Nokea
When a nurse commits an error in the progress notes the BEST action she should do is to
- A. cross the error many times to ensure it could no longer be road and sign
- B. delete the erroneous phrase Or sentence using correction fluid and sign.
- C. put a line across the sentence, make the correction over it and sign.
- D. erase whatever is in error using a rubber eraser and sign
Correct Answer: C
Rationale: The correct action in this scenario is to choose option C: put a line across the sentence, make the correction over it, and sign. This method is recommended because it maintains the integrity of the original record by showing what was initially written and clearly indicating the correction. By crossing out the error, making the correction, and signing the entry, the nurse acknowledges and takes responsibility for the mistake while ensuring the accuracy and transparency of the documentation.
Option A is incorrect as crossing the error many times can make the note illegible and may not clearly indicate the correction. Option B is incorrect because using correction fluid can make the note messy and may raise suspicions of tampering with the record. Option D is incorrect as erasing with a rubber eraser can damage the document and also raise concerns about the validity of the information.
In summary, option C is the best choice as it allows for a clear and professional correction without compromising the integrity of the progress notes.
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Which of the following would prove that the nursing action carried out met, the standards of care on falls ?
- A. Utilizing the nursing process in providing safe, quality nursing care
- B. Documenting the procedures done
- C. Carrying out the doctor's order
- D. Performing physical assessment
Correct Answer: A
Rationale: The correct answer is A: Utilizing the nursing process in providing safe, quality nursing care. This is because the nursing process involves assessment, diagnosis, planning, implementation, and evaluation, which ensures comprehensive and individualized care. Documenting procedures (B) is important but does not guarantee meeting standards of care. Simply carrying out doctor's orders (C) may not address all aspects of patient care. Performing physical assessment (D) is crucial but only one component of the nursing process. Ultimately, utilizing the nursing process ensures holistic and evidence-based care, meeting the standards of care on falls.
A patient presents with acute onset of shoulder pain and limited range of motion after a fall onto an outstretched hand. Physical examination reveals tenderness over the greater tuberosity of the humerus and pain with passive abduction and external rotation of the shoulder. Which of the following conditions is most likely?
- A. Rotator cuff tear
- B. Glenohumeral dislocation
- C. Acromioclavicular joint separation
- D. Proximal humerus fracture
Correct Answer: A
Rationale: The correct answer is A: Rotator cuff tear. The presentation of acute shoulder pain and limited range of motion after a fall onto an outstretched hand, along with tenderness over the greater tuberosity and pain with passive abduction and external rotation, is classic for a rotator cuff tear. The mechanism of injury and physical exam findings are consistent with this condition.
B: Glenohumeral dislocation typically presents with a visibly deformed shoulder and loss of normal shoulder contour.
C: Acromioclavicular joint separation would present with tenderness over the AC joint rather than the greater tuberosity, and typically involves a history of direct trauma to the shoulder.
D: Proximal humerus fracture would present with more diffuse shoulder pain and swelling, and not specific tenderness over the greater tuberosity.
Which of the following conditions is characterized by inflammation of the plantar fascia, resulting in heel pain that is typically worse with the first steps in the morning?
- A. Achilles tendinitis
- B. Plantar fasciitis
- C. Morton's neuroma
- D. Stress fracture of the calcaneus
Correct Answer: B
Rationale: Plantar fasciitis is the correct answer. It is characterized by inflammation of the plantar fascia, leading to heel pain, especially in the morning. The plantar fascia is a band of tissue that connects the heel bone to the toes. The pain is usually worse with the first steps after resting.
Achilles tendinitis involves inflammation of the Achilles tendon, which connects the calf muscles to the heel bone, causing pain at the back of the heel and ankle. Morton's neuroma is a condition involving a thickening of tissue around a nerve in the ball of the foot, leading to sharp, burning pain in the toes.
Stress fracture of the calcaneus refers to a small crack in the heel bone due to repetitive stress or overuse, resulting in heel pain that may worsen with activity, but not specifically with the first steps in the morning.
A patient admitted to the ICU develops acute delirium with agitation and hallucinations. What intervention should the healthcare team prioritize to manage the patient's delirium?
- A. Implement environmental modifications to promote sleep hygiene.
- B. Administer antipsychotic medications for symptom control.
- C. Perform neurological assessments to rule out focal deficits.
- D. Recommend benzodiazepines for sedation and anxiety relief.
Correct Answer: A
Rationale: The correct answer is A: Implement environmental modifications to promote sleep hygiene. Delirium is often triggered by environmental factors like noise, light, and disruption of sleep. By optimizing the environment for rest and minimizing stimuli, the patient's delirium can improve. This approach focuses on addressing the root cause rather than just managing symptoms.
Choice B is incorrect because antipsychotic medications can worsen delirium and are not recommended as first-line treatment.
Choice C is not the priority as ruling out focal deficits may be important but does not directly address the delirium.
Choice D is incorrect as benzodiazepines can exacerbate delirium and are not recommended due to their potential to worsen cognitive function.
A patient presents with petechiae, ecchymoses, and gingival bleeding. Laboratory tests reveal prolonged bleeding time, normal platelet count, and normal PT and aPTT. Which of the following conditions is most likely to cause these findings?
- A. Glanzmann thrombasthenia
- B. Bernard-Soulier syndrome
- C. Acquired von Willebrand syndrome
- D. Hemophilia A
Correct Answer: C
Rationale: The correct answer is C: Acquired von Willebrand syndrome. This condition is characterized by a defect in von Willebrand factor function, leading to prolonged bleeding time and mucocutaneous bleeding. Normal platelet count rules out Glanzmann thrombasthenia and Bernard-Soulier syndrome which are platelet disorders. Normal PT and aPTT rule out Hemophilia A, a coagulation factor deficiency. Acquired von Willebrand syndrome is the most likely cause based on the clinical presentation and laboratory findings.