A patient admitted to the ICU develops acute gastrointestinal bleeding requiring urgent intervention. What intervention should the healthcare team prioritize to manage the patient's bleeding?

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: D

Rationale: In the scenario described, with the patient having an acute exacerbation of chronic kidney disease (CKD) leading to hyperkalemia and metabolic acidosis, the priority intervention to manage the metabolic derangements is to perform emergent hemodialysis for potassium removal. Hemodialysis is the most effective and rapid method to lower dangerously high potassium levels in the blood. It is crucial in cases of severe hyperkalemia where other measures such as medications or dietary modifications may not be sufficient or fast enough to correct the elevated potassium levels. Additionally, hemodialysis can also help in improving metabolic acidosis by removing waste products and excess electrolytes from the blood. Overall, emergent hemodialysis is the most appropriate intervention for managing the acute metabolic abnormalities in this critically ill patient.

Correct Answer: B

Rationale: Performing a sigmoidoscopy, which is a procedure to examine the lower part of the colon and rectum, during a health screening event at a community center may not be practical for several reasons. Firstly, sigmoidoscopy is relatively invasive compared to other screening methods for colon cancer, such as fecal occult blood tests or colonoscopy. Secondly, it can be expensive to perform, especially in a community setting where cost-effectiveness is an important consideration. Therefore, Nurse Filomena would likely point out the invasiveness and cost factors to explain why a sigmoidoscopy may not be suitable for a health screening event at a local community center.

Correct Answer: A

Rationale: A strong team is cohesive, meaning its members work well together, communicate effectively, and support each other. Cohesion helps the team to function smoothly and achieve its goals efficiently. While being driven, having shared goals, and a sense of mission are important characteristics of a strong team, cohesion is the foundation that holds the team together and allows these other factors to thrive.

Correct Answer: C

Rationale: In a pregnant patient with suspected pulmonary embolism (PE), the most appropriate imaging modality for evaluation is contrast-enhanced computed tomography (CT) pulmonary angiography. This imaging technique has been shown to be safe for the fetus when necessary, especially if the benefits of making a diagnosis outweigh the minimal risks associated with radiation exposure. It provides quick and accurate detection of PE with high sensitivity and specificity.

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.

Correct Answer: B

Rationale: The effects of AIDS on pregnancy do not generally include repeated abortion as a direct consequence. AIDS can impact pregnancy by increasing the risk of complications such as premature birth, low birth weight, and potential transmission of the virus from mother to child. Infertility can also be a concern, but repeated abortion is not a common effect of AIDS on pregnancy. It is important to provide accurate information about the effects of AIDS on pregnancy to ensure proper understanding and support for individuals affected by this condition.

Correct Answer: C

Rationale: Prolonged labor is a condition in which labor lasts for an extended period, typically more than 20 hours for first-time mothers and more than 14 hours for experienced mothers. Prolonged labor can contribute to slowing down uterine involution because the prolonged pressure and strain on the uterus can affect its ability to return to its pre-pregnancy size and position. The prolonged contractions and stretching of the uterine muscles can hinder the normal process of uterine involution, leading to a delay in the uterus shrinking back to its non-pregnant state. Additionally, prolonged labor can increase the risk of postpartum complications such as excessive bleeding and infection, which can further impact uterine involution. Therefore, it is crucial for healthcare providers to monitor labor progress closely to prevent prolonged labor and its potential effects on uterine involution.

Correct Answer: A

Rationale: The appropriate action for a nurse in this situation is to request the senior nurse to read the illegible order for clarification. It is essential to ensure accurate and safe patient care by confirming the correct interpretation of the order with a colleague familiar with the handwriting. This action helps prevent errors and misunderstandings that may occur due to illegible handwriting. Consulting with the senior nurse is a common practice in healthcare settings to maintain effective communication and avoid mistakes in patient care.