Nokea
A patient with chronic kidney disease is prescribed erythropoietin-stimulating agents (ESAs) to manage anemia. Which laboratory parameter should be monitored closely during ESA therapy?
- A. Serum potassium
- B. Serum creatinine
- C. Hemoglobin
- D. Platelet count
Correct Answer: C
Rationale: Erythropoietin-stimulating agents (ESAs) are prescribed to manage anemia in patients with chronic kidney disease. Monitoring the hemoglobin level closely during ESA therapy is crucial to ensure that the treatment is effective in increasing red blood cell production without causing excessive elevation. Hemoglobin levels should be checked regularly to adjust the ESA dosage accordingly and prevent risks associated with high hematocrit levels, such as increasing blood viscosity and cardiovascular events. Monitoring serum potassium, creatinine, and platelet count are important in the management of chronic kidney disease for different reasons, but for ESA therapy, monitoring hemoglobin is the most essential parameter.
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Which of the following actions is appropriate for managing a conscious patient with a foreign object lodged in the eye?
- A. Attempting to remove the object with tweezers.
- B. Rinsing the eye with sterile saline solution.
- C. Applying pressure to the eyelid to dislodge the object.
- D. Placing a bandage over the affected eye.
Correct Answer: B
Rationale: When managing a conscious patient with a foreign object lodged in the eye, the appropriate action is to rinse the eye with sterile saline solution. This helps to flush out the foreign object and reduce the risk of further injury or infection. Attempting to remove the object with tweezers or applying pressure to the eyelid can potentially cause more harm to the eye. Placing a bandage over the affected eye is not beneficial in this situation as it does not address the presence of the foreign object. Rinsing the eye with sterile saline solution is the safest and most effective initial step to take in managing a foreign object lodged in the eye.
A patient presents with acute onset of severe headache, visual disturbances, and altered mental status. Imaging reveals a tumor compressing the optic chiasm. Which of the following neurological conditions is most likely responsible for these symptoms?
- A. Meningioma
- B. Glioblastoma multiforme
- C. Pituitary adenoma
- D. Medulloblastoma
Correct Answer: C
Rationale: Pituitary adenoma is the most likely neurological condition responsible for the described symptoms of acute onset severe headache, visual disturbances, and altered mental status when a tumor is found compressing the optic chiasm. Pituitary adenomas are benign tumors arising from the pituitary gland located at the base of the brain. As the tumor grows, it can compress nearby structures such as the optic chiasm, leading to visual disturbances (due to pressure on the optic nerves), severe headache (due to increased intracranial pressure), and altered mental status (due to effects on nearby brain structures).
In instilling the eye drops you have to tilt the back slightly Claudia's head. Which of the following is the RATIONALE for this nursing action?
- A. To prevent any spill from the eye during the procedure
- B. To keep any debris away from the lacrimal duct
- C. To facilitate the procedure
- D. To reach the conjunctival sac easily
Correct Answer: D
Rationale: Tipping Claudia's head back slightly helps in reaching the conjunctival sac easily. The conjunctival sac is a small space between the lower eyelid and the eye itself where eye drops are typically administered. Tilting the head back allows for better access to this area, ensuring the eye drops are delivered accurately and effectively into the eye.
When a patient develops a temperature of 39.8 degree centigrade after an abdominal surgery with an ongoing blood transfusion, the PACU nurse should notify the surgeon as this may indicate ______.
- A. abdominal tissue injury
- B. on going potential infection
- C. post-anesthesia drug reaction
- D. allergic reaction from blood transfusion
Correct Answer: B
Rationale: A temperature of 39.8 degrees Celsius (103.6 degrees Fahrenheit) in a patient following abdominal surgery and ongoing blood transfusion may indicate an ongoing potential infection. During surgery, the body is exposed to various microorganisms, and the stress of surgery can weaken the immune system, making the patient more susceptible to infections. Blood transfusions also carry a risk of introducing infections if not properly screened. Therefore, in this situation, an elevated temperature may be a sign that an infection is developing, and prompt notification of the surgeon is important for further evaluation and management.
The physician prescribes a treatment plan for patient Mila. Nurse Victor understands that the initial treatment goal is which of the following?
- A. Prevent infection
- B. Correct hypoxia
- C. Correct metabolic acidosis
- D. Increase myocardial oxygen supply
Correct Answer: A
Rationale: The initial treatment goal for a patient like Mila is often focused on preventing infection. Infection prevention is a basic and essential step in patient care, especially for someone who may be at risk due to their medical condition or treatment plan. By preventing infection, healthcare providers can help ensure the patient's safety and promote successful outcomes for the overall treatment plan. Correcting hypoxia, metabolic acidosis, and increasing myocardial oxygen supply may be important goals as well, but preventing infection is usually prioritized as it can have serious consequences if not addressed promptly.