Nokea
Nurse Sarah reads the physician's prescription to administer methylergonovine maleate (Methergin) intramuscularly after delivery. The rationale for giving this medication is which of the following?
- A. Reduces the amount of lochia drainage.
- B. Prevents postpartum hemorrhage.
- C. Decreases uterine contractions.
- D. Maintains normal blood pressure.
Correct Answer: B
Rationale: The correct answer is B: Prevents postpartum hemorrhage. Methylergonovine maleate is a uterotonic medication used to prevent and treat postpartum hemorrhage by causing strong uterine contractions, which help to control bleeding after delivery. It is not used to reduce lochia drainage (choice A), decrease uterine contractions (choice C), or maintain normal blood pressure (choice D). By understanding the pharmacological action of methylergonovine maleate in preventing postpartum hemorrhage, we can confidently select choice B as the correct answer.
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A nurse is preparing to assist with a lumbar epidural steroid injection (LESI) procedure for a patient with chronic back pain. What action should the nurse prioritize to ensure procedural accuracy?
- A. Confirming the patient's identity and procedure site using two identifiers
- B. Positioning the patient in a prone position with a pillow under the abdomen
- C. Providing conscious sedation to the patient to minimize discomfort
- D. Administering local anesthesia to the skin before needle insertion
Correct Answer: A
Rationale: Correct Answer: A
Rationale:
1. Confirming the patient's identity ensures the right patient is receiving the intended procedure.
2. Verifying the procedure site using two identifiers prevents errors in site selection.
3. This step aligns with the World Health Organization's Surgical Safety Checklist, reducing the risk of wrong-site procedures.
4. Positioning, sedation, and local anesthesia are important but secondary to ensuring the correct patient and site.
Summary:
- Option B: Positioning is essential but not the top priority for procedural accuracy.
- Option C: Sedation aims to minimize discomfort but does not guarantee procedural accuracy.
- Option D: Administering local anesthesia is crucial but not as critical as confirming patient identity and procedure site.
A patient presents with a painful, vesicular rash following a linear pattern on the left forearm. The patient reports a history of gardening without gloves. Which of the following conditions is most likely responsible for this presentation?
- A. Allergic contact dermatitis
- B. Herpes simplex virus infection
- C. Scabies
- D. Poison ivy dermatitis
Correct Answer: B
Rationale: The correct answer is B: Herpes simplex virus infection. The presentation of a painful, vesicular rash following a linear pattern on the left forearm is characteristic of herpes simplex virus infection, specifically herpes zoster (shingles). The linear pattern is due to the virus following a specific nerve pathway. This is different from the other choices - A: Allergic contact dermatitis typically presents as a diffuse rash at the site of contact with an allergen, not a linear pattern. C: Scabies presents with burrows and papules, not vesicles in a linear pattern. D: Poison ivy dermatitis causes a diffuse rash, not a linear vesicular rash.
A patient with advanced cancer develops malignant bowel obstruction, resulting in abdominal pain and distension. What intervention should the palliative nurse prioritize to manage the patient's symptoms?
- A. Initiate bowel rest and maintain the patient in a semi-Fowler's position.
- B. Administer opioid analgesics to alleviate abdominal pain and discomfort.
- C. Refer the patient to a surgeon for consideration of surgical intervention.
- D. Prescribe antiemetic medications to prevent nausea and vomiting.
Correct Answer: B
Rationale: The correct answer is B: Administer opioid analgesics to alleviate abdominal pain and discomfort. Opioid analgesics are effective in managing severe pain associated with malignant bowel obstruction. By providing adequate pain relief, the patient's comfort and quality of life can be significantly improved.
Choice A is incorrect because initiating bowel rest and maintaining the patient in a semi-Fowler's position may not effectively address the severe pain and discomfort experienced by the patient.
Choice C is incorrect as surgical intervention in this scenario may not be appropriate or feasible due to the advanced stage of cancer and the presence of malignant bowel obstruction.
Choice D is incorrect as antiemetic medications primarily target nausea and vomiting, which may not be the primary symptoms of concern in this case. Focusing on pain management should be the priority.
In providing tracheostomy care which of the following is the nurse's PRIORITY nursing action? The nurse ________.
- A. Cuts the dressing using sterile scissors
- B. Clean the incisions with iodine-based antiseptic
- C. Secures clean ties before removing soiled ones
- D. Uses clean technique
Correct Answer: C
Rationale: The correct answer is C: Secures clean ties before removing soiled ones. This is the priority action because securing clean ties prevents accidental dislodgement of the tracheostomy tube, ensuring the patient's airway remains patent. Cutting the dressing (A) or cleaning the incisions (B) can be important but not as critical as securing the tube. Using clean technique (D) is essential but not the priority in this situation.
Which of the following cell types is primarily responsible for presenting antigens to T cells during the immune response?
- A. B cells
- B. Natural killer (NK) cells
- C. Macrophages
- D. Eosinophils
Correct Answer: C
Rationale: The correct answer is C: Macrophages. Macrophages are antigen-presenting cells that engulf pathogens and present their antigens to T cells, initiating an immune response. They express major histocompatibility complex (MHC) molecules necessary for T cell recognition. B cells also present antigens but primarily to B cells for antibody production. NK cells are involved in killing infected cells, not antigen presentation. Eosinophils are mainly involved in allergic responses and defense against parasites, not antigen presentation.