Nokea
A patient is prescribed an angiotensin-converting enzyme (ACE) inhibitor for the management of hypertension. Which adverse effect should the nurse monitor closely in the patient?
- A. Hyperkalemia
- B. Hypoglycemia
- C. Hypercalcemia
- D. Hypotension Theatre Nursing
Correct Answer: A
Rationale: When a patient is prescribed with an angiotensin-converting enzyme (ACE) inhibitor for managing hypertension, the nurse should monitor closely for signs of hyperkalemia. ACE inhibitors can affect the renin-angiotensin-aldosterone system, leading to decreased aldosterone secretion and impaired potassium excretion by the kidneys. As a result, potassium levels in the blood may increase, leading to hyperkalemia.
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Which of the following conditions does the nurse explain to the patient the contributory factor that slows uterine involution?
- A. Full bladder during labor
- B. Difficult birth
- C. Prolonged labor
- D. Infection during pregnancy
Correct Answer: C
Rationale: Prolonged labor is a condition in which labor lasts for an extended period, typically more than 20 hours for first-time mothers and more than 14 hours for experienced mothers. Prolonged labor can contribute to slowing down uterine involution because the prolonged pressure and strain on the uterus can affect its ability to return to its pre-pregnancy size and position. The prolonged contractions and stretching of the uterine muscles can hinder the normal process of uterine involution, leading to a delay in the uterus shrinking back to its non-pregnant state. Additionally, prolonged labor can increase the risk of postpartum complications such as excessive bleeding and infection, which can further impact uterine involution. Therefore, it is crucial for healthcare providers to monitor labor progress closely to prevent prolonged labor and its potential effects on uterine involution.
Upon further assessment, you notices that she had any scratches on her right ankle, a resulting infection, and cellulitis. When you asked her about the scratches, the patient states, "Oh, my cat might have been using my leg as a scratiching post again and I did not even feel it." Which diabetic complicatons suspect the patient to have?
- A. Neuropathy
- B. Retinopathy
- C. Macroangiopathy
- D. Nephropathy
Correct Answer: A
Rationale: The patient's lack of sensation in her right leg, allowing her cat to scratch her without her noticing, is indicative of neuropathy. Neuropathy is a common diabetic complication characterized by nerve damage that can result in loss of sensation or altered sensation in different parts of the body, including the extremities. In this case, neuropathy has likely affected the patient's right lower extremity, leading to her inability to feel the cat scratching her leg and resulting in the unnoticed scratches, infection, and subsequent cellulitis.
A patient admitted to the ICU develops acute gastrointestinal bleeding requiring urgent intervention. What intervention should the healthcare team prioritize to manage the patient's bleeding?
- A. Perform endoscopic hemostasis with mechanical or thermal techniques.
- B. Administer proton pump inhibitors (PPIs) to reduce gastric acid secretion.
- C. Implement strict bed rest to minimize physical exertion and bleeding risk.
- D. Recommend transfusion of fresh frozen plasma to correct coagulopathy.
Correct Answer: A
Rationale: In a patient with acute gastrointestinal bleeding requiring urgent intervention, the healthcare team should prioritize performing endoscopic hemostasis with mechanical or thermal techniques. Endoscopy allows for direct visualization of the source of bleeding in the gastrointestinal tract, enabling targeted interventions such as clipping, cauterization, or injection of epinephrine to achieve hemostasis. This approach is effective in managing acute bleeds and can help stop the bleeding quickly, reducing the need for more invasive procedures or surgeries. Administering proton pump inhibitors (PPIs) may be considered for acid-related bleeding, but it is not the primary intervention for acute bleeding requiring urgent management. Strict bed rest may not be necessary and can increase the risk of complications such as deep vein thrombosis. Transfusion of fresh frozen plasma may be indicated if there is evidence of coagulopathy, but addressing the bleeding source should be the initial priority to
Based on her knowledge on otitis media, Nurse Selma recalls that children are predisposed to AOM due to the following rish factors, EXCEPT ______.
- A. absence of breastfeeding
- B. swimming
- C. exposure to cigarette smoke
- D. poor hygiene
Correct Answer: A
Rationale: Breastfeeding is actually a protective factor against acute otitis media (AOM) in children due to the antibodies and nutrients present in breast milk that help strengthen the immune system and the Eustachian tube function. Swimming, exposure to cigarette smoke, and poor hygiene are all risk factors for AOM. Swimming can introduce water into the ears, which can lead to infections. Exposure to cigarette smoke can irritate the mucous membranes in the respiratory tract and increase the risk of infections. Poor hygiene can lead to the spread of bacteria that can cause AOM.
When preparing the patient for suctioning, what is the FIRST step?
- A. Perform hand hygiene
- B. Gather equipment
- C. Assess lung sounds, heart rate and rhythm
- D. Check physician's order and patient care plan
Correct Answer: D
Rationale: Before any procedure, it is crucial to ensure that you have the proper authorization and guidelines in place. By checking the physician's order and the patient care plan, you confirm that suctioning is indeed needed and that you follow the specific instructions for that patient. This step helps ensure patient safety and effective care delivery. Once you have verified this information, you can proceed with gathering equipment, performing hand hygiene, and assessing the patient's condition as necessary.