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During a surgical procedure, the nurse observes excessive bleeding from the surgical site. What intervention should the nurse prioritize?
- A. Apply pressure to the bleeding site
- B. Administer intravenous fluids rapidly
- C. Notify the surgeon immediately
- D. Request blood products from the blood bank
Correct Answer: C
Rationale: Excessive bleeding during a surgical procedure is a critical situation that requires immediate attention. The surgeon should be notified promptly so that appropriate interventions can be initiated to control the bleeding, such as applying pressure, administering hemostatic agents, or performing additional surgical measures. The surgeon is ultimately responsible for addressing the source of bleeding and ensuring the patient's safety during the procedure. It is important for the nurse to communicate effectively and collaborate with the surgical team to manage the situation efficiently and effectively.
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A patient presents with a painless, gradually enlarging mass in the left neck, anterior to the sternocleidomastoid muscle. Fine-needle aspiration cytology reveals thyroid follicular cells. Which of the following conditions is most likely responsible for this presentation?
- A. Thyroglossal duct cyst
- B. Lymphadenopathy
- C. Thyroid adenoma
- D. Thyroid carcinoma
Correct Answer: C
Rationale: The presentation described is most consistent with a thyroid adenoma. Thyroid adenomas are benign neoplasms of the thyroid gland and can present as painless, gradually enlarging masses in the neck. Fine-needle aspiration cytology revealing thyroid follicular cells further supports the diagnosis of a thyroid adenoma. Thyroglossal duct cysts typically present as midline neck masses that move with swallowing, while lymphadenopathy presents as enlarged lymph nodes and may be associated with infection or malignancy. Thyroid carcinoma may also present as a neck mass but is more likely to be associated with other features such as vocal cord paralysis, hoarseness, or enlarged cervical lymph nodes.
Which of the following signs is indicative of shock in a trauma patient?
- A. Increased heart rate
- B. Hypertension
- C. Rapid capillary refill
- D. Hyperthermia
Correct Answer: C
Rationale: Rapid capillary refill is a sign indicative of shock in a trauma patient. Shock is a life-threatening condition where the body's organs and tissues do not receive adequate blood flow and oxygen, leading to cellular damage and eventual organ failure. In a trauma patient, rapid capillary refill suggests poor perfusion, which is a common feature of shock. The capillary refill time is an important clinical assessment that measures the time it takes for color to return to the nail bed after pressure is applied. In cases of shock, the refill time is faster than normal, indicating a systemic circulatory disturbance. Other signs of shock may include tachycardia (increased heart rate), hypotension (not hypertension), and hypothermia (not hyperthermia).
A patient presents with multiple, flesh-colored, dome-shaped papules with a central umbilication on the face. Which of the following conditions is most likely responsible for this presentation?
- A. Molluscum contagiosum
- B. Acne vulgaris
- C. Sebaceous hyperplasia
- D. Basal cell carcinoma
Correct Answer: A
Rationale: Molluscum contagiosum is a viral skin infection caused by the poxvirus. It commonly presents as flesh-colored, dome-shaped papules with central umbilication on the face, trunk, and extremities. The central umbilication indicates the presence of a crater-like indentation in the center of the lesion. It is a benign condition and usually self-limited, but it can be persistent and contagious. Treatment options include cryotherapy, curettage, topical therapies, and observation. Acne vulgaris presents with comedones, papules, pustules, and nodules primarily on the face, chest, and back. Sebaceous hyperplasia is characterized by yellowish papules with central dell on the face. Basal cell carcinoma typically presents as a pearly papule with telangiectasias and may have ulceration or bleeding.
A nurse conducts a regular audit of the medical records the PRIMARY purpose of conducting audit in a health facility is to _____.
- A. identify errors made by health personnel.
- B. identify areas for improvement
- C. ensure that standards are met.
- D. promote risk management.
Correct Answer: C
Rationale: The primary purpose of conducting an audit in a health facility is to ensure that standards are met. Audits are conducted to review and evaluate the documentation and practices within a healthcare facility to ensure compliance with established standards, protocols, procedures, and regulations. By conducting audits, the facility can identify any discrepancies, non-compliance with standards, or areas for improvement to maintain high-quality care and patient safety. This process helps in maintaining a high standard of care, reducing errors, promoting quality improvement initiatives, and ensuring the overall efficiency and effectiveness of healthcare services provided in the facility.
The nursing team plans to do chart audit project on post-op patients who and developed pressure sores at the Orthopedic unit over the past year to present. What type of audit is?
- A. Retrospective
- B. Concurrent
- C. Process
- D. Outcome
Correct Answer: A
Rationale: A retrospective audit involves reviewing past cases or data to evaluate processes, outcomes, or compliance with standards. In this scenario, the nursing team plans to audit post-op patients who developed pressure sores over the past year at the Orthopedic unit. By looking at historical data from the past year, the audit is considered retrospective as it assesses what has occurred over a specified period. This type of audit helps identify trends, patterns, and areas for improvement based on past events.