Nokea
Goals for patient safety in the OR include the Universal Protocol. What is included in this protocol?
- A. All surgical centers of any type must submit reports on patient safety infractions to the accreditation agencies.
- B. Members of the surgical team stop whatever they are doing to check that all sterile items have been prepared properly.
- C. Members of the surgical team pause right before surgery to meditate for 1 minute to decrease stress and possible errors.
- D. A surgical timeout is performed just before the procedure is started to verify patient identity, surgical procedure, and surgical site.
Correct Answer: D
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
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When assessing a client with pneumonia, which clinical manifestation should the nurse expect to find?
- A. Fremitus
- B. Hyperresonance
- C. Dullness on percussion
- D. Decreased tactile fremitus
Correct Answer: C
Rationale: The correct answer is C: Dullness on percussion. In pneumonia, the affected lung tissue becomes consolidated, leading to dullness on percussion due to decreased air movement. The rationale behind this is that consolidation causes the air-filled lung tissue to become filled with fluid and inflammatory cells, impairing normal sound transmission upon percussion.
Incorrect choices:
A: Fremitus - Increased tactile fremitus is typically found in pneumonia due to the denser lung tissue, making this choice incorrect.
B: Hyperresonance - Hyperresonance is commonly found in conditions like emphysema with increased lung air volume, not in pneumonia.
D: Decreased tactile fremitus - This is contradictory as pneumonia usually presents with increased tactile fremitus due to the consolidated lung tissue.
A client with asthma is being taught about peak flow meter use. Which statement by the client indicates understanding of the teaching?
- A. I will use my peak flow meter every morning.
- B. I will use my peak flow meter when I feel short of breath.
- C. I will use my peak flow meter before using my inhaler.
- D. I will use my peak flow meter after using my inhaler.
Correct Answer: A
Rationale: The correct answer is A because using the peak flow meter every morning provides a baseline measurement of lung function when the client is typically stable. This allows for early detection of changes and adjustment of treatment. Choice B is incorrect as waiting until feeling short of breath may be too late. Choice C is incorrect because using the peak flow meter before the inhaler may not provide an accurate measurement. Choice D is incorrect as using the peak flow meter after the inhaler may not reflect the true lung function.
Which are collaborative problem statements (select all that apply)?
- A. Fatigue related to sleep deprivation
- B. Infection related to immunosuppression
- C. Excess fluid volume related to high sodium intake
- D. Hypoxia related to chronic obstructive pulmonary disease
Correct Answer: B
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
A nurse is evaluating a 3-day diet history with a client who has an elevated lipid panel. What meal selection indicates the client is managing this condition well with diet?
- A. A 4-ounce steak, French fries, iceberg lettuce
- B. Baked chicken breast, broccoli, tomatoes
- C. Fried catfish, cornbread, peas
- D. Spaghetti with meat sauce, garlic bread
Correct Answer: B
Rationale: The correct answer is B because it includes a lean protein (baked chicken breast) and high-fiber vegetables (broccoli, tomatoes) which are beneficial for managing elevated lipid levels. Lean protein helps reduce saturated fat intake while fiber from vegetables aids in lowering cholesterol levels. Choice A includes a high-saturated fat steak and French fries, not ideal for managing lipid levels. Choice C contains fried catfish and cornbread which are high in unhealthy fats and refined carbohydrates. Choice D has spaghetti with meat sauce and garlic bread, which are high in refined carbohydrates and saturated fats, not recommended for someone with elevated lipid levels.
5. Which statement accurately describes the use of complementary and alternative medicine (CAM)?
- A. CAM therapy incorporates only the emotional and spiritual realms of the patient.
- B. The increase in the use of CAM therapies is due to an increase in cost of conventional therapy.
- C. Research and education in CAM therapies are financially supported by the American Holistic Nurses Association.
- D. Practices that are considered complementary and alternative in one culture or time might be considered conventional in another culture or time.
Correct Answer: D
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.