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The nurse is caring for a patient receiving total parenteral nutrition (TPN). Which action will the nurse take?
- A. Run lipids for no longer than 24 hours.
- B. Take down a running bag of TPN after 36 hours.
- C. Clean injection port with alcohol 5 seconds before and after use.
- D. Wear a sterile mask when changing the central venous catheter dressing.
Correct Answer: D
Rationale: When caring for a patient receiving total parenteral nutrition (TPN), it is crucial to maintain strict aseptic technique to prevent infection. Wearing a sterile mask when changing the central venous catheter dressing helps to reduce the risk of introducing pathogens into the catheter site, which can lead to serious bloodstream infections. It is essential to use sterile gloves, a sterile mask, and to assess the insertion site for any signs or symptoms of infection during central venous catheter dressing changes. Additionally, to prevent infection, TPN infusion tubing should be changed every 24 hours, and no single container of TPN should be hung for longer than 24 hours, with lipids not running for longer than 12 hours.
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Which assessment by the nurNseU wRoSuIldN dGiffTerBen.tiCatOe Ma placenta previa from an abruptio placentae?
- A. Saturated perineal pad in 1 hour
- B. Pain level 0 on a scale of 0 to 10
- C. Cervical dilation at 2 cm
- D. Fetal heart rate at 160 bpm
Correct Answer: A
Rationale: In the assessment of a patient with potential placenta previa or abruptio placentae, the nurse should pay close attention to the amount and characteristics of vaginal bleeding. Placenta previa typically presents with painless vaginal bleeding, which can be sudden and significant. Therefore, a saturated perineal pad within a short period of time (1 hour) is more indicative of placenta previa, as opposed to abruptio placentae which usually presents with painful vaginal bleeding and may not necessarily saturate a perineal pad quickly. Monitoring the amount of bleeding and keeping track of pad saturation over time can provide valuable information to differentiate between these two conditions.
A patient with glaucoma has presented for a scheduled clinic visit and tells the nurse that she has begun taking an herbal remedy for her condition that was recommended by a work colleague. What instruction should the nurse provide to the patient?
- A. The patient should discuss this new remedy with her ophthalmologist promptly.
- B. The patient should monitor her IOP closely for the next several weeks.
- C. The patient should do further research on the herbal remedy.
- D. The patient should report any adverse effects to her pharmacist.
Correct Answer: A
Rationale: The correct instruction for the nurse to provide to the patient is that the patient should discuss this new herbal remedy with her ophthalmologist promptly. This is essential because herbal remedies can interact with prescription medications or affect the patient's eye condition. The ophthalmologist can provide guidance on the safety and effectiveness of the herbal remedy in relation to the patient's glaucoma treatment plan. It is crucial for healthcare providers to be aware of all treatments the patient is receiving to ensure coordinated and optimal care.
A nurse is asked how many kcal per gram fats provided. How should the nurse answer?
- A. 3
- B. 4
- C. 6
- D. 9
Correct Answer: D
Rationale: Fats, also known as lipids, are the most calorie-dense nutrient, providing 9 kcal per gram. This high calorie content is due to the structure of fats, which contain more carbon-hydrogen bonds, making them more energy-dense compared to carbohydrates and proteins. Carbohydrates and proteins, on the other hand, provide 4 kcal per gram each. This makes fats an important source of energy in the diet, but they should be consumed in moderation to maintain a healthy balance of nutrients.
The nurse in the ED is caring for a 4 year-old brought in by his parents who state that the child will not stop crying and pulling at his ear. Based on information collected by the nurse, which of the following statements applies to a diagnosis of external otitis?
- A. External otitis is characterized by aural tenderness.
- B. External otitis is usually accompanied by a high fever.
- C. External otitis is usually related to an upper respiratory infection.
- D. External otitis can be prevented by using cotton-tipped applicators to clean the ear.
Correct Answer: A
Rationale: External otitis, also known as swimmer's ear, is an infection of the outer ear canal. It is often characterized by aural tenderness, which means that the ear is sensitive to touch and can be painful, especially when pressure is applied to the area. This tenderness is a hallmark symptom of external otitis and helps differentiate it from other ear conditions. Other common symptoms of external otitis include ear pain, itchiness, redness, and swelling of the ear canal. External otitis is usually not accompanied by a high fever, and it is not typically related to an upper respiratory infection. Using cotton-tipped applicators to clean the ear can actually increase the risk of developing external otitis by disrupting the natural protective barrier of the ear canal.
The nurse, upon reviewing the history, discoversthe patient has dysuria. Which assessment finding is consistent with dysuria?
- A. Blood in the urine
- B. Burning upon urination
- C. Immediate, strong desire to void
- D. Awakes from sleep due to urge to void
Correct Answer: B
Rationale: Dysuria is defined as a burning or painful sensation during urination. It is a common symptom of various urinary tract infections and other conditions affecting the urinary system. Patients experiencing dysuria often describe a discomfort or burning sensation while passing urine. Therefore, the assessment finding consistent with dysuria is the presence of burning upon urination.