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A patient with a history of stroke is prescribed clopidogrel (Plavix) for secondary prevention of thrombotic events. Which laboratory test should the nurse monitor closely during clopidogrel therapy?
- A. Prothrombin time (PT)
- B. Activated partial thromboplastin time (aPTT)
- C. Platelet count
- D. International normalized ratio (INR)
Correct Answer: C
Rationale: The correct answer is C: Platelet count. Platelet count should be monitored closely during clopidogrel therapy because it works by inhibiting platelet aggregation, reducing the risk of clot formation. Monitoring platelet count helps assess the drug's effectiveness and prevent potential complications like bleeding or clotting events. Prothrombin time (A), activated partial thromboplastin time (B), and international normalized ratio (D) are tests that primarily assess the coagulation factors and are not directly affected by clopidogrel therapy, making them less relevant for monitoring this specific medication.
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Which of the following is an example of a PRIMARY) source in a research study?
- A. A textbook of medical-surgical nursing
- B. A doctoral dissertation that critiques all research in the area of attention deficit disorder
- C. A published commentary on the findings of another study
- D. A journal article about a study that used large, previously unpublished databases generated
Correct Answer: D
Rationale: The correct answer is D because a journal article about a study using large, previously unpublished databases is a primary source as it presents original research findings firsthand. It contributes new knowledge to the field. A textbook (A) compiles existing information, not original research. A doctoral dissertation (B) critiques research but is not a primary source. A published commentary (C) interprets others' findings, making it a secondary source.
The physician inserted a chest tube drainage to Mr. Alda in order to help re-expand the lungs. Which of the following should you prepare FIRST as a nurse in case of emergency when the tube is accidentally disconnected?
- A. sterile clamps
- B. Sterile dressing.
- C. Another chest tube
- D. A bottle of sterile water.
Correct Answer: A
Rationale: Correct Answer: A - sterile clamps
Rationale:
1. **Immediate action**: Sterile clamps are essential to clamp the chest tube to prevent air from entering the pleural space.
2. **Prevent lung collapse**: Clamping the tube will prevent lung collapse and maintain positive pressure in the pleural space.
3. **Buy time**: By clamping the tube, you buy time to properly reattach the tube or secure it with a new connection.
4. **Safety**: Sterile clamps are a quick and effective solution to prevent a potentially life-threatening situation.
Summary of other choices:
B: Sterile dressing - Not the first priority as the immediate concern is preventing air from entering the pleural space.
C: Another chest tube - Not necessary initially as clamping can buy time to reattach the disconnected tube.
D: A bottle of sterile water - Not needed for emergency management of a disconnected chest tube.
To assist them enhance their performance at work, the nurse manager should review regularly pertaining to the staff's
- A. Number of submitted incident report
- B. Academic performance in college
- C. Job description
- D. Family dynamics
Correct Answer: C
Rationale: Step 1: Job description is crucial for clarifying roles and responsibilities, ensuring staff understand their duties.
Step 2: Regular review of job descriptions helps align staff performance with organizational goals and expectations.
Step 3: It allows for identifying areas of improvement and providing necessary support and resources.
Step 4: Academic performance in college, family dynamics, and number of incident reports are not directly related to work performance.
Summary: Regularly reviewing staff job descriptions is essential for enhancing performance by clarifying roles, aligning expectations, and identifying areas for improvement. Other choices lack direct relevance to work performance.
When there is failure to supervise a child adequately, especially in children younger than 12, the kind of child abuse is, which of the following?
- A. Emotional
- B. Neglect
- C. Sexual
- D. Physical
Correct Answer: B
Rationale: The correct answer is B: Neglect. Failure to supervise a child adequately falls under the category of neglect, which is the failure to provide for a child's basic needs such as supervision, food, shelter, and medical care. In this scenario, the lack of proper supervision constitutes neglect as it puts the child at risk of harm or danger. Emotional abuse (A) involves harming a child's emotional well-being through actions like verbal abuse. Sexual abuse (C) involves inappropriate sexual behavior towards a child. Physical abuse (D) involves causing physical harm or injury to a child. In this case, the failure to supervise the child adequately is best categorized as neglect, making choice B the correct answer.
A patient with advanced cancer develops malignant bowel obstruction, resulting in abdominal pain and distension. What intervention should the palliative nurse prioritize to manage the patient's symptoms?
- A. Initiate bowel rest and maintain the patient in a semi-Fowler's position.
- B. Administer opioid analgesics to alleviate abdominal pain and discomfort.
- C. Refer the patient to a surgeon for consideration of surgical intervention.
- D. Prescribe antiemetic medications to prevent nausea and vomiting.
Correct Answer: B
Rationale: The correct answer is B: Administer opioid analgesics to alleviate abdominal pain and discomfort. Opioid analgesics are effective in managing severe pain associated with malignant bowel obstruction. By providing adequate pain relief, the patient's comfort and quality of life can be significantly improved.
Choice A is incorrect because initiating bowel rest and maintaining the patient in a semi-Fowler's position may not effectively address the severe pain and discomfort experienced by the patient.
Choice C is incorrect as surgical intervention in this scenario may not be appropriate or feasible due to the advanced stage of cancer and the presence of malignant bowel obstruction.
Choice D is incorrect as antiemetic medications primarily target nausea and vomiting, which may not be the primary symptoms of concern in this case. Focusing on pain management should be the priority.