A 72-year-old man has just received midazolam for an endoscopic procedure of the upper gastrointestinal tract. Sedation is easily antagonized by flumazenil. Although the endoscopist asks to send the patient home in 1 hour, which of the following factors BEST explains why this patient should remain hospitalized for observation?

Correct Answer: C

Rationale: Midazolam's duration of action (1-6 hours) exceeds flumazenil's (0.5-1 hour), risking resedation after flumazenil wears off, necessitating prolonged observation.

Correct Answer: B

Rationale: Correct Answer: B - Splinting Rationale: 1. Splinting supports the incision site during coughing, reducing pain. 2. The pillow provides external support, decreasing strain on the incision. 3. By promoting splinting, the nurse helps prevent wound dehiscence. 4. Pain relief, distraction, and anxiety reduction are not the primary focus in this scenario.

Correct Answer: C

Rationale: The correct answer is C: Complete an addendum, and return to the hospital to add it to the report. This is the most appropriate action because it ensures that the missing patient information is accurately documented in the patient care report. By completing an addendum, you are providing a formal and transparent way to add the information to the report, maintaining the integrity of the documentation. Returning to the hospital to add the information also allows for any necessary follow-up or clarification with the patient or medical staff. Explanation of why the other choices are incorrect: A: Document the information on the back of your original patient care report - This option does not provide a formal and standardized way to update the patient care report and may not be considered a valid amendment to the original documentation. B: Contact the emergency department staff and notify them of your error - While it is important to communicate the error, contacting the emergency department staff alone does not address the issue of correcting the patient care report. D: Do nothing since you

Correct Answer: D

Rationale: The correct answer is D: Cuffed 7-8 mm endotracheal tube. Rationale: 1. Cuffed tubes provide a better seal in the trachea, reducing the risk of aspiration and air leak. 2. A larger diameter tube (7-8 mm) is more appropriate for an average adult, ensuring adequate airflow. 3. Nasotracheal intubation requires a tube with a cuff to prevent nasal secretions from entering the lungs. Summary: A: A cuffed tube is needed for nasotracheal intubation to prevent complications. The diameter is too small for an adult. B: An uncuffed tube may not provide a secure seal in the trachea, increasing the risk of aspiration. C: An uncuffed tube is not suitable for nasotracheal intubation in an adult due to the risk of air leak and aspiration.

Correct Answer: B

Rationale: The correct answer is B: To help maintain a normal body temperature during hypovolemia. Rationale: 1. When a patient is experiencing hypovolemia, their body is already under stress, potentially leading to a decrease in body temperature. 2. Administering warm normal saline helps prevent further cooling of the body and aids in maintaining a normal body temperature. 3. Maintaining normal body temperature is crucial for proper physiological functions and overall patient well-being during hypovolemia. Summary of other choices: A: Warm saline's temperature does not affect its affinity for oxygen transport. C: The energy required for warm saline to enter circulation is not significantly different from room temperature saline. D: Warm saline may slightly affect cardiac output due to temperature, but the primary reason for warming saline is to maintain body temperature in hypovolemia.