Nokea
A patient in the ICU develops acute kidney injury (AKI) secondary to sepsis. What intervention should the healthcare team prioritize to manage the patient's renal function?
- A. Initiate continuous veno-venous hemofiltration (CVVH) for renal replacement therapy.
- B. Administer diuretic medications to promote urine output.
- C. Implement strict fluid restriction to prevent further renal injury.
- D. Perform a renal biopsy to assess the underlying cause of AKI.
Correct Answer: A
Rationale: In a patient with acute kidney injury (AKI) secondary to sepsis in the ICU, the healthcare team should prioritize initiating continuous veno-venous hemofiltration (CVVH) for renal replacement therapy. CVVH is a form of continuous renal replacement therapy that helps support renal function by removing waste products, excess fluids, and electrolytes from the blood while providing hemodynamic stability. This intervention is crucial in managing fluid overload, electrolyte disturbances, and uremia associated with AKI in critically ill patients. It can also help improve overall outcomes and prevent further complications related to renal dysfunction in this setting. Administering diuretics, implementing fluid restriction, or performing a renal biopsy may not directly address the acute renal failure and may not provide the necessary renal support needed in this urgent situation.
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During surgery, the nurse notices an abnormal heart rhythm on the patient's cardiac monitor. What is the nurse's priority action?
- A. Administer antiarrhythmic medication
- B. Assess the patient's vital signs and symptoms
- C. Document the rhythm in the patient's chart
- D. Inform the anesthesiologist immediately
Correct Answer: B
Rationale: The nurse's priority action when noticing an abnormal heart rhythm on the patient's cardiac monitor during surgery is to assess the patient's vital signs and symptoms. This is important because the nurse needs to gather more information about the patient's condition to determine the significance of the abnormal rhythm and the potential impact on the patient's health. By assessing the vital signs and symptoms, the nurse can obtain a more complete picture of the situation and make informed decisions about the next steps in caring for the patient. Once the assessment is done, appropriate actions such as administering medication or notifying the anesthesiologist can be taken based on the findings.
A patient with a history of chronic obstructive pulmonary disease (COPD) is prescribed a metered-dose inhaler (MDI) with a spacer. Which instruction should the nurse include in the demonstration of MDI use?
- A. Inhale slowly and deeply while pressing the canister.
- B. Exhale completely before inhaling the medication.
- C. Shake the inhaler vigorously before each puff.
- D. Hold the breath for 10 seconds after inhaling the medication.
Correct Answer: A
Rationale: The correct instruction for using a metered-dose inhaler (MDI) with a spacer for a patient with COPD is to inhale slowly and deeply while pressing the canister. This technique helps ensure that the medication reaches the lungs effectively. Inhaling slowly and deeply allows the medication to be properly delivered to the airways, maximizing its effectiveness in treating the symptoms of COPD. This instruction helps the patient coordinate pressing the canister with their inhalation, which is crucial for proper medication delivery in COPD management.
A postpartum client who delivered via cesarean section expresses concerns about abdominal incision care and the prevention of wound complications. What nursing intervention should be prioritized to promote optimal incision healing?
- A. Providing education on proper incisional wound care techniques
- B. Administering prophylactic antibiotics to prevent infection
- C. Encouraging the use of abdominal binders for support and compression
- D. Instructing the client on the avoidance of heavy lifting and strenuous activity
Correct Answer: A
Rationale: Nursing intervention should prioritize providing education on proper incisional wound care techniques to promote optimal healing of the abdominal incision. This may include instructions on how to clean the incision site, signs and symptoms of infection, and when to seek medical attention. Proper wound care can help prevent complications such as infection and dehiscence, leading to better outcomes for the client. Administering prophylactic antibiotics, encouraging the use of abdominal binders, and instructing the client on activity restrictions are also important interventions, but educating the client on wound care techniques is crucial for their active participation in their recovery process.
When documenting the procedures done, which of the following should NOT be recorded?
- A. Date
- B. Manufacturer
- C. Lot number
- D. Needle gauge
Correct Answer: B
Rationale: In documenting procedures, it is essential to record information that is relevant to the specific procedure done. Recording the date (A), lot number (C), and needle gauge (D) are critical details that provide important context and traceability for the procedure performed. The date helps to keep track of when the procedure was conducted. The lot number is essential for tracking the specific batch of materials used in the procedure. The needle gauge is important for ensuring the appropriate equipment is used for the procedure. However, recording the manufacturer (B) is not necessary for documenting the procedures as it does not directly impact the quality or traceability of the procedure itself.
Which IMPORTANT Information the nurse should inform the public about rabies?
- A. It could be prevented
- B. It is an ordinary disease
- C. Rabies is not deadly
- D. It kills
Correct Answer: A
Rationale: The nurse should inform the public that rabies can be prevented. This is an extremely important piece of information to help raise awareness about the disease and promote preventive measures such as timely vaccination of both animals and humans. Rabies is a deadly viral infection that affects the central nervous system, and prevention through vaccination is highly effective in controlling its spread. By emphasizing the preventability of rabies, the nurse can educate the public on the importance of taking proactive steps to avoid contracting the disease.