Marichu is admitted to the hospital because of hepatic failure and was prescribed with lactulose (Duphalac). The primary action of this drug is:
- A. prevent constipation
- B. decrease resident intestinal flora
- C. increase intestinal peristalsis
- D. prevent portal hypertension
Correct Answer: B
Rationale: Lactulose (Duphalac) is a synthetic sugar that is not absorbed in the small intestine but is broken down by bacteria in the colon into short-chain fatty acids and low molecular weight organic acids. The primary action of lactulose is to decrease resident intestinal flora. This reduces the production of ammonia in the colon and leads to acidification of the colonic contents. By doing so, lactulose helps in treating hepatic encephalopathy, a condition associated with hepatic failure where ammonia levels are elevated in the body. It works by promoting the excretion of ammonia through the stool, thereby reducing the toxic effects of ammonia on the brain.
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A nurse is formulating a clinical question for evidence-based practice. Place in order the steps the nurse should use to clarify the scope of the problem and clinical topic of interest. Begin with the first step of the process and proceed ordering the steps ending with the final step of the process. Provide answer as lowercase letters separated by commas (e.g., a, b, c, d, e).
- A. Intervention
- B. Outcome
- C. Population
- D. Time
Correct Answer: c
Rationale: Population : The first step is to clearly define the population of interest for the clinical question. Identifying the specific population will help in formulating a focused and relevant question.
Which of the ff. nursing interventions would have the highest priority in the plan of care for the postoperative eye patient?
- A. Do not leave the patient unattended at any time.
- B. Teach the patient not to bend over.
- C. Report sudden onset of acute pain.
- D. Apply sandbags to either side of the head.
Correct Answer: C
Rationale: In the postoperative period for an eye patient, sudden onset of acute pain can be indicative of a complication or an issue that needs immediate attention. Promptly reporting and addressing the pain is essential to prevent any further complications, such as infection, corneal abrasion, or increased intraocular pressure. This intervention takes priority over the other options listed as it involves the patient's immediate safety and well-being. It is crucial to follow postoperative protocols and report any unexpected or severe symptoms to ensure appropriate treatment and prevent any potential harm to the patient's eyesight.
Which of the ff. positions is best for a chest drainage system when the patient is being transported by wheelchair?
- A. Hang it on the top of the wheelchair backrest.
- B. Place it on the patient's feet and ask the patient to hold it.
- C. Hang it on the same pole as the patient's IV.
- D. Place it in the patient's lap.
Correct Answer: A
Rationale: The best position for a chest drainage system when the patient is being transported by wheelchair is to hang it on the top of the wheelchair backrest (Option A). This ensures that the chest drainage system remains upright and secure during transportation. Placing it on the patient's feet and asking the patient to hold it (Option B) is not ideal as it can cause discomfort and potentially compromise the drainage system. Hanging it on the same pole as the patient's IV (Option C) may lead to entanglement and interference with the IV line. Placing it in the patient's lap (Option D) is also not recommended as it can be cumbersome and may lead to accidental dislodgement of the chest drainage system. Therefore, hanging it on the top of the wheelchair backrest provides stability and ease of transport for the patient.
A newborn has small, whitish, pinpoint spots over the nose, which the nurse knows are caused by retained sebaceous secretions. When charting this observation, the nurse identifies it as:
- A. Milia
- B. Lanugo
- C. Whiteheads
- D. Mongolian spots
Correct Answer: A
Rationale: Milia are small, whitish, pinpoint spots that commonly occur in newborns due to retained sebaceous secretions in the skin. They are commonly seen on the nose and can also appear on the cheeks and chin. Milia are not indicative of any illness and tend to disappear on their own without any treatment. They are a benign and temporary skin condition in newborns.
An infant with bladder exstrophy has had a continent urinary reservoir placed. Which discharge instruction should be included?
- A. Allow your child to sleep on the abdomen for comfort.
- B. Avoid contact with latex-containing surfaces (e.g., playgrounds with rubber) to prevent allergic reactions.
- C. Encourage a varied diet to prevent allergies.
- D. Provide brightly colored objects to stimulate development.
Correct Answer: B
Rationale: Children with urologic malformations are prone to latex allergies; parents should be advised to avoid latex exposure.