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The nurse is caring for a patient who has recently had a successful catheter ablation. Which assessment finding demonstrates a successful outcome of this procedure?
- A. The patient is free of electrolyte imbalances
- B. The patient's WBC count is within normal limits
- C. The patient's EKG reading is regular
- D. The patient's urine output is 45 mL/hour
Correct Answer: C
Rationale: A successful outcome of a catheter ablation procedure for arrhythmias, particularly SVT, is indicated by a regular EKG reading. Catheter ablation involves the use of radiofrequency energy to destroy the conduction fiber in the heart responsible for the arrhythmia. This destruction helps in preventing further episodes of arrhythmia. While choices A, B, and D are important assessments in patient care, they are not specific indicators of the success of a catheter ablation procedure. Electrolyte imbalances, WBC count, and urine output can be affected by various factors and are not directly related to the effectiveness of a catheter ablation in treating arrhythmias.
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A patient is deciding whether they should take the live influenza vaccine (nasal spray) or the inactivated influenza vaccine (shot). The nurse reviews the client's history. Which condition would NOT contraindicate the nasal (live vaccine) route of administration?
- A. The patient takes long-term corticosteroids
- B. The patient is not feeling well today
- C. The patient is 55 years old
- D. The patient has young children
Correct Answer: D
Rationale: The correct answer is that the patient has young children. Having young children is not a contraindication for the live influenza vaccine unless the children are immunocompromised, which is not mentioned. Choice A, the patient taking long-term corticosteroids, is a contraindication for the live vaccine due to potential immunosuppression. Choice B, the patient not feeling well today, is a general precaution for vaccination and not a contraindication specific to the live influenza vaccine. Choice C, the patient being 55 years old, is not a contraindication for the live vaccine unless there are other specific medical conditions present.
When asked to describe in layman's terms an overview of the condition called osteomyelitis, what would be the nurse's best response?
- A. Osteomyelitis is a gradual breakdown and weakening of your bones. It's most often age-related.
- B. Osteomyelitis is caused by not having enough Vitamin D, which in turn causes your bones to be softer and demineralized.
- C. Osteomyelitis is an infection in the bone. It can be caused by bacteria reaching your bone from outside or inside your body.
- D. This is a question that should be directed to your healthcare provider.
Correct Answer: C
Rationale: Osteomyelitis is an infection in the bone that can be caused by bacteria reaching the bone either from outside the body (such as through an open fracture) or inside the body (such as through the bloodstream). This response provides a concise and accurate explanation of osteomyelitis, making it the best choice. Choices A and B provide inaccurate information about the condition, attributing it to age-related bone breakdown and Vitamin D deficiency, which are not correct causes of osteomyelitis. Choice D deflects the question instead of providing the patient with a clear explanation, making it an inappropriate response.
While eating in the hospital cafeteria, a nurse notices a toddler at a nearby table choking on a piece of food and appearing slightly blue. What is the appropriate initial action to take?
- A. Begin mouth-to-mouth resuscitation
- B. Give the child water to help with swallowing
- C. Perform 5 abdominal thrusts
- D. Call for the emergency response team
Correct Answer: C
Rationale: When a toddler is choking on a piece of food and appears blue, it indicates airway obstruction. The appropriate initial action should be to perform 5 abdominal thrusts. This technique can help dislodge the obstructing object and clear the airway. Initiating mouth-to-mouth resuscitation is not recommended as the first step in a choking emergency, especially in children. Giving water may not be effective and can worsen the situation by causing further blockage. Calling the emergency response team should be considered if the abdominal thrusts are unsuccessful in clearing the airway.
A patient presents to the office with a pencil that has completely penetrated the palm of her hand. Which of the following treatments would be BEST in this situation?
- A. Assist the doctor while he sedates the patient and removes the pencil from her hand.
- B. Have the patient gently pull the pencil out of her hand and assist the physician with stitches.
- C. Wrap a gauze around the pencil, securing it as much as possible until the patient can get to a local emergency room.
- D. Tell the patient to go to the local emergency room. With a doctor's order, give the patient some aspirin for the pain.
Correct Answer: C
Rationale: Penetrating wounds that leave an object behind may have damaged important blood vessels. Removing the object may lead to significant bleeding. The correct approach is to gently wrap the wound with the object in place to help control bleeding and prevent further injury. The patient should be taken promptly to the nearest emergency room where healthcare professionals can safely and appropriately remove the object and provide necessary treatment. Choice A is incorrect because removing the pencil without proper medical evaluation can worsen the injury. Choice B is incorrect because pulling out the object can cause additional damage and bleeding. Choice D is incorrect because giving aspirin without knowing the extent of the injury and causing potential drug interactions can be harmful.
The healthcare provider is caring for a 20 lbs (9 kg) 6-month-old with a 3-day history of diarrhea, occasional vomiting, and fever. Peripheral intravenous therapy has been initiated, with 5% dextrose in 0.33% normal saline with 20 mEq of potassium per liter infusing at 35 ml/hr. Which finding should be reported to the healthcare provider immediately?
- A. 3 episodes of vomiting in 1 hour
- B. Periodic crying and irritability
- C. Vigorous sucking on a pacifier
- D. No measurable voiding in 4 hours
Correct Answer: D
Rationale: The correct answer is 'No measurable voiding in 4 hours.' This finding should be reported to the healthcare provider immediately. The concern is the possibility of hyperkalemia, which could occur with continued potassium administration and a decrease in urinary output since potassium is excreted via the kidneys. It is crucial to monitor urinary output in pediatric patients receiving potassium-containing IV solutions to prevent electrolyte imbalances and potential complications.
Choices A, B, and C are not the most critical findings that require immediate reporting. '3 episodes of vomiting in 1 hour' may suggest a need for antiemetic therapy or further assessment of the underlying cause but does not pose an immediate risk like the potential electrolyte imbalance from decreased urinary output. 'Periodic crying and irritability' and 'Vigorous sucking on a pacifier' are common behaviors in infants and are not indicative of a critical condition that requires urgent attention in this scenario.