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A patient is admitted for a splenectomy. Why is an injection of Vit. K ordered before surgery?
- A. To correct clotting problems
- B. To prevent postoperative infection
- C. To promote healing
- D. To dry secretions
Correct Answer: A
Rationale: Step 1: Vitamin K is essential for the synthesis of clotting factors in the liver.
Step 2: A splenectomy increases the risk of bleeding due to decreased platelet sequestration.
Step 3: Preoperative Vitamin K injection helps correct any clotting deficiencies.
Summary:
- Choice B is incorrect as Vitamin K does not prevent infection.
- Choice C is incorrect as Vitamin K does not directly promote healing.
- Choice D is incorrect as Vitamin K does not dry secretions.
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Which antiparkinsonian drug is associated with the on-off phenomenon and the wearing-off effect?
- A. Amantadine
- B. Levodopa
- C. Benztropine
- D. Pramixole
Correct Answer: B
Rationale: The correct answer is B: Levodopa. Levodopa is associated with the on-off phenomenon and wearing-off effect in Parkinson's disease treatment due to fluctuations in its effectiveness over time. The on-off phenomenon refers to sudden and unpredictable changes in motor function, while wearing-off effect occurs when the medication's effects diminish before the next dose. Amantadine (A) is not typically associated with these phenomena. Benztropine (C) is an anticholinergic used for tremors and rigidity. Pramixole (D) is a dopamine agonist that can cause dyskinesias but is not primarily linked to on-off or wearing-off effects.
At 1400, the nurse notices that the dressing is saturated and leaking. What is the nurse’s next action?
- A. Wait and change the dressing at 1800 as ordered. NursingStoreRN
- B. Revise the plan of care and change the dressing now.
- C. Reassess the dressing and the wound in 2 hours.
- D. Discontinue the plan of care for wound care.
Correct Answer: B
Rationale: The correct answer is B because a saturated and leaking dressing indicates a potential infection risk and compromised wound healing. The nurse should revise the plan of care and change the dressing immediately to prevent complications. Waiting until 1800 (choice A) could lead to further contamination and delay in treatment. Reassessing in 2 hours (choice C) might worsen the condition. Discontinuing the plan of care (choice D) is not appropriate without addressing the immediate issue.
A nurse is developing a care plan. Which intervention is most appropriate for the nursing diagnostic statement Risk for loneliness related to impaired verbal communication?
- A. Provide the patient with a writing board each shift.
- B. Obtain an interpreter for the patient as soon as possible.
- C. Assist the patient in performing swallowing exercises each shift.
- D. Ask the family to provide a sitter to remain with the patient at all times.
Correct Answer: A
Rationale: The correct answer is A: Provide the patient with a writing board each shift. This intervention addresses the impaired verbal communication by offering an alternative way for the patient to communicate. Writing board enables the patient to express thoughts and feelings, reducing the risk of loneliness. Choice B doesn't directly address the communication issue. Choice C is not relevant to the nursing diagnosis. Choice D, while promoting companionship, doesn't address the specific communication concern stated in the diagnosis.
Which of the following BP changes alerts the nurse to increasing ICP, and should be reported immediately?
- A. Gradual increase
- B. Widening pulse pressure
- C. Rapid drop followed by gradual increase
- D. Rapid fluctuations
Correct Answer: B
Rationale: The correct answer is B, Widening pulse pressure. This indicates increasing intracranial pressure (ICP) as it signifies a significant difference between systolic and diastolic blood pressure. A widening pulse pressure is a key sign of impending herniation and requires immediate intervention.
A: Gradual increase does not provide a clear indication of acute changes in ICP.
C: Rapid drop followed by gradual increase may suggest other conditions and is not specific to increasing ICP.
D: Rapid fluctuations may occur in various scenarios and do not specifically point to increasing ICP.
In summary, a widening pulse pressure is the most critical and specific indicator of increasing ICP among the choices provided.
Which of the following guidekines does not observe surgical asepisi in the operating room?
- A. sterile articles may touch other sterile articles or surface and remain sterile
- B. gowns of surgical team are considered sterile in front from the chest down to the bottom of the gown
- C. whenever a sterile barrier is breached, the area must be considered contaminated
- D. sterile drapes are used to create a sterile field
Correct Answer: A
Rationale: The correct answer is A because in surgical asepsis, sterile articles should not touch other sterile articles or surfaces to maintain sterility. Choice B is correct as surgical team gowns are sterile in front. Choice C is correct as any breach makes the area contaminated. Choice D is correct as sterile drapes create a sterile field.