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Which of the following actions is recommended for controlling severe external bleeding from an extremity?
- A. Applying a tourniquet proximal to the injury site.
- B. Elevating the extremity above the level of the heart.
- C. Applying direct pressure with a sterile dressing.
- D. Removing any impaled objects.
Correct Answer: C
Rationale: When controlling severe external bleeding from an extremity, the recommended action is to apply direct pressure with a sterile dressing. Direct pressure helps to stop the bleeding by promoting clot formation and reducing blood flow from the wound. This method is effective in most cases and should be the first response to control bleeding. Elevating the extremity above the level of the heart can be helpful in some cases, but direct pressure is the initial recommended action. Applying a tourniquet proximal to the injury site should only be done as a last resort when other methods are not successful, as it can lead to complications such as tissue damage. Removing any impaled objects can actually worsen the bleeding and should be avoided unless necessary for immediate life-saving measures.
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The nurse is conducting an assessment to her patient who has edema of the lower extremities due to congestive heart failure. If edema is graded on a scale of +1 (no visible edema in the leg) to 4+ (leg very swollen), what will the Nurse document in her chart if her assessment findings of the edema is SLIGHTLY swollen?
- A. 4
- B. 2
- C. 1
- D. 3
Correct Answer: B
Rationale: In the grading system used for edema, +1 indicates no visible edema in the leg, +2 indicates slight edema with indentations that quickly resolve, +3 indicates moderate edema with deeper indentations that may take longer to resolve, and +4 indicates severe edema with very swollen legs. In this case, since the edema is described as slightly swollen, the appropriate grade to document would be +2.
During the first contact of the patient with the nurse, the latter should demonstrate the following behavior, which the EXCEPTION of _______.
- A. Caring
- B. Encouraging
- C. Comforting
- D. Compelling
Correct Answer: D
Rationale: During the first contact with a patient, a nurse should demonstrate caring, encouraging, and comforting behaviors. These qualities help create a positive and supportive environment for the patient. However, compelling behavior, which implies forcing or pressuring someone to do something, is not appropriate during the initial interaction with a patient. It is essential for the nurse to build trust and rapport with the patient, and compelling behavior can be counterproductive to establishing a nurturing relationship. Thus, compelling is the exception among the given choices for the nurse's behavior during the first contact with a patient.
A postpartum client reports persistent, severe perineal pain despite analgesic medication. On assessment, the nurse observes ecchymosis and swelling of the perineum. Which nursing action is most appropriate?
- A. Applying ice packs to the perineum for pain relief
- B. Encouraging the client to sit on a donut cushion
- C. Notifying the healthcare provider immediately
- D. Administering additional analgesic medication
Correct Answer: C
Rationale: The presence of ecchymosis (bruising) and significant swelling in the perineum despite analgesic medication suggests a potential complication such as a hematoma. A hematoma is a collection of blood that can occur due to trauma or during childbirth. It is important to notify the healthcare provider immediately so that further assessment and interventions, such as drainage of the hematoma, can be initiated promptly to prevent complications and alleviate the client's pain. Applying ice packs or encouraging the client to sit on a donut cushion may provide temporary relief but will not address the underlying issue of a potentially serious hematoma. Administering additional analgesic medication may not be effective in this case if the pain is primarily due to the hematoma. Prompt notification of the healthcare provider is crucial for proper management of this situation.
The applicant was further asked about an incident report. Which of the following is a PRIORITY Case for an incident report be accomplished?
- A. Patient fell from the bed.
- B. Refusal to go to the physical therapy session.
- C. A visitor encourages a patient on bed rest to ambulate.
- D. Nurse left before his duty ends.
Correct Answer: A
Rationale: A patient falling from the bed is a critical incident that must be prioritized for an incident report. Patient falls can lead to injuries, complications, or even serious consequences. Documenting this incident is crucial for analyzing the cause of the fall, implementing prevention measures, and ensuring patient safety. Additionally, reporting patient falls is a standard practice in healthcare settings to maintain transparency and accountability in patient care.
Which of the following screening tests is recommended for cervical cancer prevention in women aged 21 to 65 years?
- A. Human papillomavirus (HPV) testing alone
- B. Cytology (Pap smear) alone
- C. Co-testing with cytology and HPV testing
- D. Endometrial biopsy
Correct Answer: B
Rationale: The recommended screening test for cervical cancer prevention in women aged 21 to 65 years is cytology, also known as a Pap smear. The Pap smear is a test that looks for changes in the cells of the cervix that could indicate the presence of cervical cancer or pre-cancerous conditions. This test is recommended every 3 years for women aged 21-29 years, and every 3-5 years for women aged 30-65 years, depending on the screening method used. HPV testing alone or co-testing with both cytology and HPV testing may be used in certain situations, but for most women in this age group, cytology (Pap smear) alone is the recommended screening test.