A nurse is preparing to assist with a cardiopulmonary resuscitation (CPR) procedure for a patient in cardiac arrest. What action should the nurse prioritize during the initial assessment?

Correct Answer: D

Rationale: The correct action to prioritize during the initial assessment when preparing to assist with a cardiopulmonary resuscitation (CPR) procedure for a patient in cardiac arrest is to assess the patient's airway, breathing, and circulation (ABCs). This involves quickly checking the patient's airway for any obstructions, assessing their breathing for signs of breathing difficulties or absence of breathing, and evaluating their circulation by checking for a pulse. This step is crucial in determining the need for immediate intervention, such as clearing the airway, providing rescue breaths, or initiating chest compressions. By prioritizing the assessment of the ABCs, the nurse can promptly identify and address life-threatening issues to improve the patient's chances of survival during a cardiac arrest situation.

Correct Answer: D

Rationale: Respiratory depression resulting from drug overdose typically leads to a decrease in the respiratory rate, known as bradypnea. This is characterized by abnormally slow breathing, which can be dangerous as it may lead to decreased oxygen levels in the blood. Bradypnea indicates a slowing down of the respiratory drive, in contrast to hyperventilation, biot's respiration, or tachypnea. It is crucial for the nurse to monitor a patient experiencing respiratory depression for signs of bradypnea and intervene promptly to prevent further complications.

Correct Answer: B

Rationale: Cultural competence is the process of acquiring specific knowledge, skills, and attitudes to effectively work with individuals from diverse cultural backgrounds. It involves understanding and respecting the values, beliefs, languages, and practices of different cultures in order to provide appropriate care and services. Cultural competence goes beyond just learning about different cultures; it requires the development of skills and attitudes that promote effective communication, understanding, and collaboration with individuals of diverse backgrounds. This includes being aware of one's own biases, being open-minded, and adapting practices to be inclusive and respectful of cultural differences. Ultimately, cultural competence is essential in providing high-quality, respectful, and effective care to clients from various cultural backgrounds.

Correct Answer: A

Rationale: Selective IgA deficiency is a primary immunodeficiency disorder characterized by low or absent levels of immunoglobulin A (IgA) in the blood. Since IgA plays a crucial role in mucosal immunity and defense against pathogens at mucosal surfaces, individuals with this deficiency are more susceptible to recurrent bacterial infections, particularly of the respiratory and gastrointestinal tracts. In contrast, severe combined immunodeficiency (SCID) is a more severe immunodeficiency disorder affecting T and B lymphocytes, chronic granulomatous disease (CGD) is a disorder of phagocytes, and autoimmune hemolytic anemia is an autoimmune disease involving red blood cells, none of which are directly associated with selective IgA deficiency.

Correct Answer: D

Rationale: Fidelity is a principle of ethics that relates to being faithful or loyal to one's commitments and responsibilities. When Nurse Pat promises to assist the post-surgical patient with ambulation after carrying out the physician's order, she is demonstrating fidelity by honoring her commitment to the patient. This principle highlights the importance of keeping promises, being reliable, and maintaining trust in the nurse-patient relationship.

Correct Answer: A

Rationale: Acute narrow-angle glaucoma is a medical emergency that requires timely intervention to reduce intraocular pressure. Acetazolamide (Diamox) is a medication commonly used to treat this condition as it works as a carbonic anhydrase inhibitor, reducing the production of aqueous humor in the eye. By reducing the production of aqueous humor, acetazolamide helps decrease intraocular pressure rapidly, which is crucial in managing acute narrow-angle glaucoma. Other options listed, such as Furosemide (Lasix), Atropine, and Urokinase (Abbokinase), are not typically used in the treatment of acute narrow-angle glaucoma.

Correct Answer: A

Rationale: In a patient with acute gastrointestinal bleeding requiring urgent intervention, the healthcare team should prioritize performing endoscopic hemostasis with mechanical or thermal techniques. Endoscopy allows for direct visualization of the source of bleeding in the gastrointestinal tract, enabling targeted interventions such as clipping, cauterization, or injection of epinephrine to achieve hemostasis. This approach is effective in managing acute bleeds and can help stop the bleeding quickly, reducing the need for more invasive procedures or surgeries. Administering proton pump inhibitors (PPIs) may be considered for acid-related bleeding, but it is not the primary intervention for acute bleeding requiring urgent management. Strict bed rest may not be necessary and can increase the risk of complications such as deep vein thrombosis. Transfusion of fresh frozen plasma may be indicated if there is evidence of coagulopathy, but addressing the bleeding source should be the initial priority to

Correct Answer: B

Rationale: Metformin is a commonly prescribed medication for the treatment of type 2 diabetes mellitus. One of the rare but serious adverse effects associated with metformin use is lactic acidosis. Lactic acidosis results from the buildup of lactic acid in the bloodstream, leading to symptoms such as weakness, rapid breathing, abdominal pain, and muscle pain. Lactic acidosis can be life-threatening and requires immediate medical attention. It is important for patients taking metformin to be aware of the signs and symptoms of lactic acidosis and seek immediate medical help if they experience any of these symptoms. Regular monitoring of kidney function is crucial in patients taking metformin to reduce the risk of lactic acidosis.

Correct Answer: D

Rationale: Incident reports (IR) are filed in the Records Section of the hospital. It is important for incident reports to be kept in the Records Section for various reasons. By being filed in the hospital's official records, incident reports are included in the hospital's documentation of events, which is crucial for legal and quality improvement purposes. Placing IRs in the Records Section ensures that they are accessible to relevant personnel who may need to refer to them in the future for investigations, audits, or further actions related to the incidents. Keeping incident reports in a centralized location like the Records Section also helps in standardizing the process of documenting and tracking incidents, maintaining consistency and accountability within the healthcare facility.