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A patient appears confused and disoriented during a consultation. What is the nurse's priority?
- A. Assume the patient is not capable of understanding and proceed with the consultation.
- B. Provide clear and simple explanations and assess for any underlying causes of confusion.
- C. Ignore the patient's confusion and proceed with the consultation.
- D. Dismiss the patient's confusion as insignificant and focus solely on the medical information.
Correct Answer: B
Rationale: The nurse's priority when a patient appears confused and disoriented during a consultation is to provide clear and simple explanations and assess for any underlying causes of confusion. It is essential to ensure that the patient understands the information being provided and to address any potential reasons for the confusion, such as medication side effects, medical conditions, or cognitive impairment. Ignoring the patient's confusion or assuming they cannot understand can lead to misunderstandings, errors in care, and ultimately jeopardize the patient's well-being. It is crucial to approach the situation with empathy, patience, and a focus on ensuring effective communication and understanding between the nurse and the patient.
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Which of the following imaging modalities is most appropriate for evaluating suspected pulmonary embolism (PE) in a pregnant patient?
- A. Chest X-ray
- B. Ventilation-perfusion (V/Q) scan
- C. Contrast-enhanced computed tomography (CT) pulmonary angiography
- D. Transthoracic echocardiography
Correct Answer: C
Rationale: In a pregnant patient with suspected pulmonary embolism (PE), the most appropriate imaging modality for evaluation is contrast-enhanced computed tomography (CT) pulmonary angiography. This imaging technique has been shown to be safe for the fetus when necessary, especially if the benefits of making a diagnosis outweigh the minimal risks associated with radiation exposure. It provides quick and accurate detection of PE with high sensitivity and specificity.
A nurse is preparing to assist with a cardiopulmonary resuscitation (CPR) procedure for a patient in cardiac arrest. What action should the nurse prioritize during the initial assessment?
- A. Administering oxygen via nasal cannula at 2 liters per minute
- B. Checking for responsiveness and calling for help immediately
- C. Placing the patient in the recovery position to facilitate breathing
- D. Assessing the patient's airway, breathing, and circulation (ABCs)
Correct Answer: D
Rationale: The correct action to prioritize during the initial assessment when preparing to assist with a cardiopulmonary resuscitation (CPR) procedure for a patient in cardiac arrest is to assess the patient's airway, breathing, and circulation (ABCs). This involves quickly checking the patient's airway for any obstructions, assessing their breathing for signs of breathing difficulties or absence of breathing, and evaluating their circulation by checking for a pulse. This step is crucial in determining the need for immediate intervention, such as clearing the airway, providing rescue breaths, or initiating chest compressions. By prioritizing the assessment of the ABCs, the nurse can promptly identify and address life-threatening issues to improve the patient's chances of survival during a cardiac arrest situation.
Which of the following interventions is appropriate for managing a conscious patient with a severe nosebleed (epistaxis)?
- A. Tilting the head back.
- B. Pinching the soft part of the nose.
- C. Packing the nose with cotton gauze.
- D. Applying direct pressure to the forehead.
Correct Answer: B
Rationale: When managing a conscious patient with a severe nosebleed (epistaxis), the appropriate intervention is to have the patient sit upright and lean slightly forward to prevent blood from flowing into the throat and causing choking or swallowing. Pinching the soft part of the nose just below the bony part can help apply pressure to the bleeding vessel and stop the bleeding. This maneuver also helps compress the blood vessels in the nose, promoting clot formation and stopping the bleeding. It is important not to tilt the head back as this can cause blood to flow into the throat and potentially lead to swallowing, choking, or aspiration. Packing the nose with cotton gauze should be done by medical professionals if the bleeding does not stop with direct pressure. Applying direct pressure to the forehead is not effective for managing nosebleeds; pressure should be applied to the nostrils instead.
Which measure will be used in the unit to ensure patient satisfaction of the delivery of health services?
- A. Encourage to use social media
- B. Provide means to evaluate services
- C. Verbal feedback
- D. Ask the local officials
Correct Answer: B
Rationale: Providing means to evaluate services is the most appropriate measure to ensure patient satisfaction with the delivery of health services. This can be done through patient surveys, feedback forms, or other evaluation methods. By systematically collecting and analyzing feedback from patients, healthcare providers can assess the quality of their services, identify areas for improvement, and address any concerns or issues raised by patients. This proactive approach allows for continuous monitoring and improvement of the healthcare services provided, leading to enhanced patient satisfaction and overall quality of care.
A patient in the ICU develops acute exacerbation of chronic kidney disease (CKD) with hyperkalemia and metabolic acidosis. What intervention should the healthcare team prioritize to manage the patient's metabolic derangements?
- A. Initiate intravenous sodium bicarbonate for acid-base correction.
- B. Administer insulin and glucose to promote cellular uptake of potassium.
- C. Recommend dietary potassium restriction and potassium-binding agents.
- D. Perform emergent hemodialysis for potassium removal.
Correct Answer: D
Rationale: In the scenario described, with the patient having an acute exacerbation of chronic kidney disease (CKD) leading to hyperkalemia and metabolic acidosis, the priority intervention to manage the metabolic derangements is to perform emergent hemodialysis for potassium removal. Hemodialysis is the most effective and rapid method to lower dangerously high potassium levels in the blood. It is crucial in cases of severe hyperkalemia where other measures such as medications or dietary modifications may not be sufficient or fast enough to correct the elevated potassium levels. Additionally, hemodialysis can also help in improving metabolic acidosis by removing waste products and excess electrolytes from the blood. Overall, emergent hemodialysis is the most appropriate intervention for managing the acute metabolic abnormalities in this critically ill patient.