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A patient is prescribed a tricyclic antidepressant for the management of depression. Which adverse effect should the nurse monitor closely in the patient?
- A. Hypertension
- B. Hypotension
- C. Hypernatremia
- D. Hyperkalemia
Correct Answer: A
Rationale: Tricyclic antidepressants (TCAs) are known to have anticholinergic effects, which can lead to various cardiovascular side effects, including orthostatic hypotension, tachycardia, and potential hypertension. While hypotension is a possible adverse effect, hypertension is more commonly associated with TCAs. Therefore, it is essential for the nurse to monitor the patient for signs of hypertension, such as elevated blood pressure readings, to prevent any adverse outcomes and ensure the patient's safety while on this medication.
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Nurse Angie added that oral contraceptives also contains progesterone. Which of the following is the action of progesterone in contraception? It inhibits _______.
- A. Testosterone production
- B. GnRH thereby inhibiting FSH and LH productions.
- C. Luteinising Hormone (LH) thereby inhibiting ovulation.
- D. Follicle Stimulating Hormone (FSH) thereby inhibiting maturation of ovum.
Correct Answer: C
Rationale: Progesterone in oral contraceptives works primarily by inhibiting ovulation. It suppresses the secretion of luteinizing hormone (LH) from the pituitary gland, which is essential for triggering the release of an egg (ovulation) from the ovary. By blocking ovulation, progesterone helps prevent pregnancy by making it less likely for a mature egg to be available for fertilization. This mechanism of action is a key factor in the effectiveness of progesterone-containing contraceptives in preventing pregnancy.
What guideline s IMPORTANT in relation to incident report( IR)? It is ______.
- A. not made part of the patient's chart
- B. placed in the nurse's 201 file
- C. filed in the nurses station
- D. filed in the Records Section of the hospital
Correct Answer: D
Rationale: Incident reports (IR) are filed in the Records Section of the hospital. It is important for incident reports to be kept in the Records Section for various reasons. By being filed in the hospital's official records, incident reports are included in the hospital's documentation of events, which is crucial for legal and quality improvement purposes. Placing IRs in the Records Section ensures that they are accessible to relevant personnel who may need to refer to them in the future for investigations, audits, or further actions related to the incidents. Keeping incident reports in a centralized location like the Records Section also helps in standardizing the process of documenting and tracking incidents, maintaining consistency and accountability within the healthcare facility.
The QA team has been bombarded by complaints of patients on their long waiting period in the OPD, before the health care professionals are examining them. In response to this concern, which type of quality assessment should the team implement?
- A. Outcome evaluation
- B. Ongoing evaluation
- C. Process evaluation
- D. Structures evaluation
Correct Answer: C
Rationale: Process evaluation focuses on assessing how well the activities and procedures are being conducted to achieve the desired outcomes. In this situation, the long waiting period in the OPD is a process issue related to the efficiency of patient flow and appointment scheduling practices. By implementing a process evaluation, the QA team can analyze and improve the workflow, identify bottlenecks causing delays, and streamline the processes to reduce waiting times for patients. This approach allows the team to make targeted improvements in the processes directly associated with the patient experience, leading to a more effective and efficient OPD operation.
Which of the following gives cues to the nurse that the patient may be grieving for loss?
- A. Thoughts, feelings , behavior, and physiologic complaints
- B. Hallucination, panic 1evel of anxiety, sense of impending doom
- C. Sad affect, anger anxiety, and sudden change of mood
- D. Complaints of abdominal pain, diarrhea, loss of appetite
Correct Answer: A
Rationale: A grieving individual may show a range of cues across different aspects of their life. Thoughts may include constant preoccupation with the loss, difficulties in concentrating, or intrusive thoughts. Feelings may involve sadness, anger, guilt, confusion, or relief. Behavioral cues may include changes in sleep patterns, appetite, energy levels, social withdrawal, or the use of substances. Physiologic complaints can manifest as headaches, stomach issues, fatigue, or other physical symptoms. Therefore, when a nurse observes cues related to thoughts, feelings, behavior, and physiologic complaints in a patient, it can suggest that the patient is grieving for a loss.
A patient in the ICU develops acute exacerbation of chronic kidney disease (CKD) with hyperkalemia and metabolic acidosis. What intervention should the healthcare team prioritize to manage the patient's metabolic derangements?
- A. Initiate intravenous sodium bicarbonate for acid-base correction.
- B. Administer insulin and glucose to promote cellular uptake of potassium.
- C. Recommend dietary potassium restriction and potassium-binding agents.
- D. Perform emergent hemodialysis for potassium removal.
Correct Answer: D
Rationale: In the scenario described, with the patient having an acute exacerbation of chronic kidney disease (CKD) leading to hyperkalemia and metabolic acidosis, the priority intervention to manage the metabolic derangements is to perform emergent hemodialysis for potassium removal. Hemodialysis is the most effective and rapid method to lower dangerously high potassium levels in the blood. It is crucial in cases of severe hyperkalemia where other measures such as medications or dietary modifications may not be sufficient or fast enough to correct the elevated potassium levels. Additionally, hemodialysis can also help in improving metabolic acidosis by removing waste products and excess electrolytes from the blood. Overall, emergent hemodialysis is the most appropriate intervention for managing the acute metabolic abnormalities in this critically ill patient.