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During a patient assessment, the nurse observes signs of distress and discomfort. What action should the nurse take to address the patient's needs?
- A. Ignoring the patient's distress to avoid making them uncomfortable
- B. Documenting the findings and informing the healthcare provider later
- C. Offering emotional support and actively listening to the patient's concerns
- D. Administering pain medication without further assessment
Correct Answer: C
Rationale: The correct action for the nurse to take when observing signs of distress and discomfort in a patient during assessment is to offer emotional support and actively listen to the patient's concerns. Ignoring the patient's distress may lead to worsening of the patient's condition and can be detrimental to the patient's well-being. Documenting the findings and informing the healthcare provider later is important but should not be the immediate response when a patient is in distress. Administering pain medication without further assessment is also not appropriate as the nurse needs to understand the underlying cause of the distress before providing appropriate interventions. Offering emotional support and actively listening to the patient's concerns can help the nurse understand the patient's needs, provide comfort, and potentially address the root cause of the distress.
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A patient with a history of heart failure is prescribed carvedilol. Which parameter should the nurse monitor closely during carvedilol therapy?
- A. Blood glucose levels
- B. Serum potassium levels
- C. Blood pressure
- D. Liver function tests Medical Surgical Nursing
Correct Answer: C
Rationale: Carvedilol is a beta-blocker primarily used to manage heart failure and hypertension. Monitoring blood pressure closely during carvedilol therapy is crucial because it helps assess the drug's effectiveness in managing heart failure and controlling hypertension. Carvedilol works by blocking certain receptors in the heart and blood vessels, which can lower blood pressure. Monitoring blood pressure fluctuations allows healthcare providers to adjust the dosage accordingly to achieve optimal results and prevent potential complications in patients with heart failure. While monitoring blood glucose levels, serum potassium levels, and liver function tests are essential in managing other conditions or medications, the priority in a patient being prescribed carvedilol for heart failure is to monitor blood pressure levels.
A patient with chronic obstructive pulmonary disease (COPD) is admitted to the hospital with acute exacerbation and respiratory failure requiring mechanical ventilation. Which of the following ventilator settings is most appropriate for minimizing the risk of ventilator-induced lung injury (VILI) in this patient?
- A. Low tidal volume and high positive end-expiratory pressure (PEEP)
- B. High tidal volume and low respiratory rate
- C. Spontaneous breathing mode with pressure support ventilation (PSV)
- D. Synchronized intermittent mandatory ventilation (SIMV)
Correct Answer: A
Rationale: Patients with COPD are at increased risk for developing ventilator-induced lung injury (VILI) due to their underlying lung pathology. Using a low tidal volume strategy (6-8 ml/kg predicted body weight) has been shown to reduce the risk of VILI in these patients. Additionally, applying high positive end-expiratory pressure (PEEP) helps to recruit collapsed alveoli, improve oxygenation, and decrease the risk of barotrauma by keeping the alveoli open throughout the respiratory cycle. Therefore, the most appropriate ventilator settings to minimize the risk of VILI in a COPD patient with acute exacerbation and respiratory failure requiring mechanical ventilation would be low tidal volume and high PEEP.
The mother of the family asked Nurse Emma how to apply the anti -scabies lotion. The nurse should teach the family to apply anti -scabies lotion to _________.
- A. all skin areas
- B. open lesions
- C. affected skin
- D. Reddened areas
Correct Answer: A
Rationale: The correct way to apply anti-scabies lotion is to cover all skin areas, not just the affected areas or red areas. Scabies is a contagious skin condition caused by mites burrowing into the skin, so applying the lotion to all skin areas helps to eliminate the mites and prevent reinfestation. It is important to follow the instructions provided by the healthcare professional for proper application and treatment of scabies.
A patient with chronic kidney disease presents with periorbital edema, hypertension, and proteinuria. Laboratory findings reveal elevated serum creatinine and urea levels, hyperkalemia, and metabolic acidosis. What is the most likely diagnosis?
- A. Nephrotic syndrome
- B. Diabetic nephropathy
- C. Acute glomerulonephritis
- D. Chronic kidney disease (CKD)
Correct Answer: D
Rationale: The constellation of symptoms presented (periorbital edema, hypertension, proteinuria) along with the laboratory findings (elevated creatinine and urea levels, hyperkalemia, metabolic acidosis) are classical signs of chronic kidney disease (CKD). In CKD, the kidneys gradually lose their function over time, leading to impaired filtration of waste products and electrolyte imbalance. The presence of hypertension and proteinuria are common in CKD due to the compromised renal function. Additionally, elevated serum creatinine and urea levels, hyperkalemia, and metabolic acidosis are indicative of kidney dysfunction.
One of the lecturers discussed the complications that patients may have while on IV therapy. Which of the following is the most common Complication that IV patients may contract while on IV therapy?
- A. Embolism
- B. Phlebitis
- C. Cardiac Overload
- D. Aneurysm
Correct Answer: B
Rationale: Phlebitis is the most common complication that patients may contract while on IV therapy. Phlebitis is the inflammation of the vein where the IV is inserted, which can cause redness, pain, and swelling along the vein. It can be caused by mechanical irritation, chemical irritation, or infection from the IV catheter. Prompt removal of the IV catheter and appropriate treatment are necessary to manage phlebitis and prevent further complications. While embolism, cardiac overload, and aneurysm are potential complications of IV therapy, phlebitis is more commonly seen in clinical practice.