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A patient presents with episodic throbbing headache associated with nausea, vomiting, and sensitivity to light and sound. Symptoms are often preceded by an aura. Which of the following neurological conditions is most likely responsible for these symptoms?
- A. Migraine headache
- B. Cluster headache
- C. Tension-type headache
- D. Chronic daily headache
Correct Answer: A
Rationale: The patient's presentation of episodic throbbing headache associated with nausea, vomiting, sensitivity to light and sound, and aura suggests a diagnosis of migraine headache. Migraines are a common neurological condition characterized by recurrent moderate to severe headaches that are often unilateral, pulsating, and aggravated by physical activity. The presence of premonitory symptoms (aura) before the headache is a key feature commonly seen in migraines. Additionally, nausea, vomiting, and sensitivity to light and sound are also common features associated with migraines.
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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.
When the nurse placed the patient in restraints before using other methods of intervention, she/he violated the patient's rights to ______.
- A. receive confidential and respectful care
- B. provide informed consent
- C. receive treatment in the least restrictive environment
- D. refuse treatment
Correct Answer: C
Rationale: Placing a patient in restraints before utilizing other less restrictive interventions violates the patient's right to receive treatment in the least restrictive environment. Restraints should be used as a last resort when all other options have been exhausted, as they can be restrictive to the patient's movement and freedom. Patients have the right to be treated in a manner that minimizes limitations on their personal freedom and autonomy. Restraints should only be utilized when absolutely necessary for the safety of the patient or others.
The positive practice environment PPE is part of the quality standards of every health facility in the country today. Which of the following is NOT a component of the PPE in the work setting?
- A. waste management
- B. electrical wires
- C. peer review
- D. infection control
Correct Answer: B
Rationale: The positive practice environment (PPE) in a health care setting typically includes components such as waste management, infection control, and peer review. However, electrical wires are not a standard component of the PPE in a work setting. Electrical safety is important in a healthcare facility, but it is usually addressed in a separate set of guidelines and protocols focusing specifically on electrical safety and maintenance. Therefore, among the given options, electrical wires are not considered a component of the positive practice environment in the work setting.
After the data analysis of their study, experiences of pregnant women in labor, they returned to the participants to determine the accuracy of the emerged themes. Which criteria of trustworthiness is the group doing?
- A. Confirmability
- B. Transferability
- C. Credibility
- D. Dependability
Correct Answer: A
Rationale: Confirmability is the criteria of trustworthiness that refers to the degree to which the findings of a study are based on the data itself and not on the biases, motivations, or interests of the researchers. In this scenario, returning to the participants to confirm the accuracy of the emerged themes is a way to ensure the confirmability of the study findings. By involving the participants in the validation process, the researchers are seeking to verify that the themes identified truly reflect the experiences of the pregnant women in labor as reported by the participants. This practice enhances the credibility and trustworthiness of the study's findings by confirming their alignment with the participants' perspectives and experiences.
A nurse is preparing to perform an intracranial pressure (ICP) monitoring procedure for a patient with traumatic brain injury. What action should the nurse prioritize to ensure procedural accuracy?
- A. Ensuring proper zeroing and calibration of the ICP monitoring system
- B. Positioning the patient in a high-Fowler's position during the procedure
- C. Administering prophylactic antibiotics to prevent infection
- D. Placing the ICP monitor in the subarachnoid space via lumbar puncture
Correct Answer: A
Rationale: The nurse should prioritize ensuring proper zeroing and calibration of the ICP monitoring system to ensure procedural accuracy and reliability of the measurements obtained. Proper zeroing involves setting the transducer at the level of the patient's external auditory meatus (ear), which serves as a reference point for accurate ICP readings. Calibration is necessary to establish accurate pressure measurements. Incorrect zeroing or calibration can lead to inaccurate ICP readings, which can impact clinical decision-making for patients with traumatic brain injury. Positioning the patient in a high-Fowler's position, administering prophylactic antibiotics, or placing the ICP monitor in the subarachnoid space via lumbar puncture are not directly related to ensuring the accuracy of the ICP monitoring procedure.