Nokea
The amount that Medicare and Medicaid will pay long-term care facilities for services is based on
- A. The resident's background
- B. The resident's need upon admission and throughout his stay
- C. The size of the facility
- D. The financial contributions from the resident's family
Correct Answer: B
Rationale: The correct answer is B because Medicare and Medicaid payments to long-term care facilities are determined by the resident's need for services, as assessed upon admission and throughout their stay. This is based on the level of care required by the resident, such as medical needs, assistance with activities of daily living, and specialized care. The payments are not influenced by the resident's background (A), the size of the facility (C), or the financial contributions from the resident's family (D). These factors do not dictate the reimbursement rates set by Medicare and Medicaid, which are primarily focused on the level of care needed by the resident.
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You are working a respiratory arrest patient and have just successfully placed a combi-tube in your apneic patient. What should you do if the chest fails to rise appropriately and gastric sounds are present?
- A. Secure tube, and ventilate through tube #1
- B. Confirm placement with CO2 detector before ventilating through tube #1
- C. Remove the BVM from tube #1 and ventilate through tube #2
- D. Pull the combi-tube back approximately 2 cm and reassess
Correct Answer: C
Rationale: The correct answer is C: Remove the BVM from tube #1 and ventilate through tube #2. If gastric sounds are present along with inadequate chest rise, it indicates that the tube may be in the esophagus rather than the trachea. By removing the BVM from tube #1 and ventilating through tube #2, you can provide ventilation directly to the lungs and avoid insufflating air into the stomach. This step ensures proper oxygenation and ventilation while preventing complications from gastric insufflation. It is essential to act promptly to optimize patient outcomes.
Incorrect answers:
A: Securing the tube and ventilating through tube #1 would continue to insufflate air into the stomach, worsening the situation.
B: Confirming placement with a CO2 detector before ventilating through tube #1 may delay appropriate intervention, risking patient harm.
D: Pulling the combi-tube back approximately 2 cm without addressing the issue of gastric sounds and inadequate chest rise would
The nurse is completing a medication history for the surgical patient in preadmission testing. Which medication should the nurse instruct the patient to hold (discontinue) in preparation for surgery according to protocol?
- A. Warfarin
- B. Vitamin C
- C. Prednisone
- D. Acetaminophen
Correct Answer: A
Rationale: Step 1: Warfarin is an anticoagulant that increases the risk of bleeding during surgery.
Step 2: Holding Warfarin helps normalize the patient's clotting ability before surgery.
Step 3: This reduces the risk of excessive bleeding during and after the procedure.
Step 4: Vitamin C, Prednisone, and Acetaminophen do not pose the same bleeding risk.
Summary: Warfarin is the correct choice due to its anticoagulant properties, making it crucial to discontinue before surgery to minimize bleeding complications. Vitamin C, Prednisone, and Acetaminophen do not have the same impact on clotting and are safe to continue.
In communication, silence indicates:
- A. A strategy to relieve stress
- B. Understanding ability of another person's reality
- C. Pondering on decisions that require much thought
- D. Attentiveness to a patient's verbal and non-verbal messages
Correct Answer: D
Rationale: Silence in communication can indicate attentiveness and active listening to the patient's messages.
One way to use proper body mechanics on the job is to
- A. Stand back from an object while lifting it
- B. Keep feet close together when lifting
- C. Use the muscles of the lower back to lift
- D. Bend at the knees to lift something
Correct Answer: D
Rationale: The correct answer is D because bending at the knees helps maintain a straight back and reduces strain on the lower back. By bending at the knees, the leg muscles are utilized to lift the object instead of relying solely on the lower back. This technique distributes the weight more evenly and decreases the risk of injury.
A: Standing back from an object while lifting it may reduce the leverage and make it harder to lift.
B: Keeping feet close together when lifting may lead to instability and increase the risk of losing balance.
C: Using the muscles of the lower back to lift is incorrect as it can strain the back and cause injury.
Something important that helps make a job interview successful is if the job applicant
- A. Exaggerates accomplishments
- B. Arrives when the interview is starting
- C. Makes eye contact during the interview
- D. Brings a family member for support
Correct Answer: C
Rationale: The correct answer is C: Makes eye contact during the interview. Making eye contact conveys confidence, attentiveness, and trustworthiness, which are crucial in an interview setting. It shows the interviewer that the applicant is engaged and interested in the conversation. Eye contact helps establish a connection and builds rapport, leading to a positive impression.
Exaggerating accomplishments (A) is unethical and can be easily detected by interviewers, leading to a negative perception of the applicant. Arriving when the interview is starting (B) is considered punctual but does not directly impact the success of the interview. Bringing a family member for support (D) is unprofessional and may raise concerns about the applicant's independence and ability to handle situations on their own.