Nokea
Which of the following actions is recommended for managing a patient with a suspected snakebite?
- A. Applying a tourniquet proximal to the bite site.
- B. Immobilizing the affected limb at the level of the heart.
- C. Making an incision over the bite site to facilitate venom extraction.
- D. Transporting the patient to a medical facility for antivenom administration.
Correct Answer: D
Rationale: The correct answer is D: Transporting the patient to a medical facility for antivenom administration. This is recommended because antivenom is the definitive treatment for snakebites. Tourniquets (choice A) can worsen tissue damage and should be avoided. Elevating the limb (choice B) may not prevent venom spread. Making an incision (choice C) can lead to infection and increased venom absorption. Antivenom administration at a medical facility is crucial for proper management of snakebites.
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Treatment of a patient without consent can constitute which is defined as intentional and unwanting touching.
- A. battery
- B. negligence
- C. slander
- D. tort
Correct Answer: A
Rationale: The correct answer is A: battery. Battery is the intentional and unwanted touching of another person without their consent, which can include medical treatment without consent. This is a clear violation of the patient's autonomy and can lead to legal consequences. Negligence (B) is the failure to exercise reasonable care, not intentional touching. Slander (C) is making false spoken statements that harm someone's reputation. Tort (D) is a broader term referring to civil wrongs, including battery, but not specifically addressing intentional and unwanted touching.
A nurse is preparing to assist with a lumbar epidural steroid injection (LESI) procedure for a patient with chronic back pain. What action should the nurse prioritize to ensure procedural accuracy?
- A. Confirming the patient's identity and procedure site using two identifiers
- B. Positioning the patient in a prone position with a pillow under the abdomen
- C. Providing conscious sedation to the patient to minimize discomfort
- D. Administering local anesthesia to the skin before needle insertion
Correct Answer: A
Rationale: Correct Answer: A
Rationale:
1. Confirming the patient's identity ensures the right patient is receiving the intended procedure.
2. Verifying the procedure site using two identifiers prevents errors in site selection.
3. This step aligns with the World Health Organization's Surgical Safety Checklist, reducing the risk of wrong-site procedures.
4. Positioning, sedation, and local anesthesia are important but secondary to ensuring the correct patient and site.
Summary:
- Option B: Positioning is essential but not the top priority for procedural accuracy.
- Option C: Sedation aims to minimize discomfort but does not guarantee procedural accuracy.
- Option D: Administering local anesthesia is crucial but not as critical as confirming patient identity and procedure site.
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.
Upon entry of the patient to ER, the nurse must FIRST perform which nursing intervention?
- A. Inject with rabies immune globulin.
- B. Cleanse the bite with soap and running water.
- C. Inject the rabies vaccine immediately.
- D. Administer the pain reliever, as ordered.
Correct Answer: B
Rationale: The correct answer is B: Cleanse the bite with soap and running water. This is the first nursing intervention because it is crucial to prevent infection. Cleaning the bite area helps remove bacteria and debris, reducing the risk of infection. Injecting with rabies immune globulin (choice A) and rabies vaccine (choice C) should be done later as per protocol after assessing the situation. Administering pain reliever (choice D) is important but not the first priority in this scenario.
A patient with chronic kidney disease presents with fatigue, dyspnea on exertion, peripheral edema, and hypertension. Laboratory findings reveal elevated serum creatinine and urea levels, metabolic acidosis, and hyperkalemia. What is the most appropriate initial management for this patient?
- A. Initiation of angiotensin-converting enzyme (ACE) inhibitor therapy
- B. Hemodialysis
- C. Intravenous administration of calcium gluconate
- D. Sodium bicarbonate administration
Correct Answer: B
Rationale: The most appropriate initial management for the patient described is hemodialysis. Hemodialysis is essential for managing chronic kidney disease with severe symptoms and electrolyte imbalances like hyperkalemia and metabolic acidosis. Hemodialysis helps to remove urea and creatinine from the blood, correct electrolyte abnormalities, and improve symptoms such as fatigue, dyspnea, and peripheral edema. Initiation of ACE inhibitor therapy (Choice A) is contraindicated in severe kidney disease due to the risk of worsening renal function. Intravenous administration of calcium gluconate (Choice C) is used for acute hyperkalemia with cardiac toxicity, not for initial management. Sodium bicarbonate administration (Choice D) may help correct metabolic acidosis, but it does not address the underlying cause or the need for urgent renal replacement therapy.