Nokea
Nurse Chona saw Patient Noel reading his own chart and question the nurse why (-) smoking and (-) liquor was recorded when he does not smoke and drink alcohol? What is the INITIAL explanation of Nurse Chona on the record?
- A. Get the chart from him and reprimand him from reading the chart
- B. The sign of negative before the word means he is not drinking alcohol or smoking cigarette.
- C. Ask patient Noel to apologize for reading the chart.
- D. Tell Noel that alcohol and liquor are important factors in diagnosing his ailment.
Correct Answer: B
Rationale: Nurse Chona should explain to Patient Noel that the sign of negative before the word means that he is not drinking alcohol or smoking cigarettes. This is a simple misunderstanding and clarification should help clear up any confusion. It is important to uphold patient confidentiality and respect their autonomy, rather than reprimanding the patient for looking at their own chart. It is also essential to address any discrepancies in the patient's medical record to ensure accurate information is documented for proper treatment and care.
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A patient in the ICU develops acute gastrointestinal bleeding (GIB) requiring urgent intervention. What intervention should the healthcare team prioritize to manage the patient's bleeding?
- A. Perform endoscopic hemostasis with mechanical or thermal techniques.
- B. Administer proton pump inhibitors (PPIs) to reduce gastric acid secretion.
- C. Implement strict bed rest to minimize physical exertion and bleeding risk.
- D. Recommend transfusion of fresh frozen plasma to correct coagulopathy.
Correct Answer: A
Rationale: The healthcare team should prioritize performing endoscopic hemostasis with mechanical or thermal techniques in a patient with acute gastrointestinal bleeding (GIB) requiring urgent intervention. This approach involves directly visualizing the bleeding site and applying methods such as clipping, coagulation, or band ligation to stop the bleeding. Endoscopic hemostasis is considered the gold standard for managing acute GIB as it allows for both diagnostic and therapeutic intervention in real-time, offering a targeted and effective way to control bleeding and prevent recurrent episodes. Administering proton pump inhibitors (PPIs) may help in reducing gastric acid secretion and promoting ulcer healing but is not the primary intervention for actively bleeding patients. Implementing strict bed rest may be necessary in some cases to minimize physical exertion, but it is not the primary intervention to manage acute GIB. Transfusion of fresh frozen plasma to correct coagulopathy may be necessary if
A patient with a history of chronic liver disease presents with easy bruising and prolonged bleeding from minor cuts. Laboratory tests reveal prolonged PT and aPTT, and mixing studies show correction of coagulation times with normal plasma. Which of the following conditions is most likely to cause these findings?
- A. Disseminated intravascular coagulation (DIC)
- B. Vitamin K deficiency
- C. Liver cirrhosis
- D. Hemophilia A
Correct Answer: B
Rationale: Vitamin K is essential for the production of several clotting factors in the liver, including factors II, VII, IX, and X. In a patient with chronic liver disease, impaired liver function can lead to decreased synthesis of these clotting factors. As a result, there is an underlying deficiency of these clotting factors, leading to prolonged PT (prothrombin time) and aPTT (activated partial thromboplastin time). The mixing studies showing correction with normal plasma further support the diagnosis of a factor deficiency rather than an inhibitor, which helps in ruling out conditions like DIC or hemophilia.
A woman in active labor is experiencing intense pain and requests non-pharmacological pain relief measures. What intervention should the nurse prioritize?
- A. Providing continuous labor support
- B. Administering intravenous opioids
- C. Performing epidural analgesia
- D. Initiating nitrous oxide inhalation
Correct Answer: A
Rationale: When a woman in active labor is experiencing intense pain and requests non-pharmacological pain relief measures, the nurse should prioritize providing continuous labor support. Continuous labor support, also known as a doula or labor companion, has been shown to be effective in reducing the perception of pain and improving labor outcomes. The presence of a supportive person can provide physical, emotional, and informational support, helping the woman cope with the pain and navigate through the labor process. This intervention can enhance the woman's overall experience of labor and improve maternal and neonatal outcomes without the need for pharmacological interventions. Administering opioids, performing epidural analgesia, or initiating nitrous oxide inhalation are pharmacological pain relief measures and may not align with the woman's preference for non-pharmacological options.
In healthcare facility, a planned program of loss prevention and liability control refers to
- A. quality assurance
- B. risk management
- C. critical pathways
- D. peer review
Correct Answer: B
Rationale: Risk management in a healthcare facility involves identifying, assessing, and minimizing risks to prevent potential harm to patients and reduce liability issues. A planned program of loss prevention and liability control falls under the umbrella of risk management. This program includes strategies to mitigate risks such as patient safety protocols, infection control measures, staff training, and proper documentation practices to minimize legal liabilities. By implementing risk management practices, healthcare facilities aim to provide safe and high-quality care to their patients while also protecting themselves against potential legal challenges.
The BEST position for the patient to assume in case of shock is ______.
- A. modified Trendelenburg
- B. recumbent
- C. high Fowler's
- D. low Fowler's
Correct Answer: A
Rationale: The BEST position for a patient in shock is the modified Trendelenburg position. In this position, the patient's legs are elevated above the level of the heart to enhance blood flow back to the heart and vital organs. Placing the patient in the modified Trendelenburg position helps increase venous return, improves cardiac output, and promotes perfusion to vital organs, which can be crucial in managing shock. This position can help stabilize the patient's condition while awaiting further medical intervention.