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The Medical Director, with the Chief Nurse and other officers, of the hospital believe that Patient Relations is important in risk management because a dissatisfied customer is likely to sue. Which is NOT the way to handle complaints?
- A. Let the patient express himself,
- B. Be sure to rebut the patient point by point.
- C. Staff should not be defensive.
- D. Listen to the patient's cue carefully.
Correct Answer: B
Rationale: Option B, "Be sure to rebut the patient point by point," is NOT the way to handle complaints. When dealing with patient complaints, it is important to take a calm and empathetic approach rather than engaging in a defensive or confrontational manner. Rebutting the patient point by point can escalate the situation and may further alienate the patient. Effective complaint management involves active listening, showing empathy, addressing concerns, and working towards a resolution that benefits both the patient and the healthcare provider.
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The nurse closely monitors the work she delegated to the barangay health worker. She is legally guided by this principle
- A. Respondent superior
- B. The good Samaritan
- C. Res ipsa loquitor
- D. Jurisprudence
Correct Answer: A
Rationale: Respondent superior is a legal doctrine that holds an employer (such as a nurse) responsible for the actions of their employees (such as a barangay health worker) performed within the scope of their employment. In the scenario provided, the nurse delegated tasks to the barangay health worker, making the health worker an agent of the nurse. By closely monitoring the delegated work, the nurse is fulfilling her legal responsibility under the principle of respondent superior to ensure that the health worker performs their duties properly and in accordance with professional standards.
A patient in the ICU develops acute kidney injury (AKI) secondary to hypovolemic shock. What intervention should the healthcare team prioritize to manage the patient's renal function?
- A. Administer intravenous fluids to restore circulating volume.
- B. Initiate continuous renal replacement therapy (CRRT) for RRT.
- C. Implement strict dietary restrictions to reduce renal workload.
- D. Recommend nephrotoxic medications for therapeutic purposes.
Correct Answer: A
Rationale: In a patient with acute kidney injury (AKI) secondary to hypovolemic shock, the priority intervention to manage the patient's renal function is to administer intravenous fluids to restore circulating volume. Hypovolemic shock leads to decreased blood flow to the kidneys, resulting in hypoperfusion and ischemic damage to the renal tubules. Prompt correction of hypovolemia with intravenous fluids helps improve renal perfusion and function by increasing blood flow to the kidneys. Adequate fluid resuscitation can potentially prevent further kidney damage and support kidney function recovery. It is crucial to address the underlying cause of AKI (hypovolemia in this case) to prevent complications and improve patient outcomes. Initiating renal replacement therapy or recommending nephrotoxic medications would not be the initial interventions for managing AKI in this scenario.
A client is admitted with acute gouty arthritis. Which medication does the nurse anticipate the health care provider may prescribe to prevent and treat an acute attack of gout?
- A. Ibuprofen (Motrin)
- B. Probenecid (Benemid)
- C. Colchicine (Colsalide)
- D. Hydrocortisone (Cortef)
Correct Answer: C
Rationale: Colchicine is a medication commonly prescribed to prevent and treat acute attacks of gout. It works by reducing inflammation caused by the buildup of uric acid crystals in the joints. Colchicine is effective in relieving pain and reducing swelling during gout attacks. It is important to follow the prescribed dosage due to potential side effects such as gastrointestinal upset. Ibuprofen is a nonsteroidal anti-inflammatory drug that can be used for pain relief but is not specific for gout treatment. Probenecid is used for chronic gout by helping the kidneys remove uric acid, not for acute gout attacks. Hydrocortisone is a steroid that may be used in some cases but is not a first-line treatment for acute gouty arthritis.
A pregnant woman presents with sudden onset of severe abdominal pain and dark red vaginal bleeding at 28 weeks gestation. On examination, the uterus is tender, and the fundus feels firm. Which of the following conditions is the most likely cause of these symptoms?
- A. Ectopic pregnancy
- B. Threatened abortion
- C. Placenta previa
- D. Abruptio placentae
Correct Answer: D
Rationale: The most likely cause of the sudden onset of severe abdominal pain and dark red vaginal bleeding with a tender, firm uterus at 28 weeks gestation is abruptio placentae. Abruptio placentae, also known as placental abruption, is the premature separation of the placenta from the uterine wall before delivery. This condition can be life-threatening to both the mother and the fetus, as it can lead to severe bleeding and compromise the oxygen and nutrients supply to the fetus. The presentation typically includes severe abdominal pain, dark red or maroon vaginal bleeding, uterine tenderness, and a firm uterus due to the blood accumulation behind the placenta. Prompt recognition and intervention are crucial to prevent adverse maternal and fetal outcomes.
A patient presents with unilateral nasal congestion, facial pain, and purulent nasal discharge. Upon examination, tenderness is noted over the affected sinus. Which of the following conditions is most likely responsible for this presentation?
- A. Allergic rhinitis
- B. Acute sinusitis
- C. Nasal polyps
- D. Deviated nasal septum
Correct Answer: B
Rationale: The patient's symptoms of unilateral nasal congestion, facial pain, and purulent nasal discharge with tenderness over the affected sinus are suggestive of acute sinusitis. Acute sinusitis is typically caused by a viral or bacterial infection leading to inflammation and swelling of the sinus mucosa, resulting in the characteristic symptoms described. The tenderness over the affected sinus indicates inflammation in that area. Allergic rhinitis typically presents with bilateral nasal congestion, clear nasal discharge, and itching, rather than facial pain and purulent discharge. Nasal polyps are associated with chronic conditions and usually lead to more gradual onset of symptoms. A deviated nasal septum may contribute to chronic sinus issues but typically does not present with acute symptoms of infection like purulent discharge and facial pain.