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A patient with a history of angina pectoris is prescribed nitroglycerin sublingual tablets for chest pain relief. Which instruction should the nurse provide to the patient regarding nitroglycerin administration?
- A. Swallow the tablet whole with water.
- B. Chew the tablet before swallowing.
- C. Place the tablet under the tongue until it dissolves.
- D. Apply the tablet to the skin over the chest area.
Correct Answer: C
Rationale: Nitroglycerin sublingual tablets are meant to be dissolved under the tongue to allow for rapid absorption into the bloodstream. Placing the tablet under the tongue helps to bypass the first-pass metabolism in the liver, leading to a quicker onset of action and chest pain relief. Chewing, swallowing, or applying the tablet to the skin will result in decreased effectiveness or delayed onset of action. Therefore, it is important for the patient to be instructed to place the nitroglycerin tablet under the tongue and allow it to dissolve for optimal therapeutic benefit.
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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.
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.
In terms of social support therapy, which of these is the MOST APRROPRIATE and therapeutic?
- A. With appropriate support, lives in the community, either independently or in supervised setting .
- B. Individualized relationship with a caregiver.
- C. High structured environment with constant aid and supervision.
- D. Vocational training with moderate supervision but not beyond second grade academic challenges.
Correct Answer: A
Rationale: In terms of social support therapy for a patient with Amyotrophic Lateral Sclerosis (ALS), the most appropriate and therapeutic option would be for the patient to live in the community with appropriate support, either independently or in a supervised setting. This approach allows the individual to maintain a sense of autonomy and independence while still having access to necessary support and care as needed. Living in the community promotes social interaction, engagement, and a sense of normalcy, which can contribute positively to the patient's mental well-being and overall quality of life. This approach also aligns with the principles of person-centered care, focusing on the individual's preferences, needs, and autonomy.
Which of the following laboratory findings is characteristic of a patient with a diagnosis of gestational diabetes mellitus (GDM)?
- A. Fasting blood glucose ≥126 mg/dL
- B. Random plasma glucose ≥200 mg/dL
- C. Hemoglobin A1c (HbA1c) ≥6.5%
- D. Oral glucose tolerance test (OGTT) 2-hour plasma glucose ≥140 mg/dL
Correct Answer: D
Rationale: The diagnosis of gestational diabetes mellitus (GDM) is typically confirmed through an oral glucose tolerance test (OGTT) during pregnancy. In GDM, the 2-hour plasma glucose level during the OGTT is equal to or greater than 140 mg/dL. This finding is characteristic of GDM and distinguishes it from other types of diabetes. Fasting blood glucose ≥126 mg/dL is diagnostic of diabetes mellitus outside of pregnancy, not specifically GDM. Random plasma glucose ≥200 mg/dL is indicative of uncontrolled diabetes in general. Hemoglobin A1c (HbA1c) ≥6.5% is used for diagnosing diabetes outside of pregnancy and is not specific to GDM.
A patient with a history of chronic kidney disease is prescribed a low-protein diet. Which dietary choice indicates understanding of the prescribed diet?
- A. Grilled salmon
- B. Lentil soup
- C. Beef stew
- D. Chicken Caesar salad
Correct Answer: D
Rationale: A patient with chronic kidney disease prescribed a low-protein diet should avoid high-protein foods like grilled salmon, lentil soup, and beef stew. Chicken Caesar salad, on the other hand, typically contains a smaller amount of protein compared to the other options. This choice indicates an understanding of the need to limit protein intake while still enjoying a balanced meal. However, it is important to note that the quantity and portion sizes of high-protein ingredients in the salad should also be moderate to comply with a low-protein diet.