Nokea
A patient in the ICU develops catheter-related bloodstream infection (CRBSI) associated with a central venous catheter. What intervention should the healthcare team prioritize to manage the patient's infection?
- A. Remove the central venous catheter to eliminate the source of infection.
- B. Administer broad-spectrum antibiotics targeting common pathogens.
- C. Perform blood cultures to identify the causative organism.
- D. Implement sterile dressing changes and catheter care protocols.
Correct Answer: A
Rationale: The primary intervention that should be prioritized for managing a catheter-related bloodstream infection (CRBSI) associated with a central venous catheter is to remove the central venous catheter. CRBSI is a serious complication that can lead to severe infections and sepsis. The removal of the catheter is crucial to eliminate the source of the infection and prevent further dissemination of the pathogens into the bloodstream. Once the catheter is removed, the healthcare team can consider other interventions such as administering targeted antibiotics based on culture results, performing blood cultures to identify the causative organism, and implementing sterile dressing changes and catheter care protocols. However, immediate removal of the catheter takes precedence in managing CRBSI to prevent worsening of the infection and improve patient outcomes.
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This theory categorizes professionals as Novice to experts is by ______.
- A. Benner
- B. Pender
- C. Abdellah
- D. Kings
Correct Answer: A
Rationale: The theory that categorizes professionals as Novice to experts is by Patricia Benner. Patricia Benner developed the Novice to Expert model, which describes how individuals progress through five levels of proficiency in a skill or field. The five levels are Novice, Advanced Beginner, Competent, Proficient, and Expert. Benner's model is widely used in nursing education and research to understand how nurses develop their clinical skills and expertise over time.
A patient presents with well-demarcated, hypopigmented macules with fine scaling, affecting the trunk and proximal extremities. The patient reports a history of sun exposure and outdoor activities. Which of the following conditions is most likely responsible for this presentation?
- A. Tinea versicolor
- B. Vitiligo
- C. Pityriasis rosea
- D. Seborrheic keratosis
Correct Answer: A
Rationale: The presentation of well-demarcated, hypopigmented macules with fine scaling on the trunk and proximal extremities is classic for tinea versicolor. Tinea versicolor is a common superficial fungal infection caused by Malassezia spp., which leads to hypo- or hyperpigmented patches on the skin. The condition often occurs in individuals with increased sebum production due to factors such as hot and humid climates, sweating, and oily skin. History of sun exposure and outdoor activities is also commonly reported by patients with tinea versicolor. Treatment usually involves antifungal medications applied topically or taken orally to eliminate the fungus. Differentiating tinea versicolor from other skin conditions, such as vitiligo, pityriasis rosea, or seborrheic keratosis, is important for appropriate management.
Which BEST advice the nurse should give in case of dog bite
- A. Wash wound with garlic
- B. Do not feed the dog
- C. Bleed the bitten area
- D. Wash thoroughly with running water
Correct Answer: D
Rationale: When someone is bitten by a dog, the most important first aid step is to wash the wound thoroughly with running water. This helps to remove any dirt or bacteria from the wound, reducing the risk of infection. Washing the wound with garlic (choice A) is not recommended as it can irritate the skin and may not effectively clean the wound. Feeding the dog (choice B) is not relevant to treating the bite wound. Bleeding the bitten area (choice C) is also not necessary and can actually increase the risk of infection. Therefore, the best advice the nurse should give in case of a dog bite is to wash the wound thoroughly with running water.
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 described presentation is classic for acute angle-closure glaucoma. This condition is characterized by sudden-onset severe eye pain, headache, nausea, and vomiting. The red eye, steamy cornea (corneal edema), and mid-dilated non-reactive pupil are consistent with acute angle-closure glaucoma. The sudden increase in intraocular pressure leads to impaired aqueous humor outflow, causing these symptoms. Immediate intervention is required to prevent permanent vision loss in such cases. Central retinal artery occlusion would present with sudden painless vision loss. Optic neuritis typically presents with vision loss and pain with eye movements. Corneal ulcer presents with eye discomfort, foreign body sensation, and may have a history of corneal trauma or contact lens wear.
A patient expresses fear of the unknown regarding an upcoming surgical procedure. What is the nurse's best response?
- A. Dismiss the patient's fear and assure them that the procedure is routine.
- B. Provide the patient with accurate information about the surgical procedure and what to expect.
- C. Ignore the patient's fear and proceed with scheduling the procedure.
- D. Tell the patient that fear of the unknown is irrational and unfounded.
Correct Answer: B
Rationale: The nurse's best response to a patient expressing fear of the unknown regarding an upcoming surgical procedure is to provide the patient with accurate information about the surgical procedure and what to expect. This approach empowers the patient with knowledge and helps alleviate anxiety by demystifying the unknown. By educating the patient about the procedure, potential risks, and postoperative care, the nurse can help the patient feel more prepared and in control of the situation. It is crucial for healthcare providers to address patient fears with compassion, understanding, and information to support the patient through the surgical process.