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Which is not a correct statement regarding record-keeping?
- A. Failure to do it could be evidence of professional liability
- B. It is an optional task to be done when circumstances allow.
- C. It is a tool in professional practice that helps provide quality care.
- D. It is part of the professional duty of the nurse.
Correct Answer: B
Rationale: Record-keeping is not an optional task; it is a critical aspect of professional nursing practice. As a nurse, maintaining accurate and timely records is essential for providing quality care, ensuring legal and ethical standards are met, and promoting patient safety. Failure to keep thorough records can lead to serious consequences such as compromising patient care, violating regulations, and even facing legal consequences. Thus, record-keeping should be seen as a mandatory part of the professional duty of nurses rather than an optional task that can be done when circumstances allow.
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The first standard step in oxygen therapy that the nurse should do is________.
- A. assess client's condition
- B. gather all the equipment and supplies
- C. prepare the client for the oxygen treatment
- D. check the chart for ordered flow rate and oxygen delivery method
Correct Answer: A
Rationale: The first standard step in oxygen therapy that the nurse should do is to assess the client's condition. Before initiating any oxygen treatment, it is essential to assess the client's respiratory status, oxygen saturation levels, vital signs, and overall condition. This initial assessment helps the nurse to determine the appropriate course of oxygen therapy based on the client's individual needs and current health status. Assessing the client's condition first ensures that the oxygen therapy provided is safe and effective for the specific needs of the client.
A patient presents with sudden onset of severe, unilateral ear pain, diminished hearing, and purulent otorrhea. Otoscopic examination reveals a bulging, erythematous tympanic membrane with obscured landmarks. Which of the following conditions is most likely responsible for this presentation?
- A. Otitis externa
- B. Acute otitis media
- C. Mastoiditis
- D. Chronic suppurative otitis media
Correct Answer: B
Rationale: Acute otitis media is the most likely condition responsible for this presentation. The sudden onset of severe, unilateral ear pain, diminished hearing, and purulent otorrhea are classic symptoms of acute otitis media. Otoscopic examination revealing a bulging, erythematous tympanic membrane with obscured landmarks further supports the diagnosis. The bulging of the tympanic membrane is due to the accumulation of fluid and pus behind it, causing the characteristic appearance. Treatment typically involves antibiotics to help clear the infection and relieve symptoms. If left untreated, acute otitis media can lead to complications such as perforation of the eardrum or mastoiditis.
A patient is prescribed a nonsteroidal anti-inflammatory drug (NSAID) for the management of osteoarthritis. Which adverse effect should the nurse monitor closely in the patient?
- A. Hypoglycemia
- B. Hyperkalemia
- C. Gastrointestinal bleeding
- D. Hypertension
Correct Answer: C
Rationale: NSAIDs are known to increase the risk of gastrointestinal complications, particularly gastrointestinal bleeding, ulcers, and perforation. This risk is higher in patients who are elderly, have a history of peptic ulcer disease, are taking high doses of NSAIDs, or are using them for a prolonged period. It is important for the nurse to closely monitor the patient for signs and symptoms of gastrointestinal bleeding, such as abdominal pain, black or tarry stools, vomiting blood, and anemia. Prompt identification and management of these complications are essential to prevent serious consequences. Monitoring for gastrointestinal adverse effects is crucial when a patient is prescribed NSAIDs for managing conditions like osteoarthritis.
Which assessment finding would lead the nurse to suspect a postpartum hemorrhage? Blood loss of _____.
- A. less than 300 ml/24 hours
- B. more than 400 ml/24 hours
- C. less than 200 ml/2 hours
- D. more than 500 m2/24 hours
Correct Answer: D
Rationale: Postpartum hemorrhage is defined as a blood loss of more than 500 ml within the first 24 hours after vaginal delivery or more than 1000 ml following a cesarean delivery. Excessive bleeding can lead to hypovolemic shock and can be life-threatening if not promptly addressed. Therefore, a blood loss of more than 500 ml/24 hours would lead the nurse to suspect a postpartum hemorrhage and prompt further assessment and intervention.
A patient with suspected tuberculosis (TB) presents with cough, weight loss, night sweats, and hemoptysis. Chest X-ray reveals upper lobe infiltrates and cavitation. Which of the following diagnostic tests is most appropriate for confirming the diagnosis of pulmonary TB?
- A. Sputum acid-fast bacilli (AFB) smear and culture
- B. Tuberculin skin test (TST)
- C. Interferon-gamma release assay (IGRA)
- D. Chest CT-guided biopsy
Correct Answer: A
Rationale: In a patient with suspected pulmonary TB, the most appropriate diagnostic test for confirming the diagnosis is the sputum acid-fast bacilli (AFB) smear and culture. This test involves examining sputum samples under the microscope for the presence of acid-fast bacilli, which are characteristic of Mycobacterium tuberculosis, the bacteria that causes TB. Additionally, culturing the sputum allows for the bacteria to grow in a controlled environment, further confirming the diagnosis. In the given scenario, the patient's symptoms (cough, weight loss, night sweats, hemoptysis), along with chest X-ray findings of upper lobe infiltrates and cavitation, are highly suggestive of pulmonary TB. Therefore, performing a sputum AFB smear and culture is crucial for definitive diagnosis and initiation of appropriate treatment. The other options (Tuberculin skin test, Interferon