Nokea
An unresponsive patient with type 2 diabetes is brought to the emergency department and diagnosed with hyperosmolar hyperglycemic syndrome (HHS). The nurse will anticipate the need to
- A. give a bolus of 50% dextrose.
- B. insert a large-bore IV catheter.
- C. initiate oxygen via nasal cannula.
- D. administer glargine (Lantus) insulin.
Correct Answer: B
Rationale: The correct answer is B: insert a large-bore IV catheter. In HHS, patients are severely dehydrated due to high blood sugar levels. Inserting a large-bore IV catheter allows for rapid rehydration with isotonic fluids. This helps to correct the hyperosmolarity and electrolyte imbalances. Giving dextrose (choice A) would worsen hyperglycemia, initiating oxygen (choice C) is not directly related to managing HHS, and administering long-acting insulin like glargine (choice D) is not the initial priority in managing acute HHS.
You may also like to solve these questions
What is the primary focus of health promotion activities?
- A. To manage chronic diseases
- B. To educate patients about their health
- C. To prevent the onset of disease
- D. To identify and treat diseases early
Correct Answer: C
Rationale: The correct answer is C: To prevent the onset of disease. Health promotion activities aim to prevent illnesses before they occur by promoting healthy behaviors and lifestyles. This is a proactive approach that focuses on preventing diseases rather than managing or treating them after they have developed. Choice A focuses on managing existing conditions, choice B emphasizes educating patients after the fact, and choice D focuses on early detection and treatment rather than prevention. Preventing disease through health promotion is the most effective and cost-efficient approach to improving overall health outcomes.
An RN enters a patient’s room to place an indwelling urinary catheter, as ordered by the health-care professional. The client is alert and oriented and tells the RN he wants to leave the hospital now and not receive further treatment. Which of the following actions by the RN would be considered false imprisonment?
- A. The RN tells the client he is not allowed to leave until the physician has released him.
- B. The RN asks the client why he wishes to leave.
- C. The RN asks the client to explain what he understands about his medical diagnosis.
- D. The RN asks the client to sign an against medical advice discharge form.
Correct Answer: A
Rationale: Step 1: The client is alert and oriented, indicating capacity to make decisions.
Step 2: The client expresses the desire to leave the hospital, exercising autonomy.
Step 3: False imprisonment occurs when a person is unlawfully restrained.
Step 4: Choice A is incorrect as it restricts the client's freedom without legal justification.
Step 5: Choices B, C, and D respect the client's autonomy and do not involve restraining.
Which of the following is a key component of patient-centered care?
- A. Provider-centered decision making
- B. Timely discharge
- C. Respect for patient preferences
- D. Focusing on clinical outcomes
Correct Answer: C
Rationale: The correct answer is C: Respect for patient preferences. Patient-centered care focuses on involving patients in the decision-making process and respecting their values, preferences, and needs. This approach emphasizes open communication, shared decision-making, and individualized care. Choice A is incorrect because patient-centered care prioritizes patient preferences over provider preferences. Choice B is incorrect as timely discharge is not a key component of patient-centered care. Choice D is incorrect as patient-centered care goes beyond clinical outcomes to consider holistic well-being and patient satisfaction.
Which of the following is a recommendation for avoiding charges of negligence and false imprisonment for confused clients?
- A. Carefully assess and document client status.
- B. Ensure all patient information is logged out and the nurse has signed out of the computer before leaving the computer station.
- C. Keep careful notes while providing care to ensure accurate documentation later in the day.
- D. Discuss safety needs with clients.
Correct Answer: A
Rationale: The correct answer is A. Carefully assessing and documenting client status is crucial to avoid charges of negligence and false imprisonment. By assessing and documenting client status, healthcare providers can ensure they are meeting the client's needs and providing appropriate care. This helps in demonstrating that the healthcare provider acted responsibly.
Option B is incorrect because ensuring all patient information is logged out and the nurse has signed out of the computer before leaving the computer station relates more to patient privacy and data security, rather than avoiding charges of negligence and false imprisonment. Option C, keeping careful notes while providing care, is important for accurate documentation but does not directly address the risk of negligence or false imprisonment. Option D, discussing safety needs with clients, is important but does not specifically address the legal aspects of negligence and false imprisonment.
What are the key elements essential to the implementation of case management? (Select all that apply.)
- A. Collaborative practice teams
- B. Established critical pathways
- C. Quality management system
- D. All of the above
Correct Answer: D
Rationale: The correct answer is D because all the elements mentioned - collaborative practice teams, established critical pathways, and quality management system - are essential for effective case management. Collaborative practice teams ensure comprehensive care, critical pathways provide a structured approach to care delivery, and a quality management system ensures high standards of care. Each element plays a crucial role in the successful implementation of case management by promoting coordination, efficiency, and quality assurance. Therefore, selecting all of the above options is necessary to cover all key aspects of effective case management.