A nurse ________.

Correct Answer: D

Rationale: A nurse should have a sense of accountability for his actions. This means taking responsibility for one's decisions and behaviors while working in the healthcare setting. Accountability ensures that the nurse is aware of the consequences of his actions and is willing to accept ownership and follow through on commitments. It is a critical aspect of nursing practice as it helps maintain professional standards, promote patient safety, and uphold trust and integrity within the profession. Nurses are entrusted with the well-being of their patients, so being accountable for their actions is essential in providing high-quality care and maintaining ethical standards.

Correct Answer: B

Rationale: In a patient with acute respiratory failure and hypercapnia due to a COPD exacerbation, the most appropriate intervention is the initiation of non-invasive positive pressure ventilation (NIPPV). NIPPV helps improve ventilation and oxygenation by providing mechanical support to the patient's breathing without the need for endotracheal intubation. It can reduce the work of breathing, decrease carbon dioxide retention, and improve respiratory muscle function. This intervention is particularly beneficial for COPD exacerbations as it can help alleviate hypercapnia and hypoxemia, leading to improved outcomes and potentially reducing the need for invasive ventilation methods. Therefore, NIPPV is the recommended management strategy in this scenario.

Correct Answer: B

Rationale: The stomach is responsible for producing hydrochloric acid and intrinsic factor. Hydrochloric acid helps in the breakdown of proteins during digestion, while intrinsic factor aids in the absorption of vitamin B12 in the small intestine. These two components are crucial for the proper functioning of the digestive system, particularly in breaking down food and absorbing essential nutrients. The liver is involved in bile production, the pancreas in the production of digestive enzymes, and the small intestine in nutrient absorption, but the specific functions related to hydrochloric acid and intrinsic factor are primarily attributed to the stomach.

Correct Answer: B

Rationale: The stomach is the organ responsible for the mechanical and chemical digestion of food. When food enters the stomach, it is mixed with stomach acid and enzymes to break down the food into smaller particles. This process helps prepare the food for further digestion and absorption of nutrients. The stomach also plays a key role in the absorption of some nutrients, such as certain vitamins and minerals. Additionally, the stomach's muscular contractions help mix the food with digestive enzymes and propel the partially digested food into the small intestine for further processing and absorption. The liver, pancreas, and large intestine have vital functions in the digestive system, but the stomach is the primary organ responsible for the initial digestion and absorption of nutrients.

Correct Answer: B

Rationale: Entamoeba histolytica is a parasitic protist known to cause amoebiasis, a gastrointestinal infection that can lead to symptoms such as foul-smelling diarrhea containing cysts. Upon microscopic examination of the feces, the presence of Entamoeba histolytica cysts is a key diagnostic feature. This parasite can be transmitted through contaminated food or water, and individuals infected with Entamoeba histolytica may experience abdominal pain, bloody diarrhea, and weight loss. Proper diagnosis and treatment are essential to manage this infection and prevent complications.

Correct Answer: B

Rationale: Negligence refers to the failure to perform a duty of care that a reasonable person would have exercised in the same situation, resulting in harm or injury to another person. In this scenario, the nurse failed to perform an ordered irrigation of a feeding tube, which is a standard nursing duty. This failure to act according to the orders resulted in harm to the patient, indicating negligence on the part of the nurse. Malpractice is a specific type of negligence that occurs when a professional fails to provide the standard level of care, so in this case, it falls under the broader category of negligence. Harm to the patient is the consequence of the nurse's negligence, and failure to follow the nurse practice act may be a contributing factor to the negligence, but the primary issue is the failure to provide proper care - which is negligence.

Correct Answer: C

Rationale: When controlling severe external bleeding from an extremity, the recommended action is to apply direct pressure with a sterile dressing. Direct pressure helps to stop the bleeding by promoting clot formation and reducing blood flow from the wound. This method is effective in most cases and should be the first response to control bleeding. Elevating the extremity above the level of the heart can be helpful in some cases, but direct pressure is the initial recommended action. Applying a tourniquet proximal to the injury site should only be done as a last resort when other methods are not successful, as it can lead to complications such as tissue damage. Removing any impaled objects can actually worsen the bleeding and should be avoided unless necessary for immediate life-saving measures.

Correct Answer: A

Rationale: The patient's presentation with a blood sugar level of 800mg/dL, absence of ketones in the urine, dehydration, and altered mental status points towards Hyperosmolar nonketotic coma (HNKC). HNKC typically occurs in patients with Type 2 diabetes and is characterized by extremely high blood glucose levels (hyperglycemia) without significant ketosis. The absence of ketones in the urine distinguishes HNKC from Diabetic ketoacidosis (DKA). Patients with HNKC often present with severe dehydration, altered mental status, and hyperosmolarity. It is crucial to address the underlying cause of the hyperglycemia, correct dehydration, and normalize blood glucose levels promptly in the management of HNKC.

Correct Answer: D

Rationale: The priority nursing initiative for Nurse May should be to set up a mental health program in the community. This proactive approach focuses on prevention, early intervention, and support for individuals experiencing mental health issues. By setting up a mental health program, Nurse May can address the root causes of mental problems in young adults in the community, provide education and awareness, offer counseling services, and promote mental well-being. This initiative can have a long-term impact on the mental health of individuals and help reduce the incidence of mental problems in the community. Setting up a mental health program is a holistic and sustainable approach to addressing mental health issues in the community.