The nurse did an admission procedure. The best position to be assumed by Roy is _____.
- A. left lateral position with the affected side inferior.
- B. semi-fowler position at least 30 degrees.
- C. dorsal position with pillows under the chest.
- D. lying on his side, the affected side of the lungs should be superior.
Correct Answer: B
Rationale: The best position for a patient to assume during an admission procedure, particularly for respiratory assessment, is the semi-fowler position at least 30 degrees. In the semi-fowler position, the patient's head and upper body are elevated to a 30-degree angle. This position helps improve lung expansion and oxygenation by reducing pressure on the diaphragm and enhancing chest expansion. It also facilitates breathing and allows for better assessment of respiratory status. Additionally, the semi-fowler position helps prevent aspiration and promotes comfort and relaxation for the patient during the admission procedure.
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Which of the following nursing measures would the nurse LEAST CONSIDERS to Patient Ellie with oxytocin drip?
- A. Know, how to recognize potential adverse reactions:
- B. Administer oxytocin drug with caution
- C. Monitor patient closely when infusing oxytocin
- D. Inform patient about potential complications.
Correct Answer: D
Rationale: While all of the nursing measures listed are important considerations when managing a patient receiving oxytocin drip, the nurse would least consider informing the patient about potential complications. The reason for this is that it is the responsibility of the healthcare provider (such as the physician or advanced practice nurse) to inform the patient about potential complications of a medication or treatment. Nurses are instrumental in providing education and support to patients, but in the case of informing patients about potential complications, this task typically falls under the purview of the prescribing provider. The primary focus of the nurse in this situation would be to assess, administer, monitor, and educate the patient as appropriate, ensuring safe and effective care delivery.
A nurse doubts that the physician has prescribed an unusually large dosage of a medication. The nurse ask the senior nurse on duty about the order if it is correct or wrong, the senior nurse tells the nurse that the order is correct. The nurse comply with the order and administer it to the patient. The patient eventually died. Who is liable for this situation.
- A. Physician
- B. Nurse
- C. Senior nurse
- D. Physician and nurse
Correct Answer: D
Rationale: The physician is ultimately responsible for prescribing the correct dosage of medication to the patient. However, the nurse also plays a critical role in ensuring patient safety by questioning any orders that appear to be unusual or incorrect. In this scenario, the nurse had doubts about the unusually large dosage but was reassured by the senior nurse that the order was correct. Both the physician and the nurse failed in their responsibilities, leading to the patient's unfortunate death. The senior nurse also shares liability as they provided incorrect guidance to the nurse administering the medication. Ultimately, the situation was a result of a breakdown in communication and adherence to proper procedures by both the physician and the nurse.
What is the PRIORITY of care for patient diagnosed with Guillain-Barre Syndrome?
- A. Maintenance of respiratory function
- B. Prevention of decubitus
- C. Control of urinary tract infection
- D. Replacement of fluid and electrolytes
Correct Answer: A
Rationale: The priority of care for a patient diagnosed with Guillain-Barre Syndrome is the maintenance of respiratory function. Guillain-Barre Syndrome can cause paralysis, including respiratory muscles, leading to respiratory failure. Ensuring adequate ventilation and oxygenation is crucial to prevent complications such as respiratory failure and the need for mechanical ventilation. Monitoring for signs of respiratory distress, such as shortness of breath, decreased oxygen saturation, and diminished lung sounds, is essential in providing prompt intervention and support for the patient's respiratory needs. Other aspects of care, such as prevention of decubitus ulcers, control of urinary tract infections, and replacement of fluid and electrolytes, are also important but not as immediate or life-threatening as ensuring adequate respiratory function in these patients.
Which law declares that the policy of the State is to promote and upgrade the practice of profession in the country?
- A. RA 7164
- B. Code of Ethics
- C. RA 9173
- D. RA 10912
Correct Answer: C
Rationale: RA 9173, also known as the Philippine Nursing Act of 2002, is the law that declares the State policy to promote and upgrade the practice of the nursing profession in the Philippines. This law provides for the regulation and maintenance of high standards of nursing education and practice in the country. It aims to ensure the welfare and professional growth of Filipino nurses and to safeguard the health of the public by maintaining competency and professionalism in the nursing profession. Therefore, RA 9173 is the correct choice that reflects the State's policy to promote and upgrade the practice of the nursing profession in the Philippines.
A patient presents with irritability, muscle weakness, tremors, and weight loss despite increased appetite. Laboratory tests reveal elevated serum thyroid hormone levels and suppressed thyroid-stimulating hormone (TSH) levels. Which endocrine disorder is most likely responsible for these symptoms?
- A. Hyperthyroidism
- B. Hypothyroidism
- C. Diabetes mellitus
- D. Cushing's syndrome
Correct Answer: A
Rationale: The symptoms of irritability, muscle weakness, tremors, weight loss despite increased appetite, along with elevated serum thyroid hormone levels and suppressed TSH levels, are indicative of hyperthyroidism. In hyperthyroidism, the thyroid gland produces an excess amount of thyroid hormone, leading to an overactive metabolism. This results in symptoms such as weight loss, tremors, irritability, and muscle weakness. The elevated levels of thyroid hormone are detected in the laboratory tests, along with low TSH levels due to negative feedback regulation. Therefore, the most likely endocrine disorder responsible for these symptoms is hyperthyroidism.
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