behavior. Distress in dementia patients can be caused by a variety of factors including physical discomfort, unmet needs, environmental stressors, emotional distress, or even medication side effects. By carefully observing and interpreting non-verbal cues, the nurse can gain insight into what might be causing the patient's distress and tailor interventions accordingly. Simply focusing on physical comfort measures may not address the root cause of the distress, and administering sedative medications without understanding the underlying cause is not considered best practice in palliative care for dementia patients.
A patient is admitted with a suspected myocardial infarction. Which cardiac biomarker is most specific for myocardial injury?
- A. Troponin
- B. Creatine kinase-MB (CK-MB)
- C. Myoglobin
- D. Brain natriuretic peptide (BNP)
Correct Answer: A
Rationale: Troponin is the most specific cardiac biomarker for myocardial injury. Troponin I and Troponin T are proteins released into the bloodstream when there is damage to the heart muscle, making them highly indicative of myocardial infarction. Troponin levels rise within a few hours of cardiac injury, peak within 24-48 hours, and can remain elevated for up to 2 weeks. Troponin is considered the gold standard biomarker for the diagnosis of acute myocardial infarction due to its high specificity and sensitivity for cardiac injury. In contrast, Creatine kinase-MB (CK-MB) and myoglobin are also used in diagnosing myocardial infarction but are less specific than troponin. Brain natriuretic peptide (BNP) is primarily used in heart failure diagnosis and management, and its levels are not specific to myocardial injury.
Which danger sign would warrant stoppage of pills?
- A. Clear vision
- B. Decrease blood pressure
- C. Simple colds
- D. Elevation of blood pressure
Correct Answer: D
Rationale: An elevation of blood pressure would warrant stoppage of pills. High blood pressure, or hypertension, in a 4-year-old child is abnormal and needs prompt medical attention. Giving pills without monitoring or stopping them if blood pressure is elevated can lead to serious health complications. It is important to address the underlying cause of high blood pressure in a child, which may require further evaluation and management by a healthcare provider.