A nurse is assessing clients who have intravenous therapy prescribed. Which assessment finding for a client with a peripherally inserted central catheter (PICC) requires immediate attention?

Correct Answer: D

Rationale: Upper extremity swelling could indicate infiltration, and the PICC will need to be removed. The initial dressing over the PICC site should be changed within 24 hours. This does not require immediate attention, but the swelling does. The dwell time for PICCs can be months or even years. Securement devices are being used more often now to secure the catheter in place and prevent complications such as phlebitis and infiltration. The IV should have one, but this does not take priority over the client whose arm is swollen.

Correct Answer: A

Rationale: The nurse should expect that an ED physician would diagnose the client with neuroleptic malignant syndrome and treat the client by discontinuing chlorpromazine (Thorazine) and administering dantrolene (Dantrium). Neuroleptic malignant syndrome is a potentially fatal condition characterized by muscle rigidity, fever, altered consciousness, and autonomic instability.

Correct Answer: C

Rationale: In this scenario, the correct answer is C) Epinephrine. When a client goes into cardiac arrest, the body initiates the stress response known as the fight-or-flight response. Epinephrine, also known as adrenaline, is a hormone released by the adrenal glands in response to stress. It plays a crucial role in increasing heart rate, constricting blood vessels, and dilating air passages to increase oxygen delivery to the body's tissues during emergencies like cardiac arrest. Option A) Endorphin is incorrect because endorphins are the body's natural painkillers and are not typically secreted in large amounts during a sudden cardiac arrest. Option B) Endothelin is incorrect as it is a peptide that constricts blood vessels, but it is not the primary hormone secreted in response to cardiac arrest. Option D) Erythropoietin is incorrect as it is a hormone primarily involved in the production of red blood cells and the regulation of blood oxygen levels, not in the immediate response to cardiac arrest. In an educational context, understanding the body's response to stress and emergencies like cardiac arrest is crucial for healthcare providers, especially nurses working in emergency settings. Knowing the role of hormones like epinephrine can help nurses anticipate and respond effectively to critical situations, ultimately improving patient outcomes.

Correct Answer: A

Rationale: In the context of grief and loss, a person's first response is often denial (or shock). This initial reaction serves as a defense mechanism to protect the individual from the overwhelming emotions associated with the loss. Denial allows the person to gradually come to terms with the reality of the situation at a pace that they can handle, providing a buffer against the intense pain of the loss. Anger, bargaining, and depression are also common responses to grief, but they typically follow the initial stage of denial. Anger may arise as the individual struggles to make sense of the loss, while bargaining involves seeking ways to reverse or mitigate the circumstances leading to the loss. Depression often sets in as the person starts to fully grasp the magnitude of their loss and the impact it will have on their life. Educationally, understanding the stages of grief and loss can help individuals, including healthcare providers, support clients and patients experiencing these emotions. By recognizing and validating these responses, professionals can offer appropriate support and interventions to help individuals navigate through their grief process in a healthy and constructive manner. It is essential to acknowledge and respect each individual's unique journey through grief, recognizing that there is no one-size-fits-all approach to coping with loss.

Correct Answer: B

Rationale: In understanding medication absorption, it is crucial for nurses to grasp the differences in absorption rates based on administration routes. The correct answer, B) Intravenous (IV) injection, has the fastest absorption rate. This is because IV administration delivers the medication directly into the bloodstream, bypassing the need for absorption through tissues or the gastrointestinal tract. As a result, the medication can reach its target site more rapidly, leading to a quicker onset of action. Option A) Cream applied to the skin, and Option C) Enteric-coated (EC) capsules, both have slower absorption rates compared to IV injections. Cream applied to the skin must first penetrate the skin barrier and then be absorbed into the bloodstream, which can be a relatively slow process. Enteric-coated capsules are designed to dissolve in the intestines rather than the stomach, delaying absorption. Option D) Subcutaneous (SC) injection also has a slower absorption rate than IV injections. While SC injections are absorbed more quickly than oral medications, they are still not as rapid as IV administration due to the difference in blood supply and tissue characteristics. Educationally, understanding the absorption rates of different medication administration routes is vital for nurses to ensure the timely and effective delivery of medications to patients. This knowledge can impact treatment outcomes, especially in critical situations where rapid drug action is necessary for patient safety and well-being.