A patient is having elective surgery under general anesthesia. Who is responsible for obtaining the informed-consent?

Correct Answer: A

Rationale: The primary responsibility for obtaining informed consent lies with the surgeon who will be performing the procedure. Informed consent is a process where the healthcare provider explains the procedure, benefits, risks, and alternatives to the patient, allowing them to make an informed decision about their care. While other healthcare team members may also participate in this process, the ultimate responsibility typically rests with the surgeon as they are the one performing the surgery.

Correct Answer: A

Rationale: The nurse should monitor serum potassium levels closely during ACE inhibitor therapy because ACE inhibitors can lead to an increase in serum potassium levels, known as hyperkalemia. ACE inhibitors block the conversion of angiotensin I to angiotensin II, which in turn decreases aldosterone secretion. Aldosterone normally acts in the kidneys to reabsorb sodium and water and excrete potassium. Therefore, when aldosterone secretion is decreased due to ACE inhibitor therapy, there can be an increase in potassium retention, potentially leading to hyperkalemia. Monitoring serum potassium levels is essential to prevent complications associated with hyperkalemia, such as cardiac arrhythmias.

Correct Answer: C

Rationale: Intracerebral hemorrhage occurs when there is bleeding directly into the brain tissue, often due to conditions such as hypertension or vascular malformations. The sudden-onset severe headache, altered mental status, and focal neurological deficits described in the patient are typical symptoms of an intracerebral hemorrhage. The location of the hemorrhagic lesion within the right basal ganglia corresponds to the clinical presentation. Ischemic stroke, subarachnoid hemorrhage, and transient ischemic attack (TIA) typically have different presentations and imaging findings compared to an intracerebral hemorrhage. Therefore, in this scenario, intracerebral hemorrhage is the most likely cause of the patient's symptoms.

Correct Answer: B

Rationale: In quantitative research, randomness plays a crucial role in eliminating bias. Random sampling ensures that every individual or element in the population has an equal chance of being selected for the study. This helps in reducing the possibility of bias creeping into the results due to selective sampling or favoritism towards certain groups. By using random sampling methods, researchers can increase the generalizability of their findings and have a higher level of confidence that the results are unbiased and representative of the entire population. Therefore, randomness is a key mechanism to eliminate bias in quantitative research studies.

Correct Answer: B

Rationale: In assessing the health condition of school children, anemia and other blood disorders are more commonly observed in this age group compared to cancer, lice, parasites, fractures, and injuries. Anemia is a common health issue among children due to various factors such as poor nutrition, iron deficiency, and infections. Regular screening for anemia is important in school-age children to prevent long-term complications and to promote their overall health and well-being. While cancer, lice, parasites, fractures, and injuries can also occur in school children, anemia and blood disorders are more prevalent in this age group.

Correct Answer: A

Rationale: In a patient with acute kidney injury (AKI) secondary to sepsis in the ICU, the healthcare team should prioritize initiating continuous veno-venous hemofiltration (CVVH) for renal replacement therapy. CVVH is a form of continuous renal replacement therapy that helps support renal function by removing waste products, excess fluids, and electrolytes from the blood while providing hemodynamic stability. This intervention is crucial in managing fluid overload, electrolyte disturbances, and uremia associated with AKI in critically ill patients. It can also help improve overall outcomes and prevent further complications related to renal dysfunction in this setting. Administering diuretics, implementing fluid restriction, or performing a renal biopsy may not directly address the acute renal failure and may not provide the necessary renal support needed in this urgent situation.

Correct Answer: D

Rationale: The appropriate nursing diagnosis for this situation is "Ineffective coping" because the patients with hypertension who stop taking their medications despite feeling good may be using this behavior as a maladaptive coping mechanism. It suggests that they might not fully understand the importance of medication adherence or are struggling to accept their diagnosis. By not adhering to their prescribed treatment, they are putting themselves at risk for complications associated with uncontrolled hypertension. Therefore, the nursing diagnosis of "Ineffective coping" addresses the patients' inability to deal with their condition in a healthy manner, leading to noncompliance with their treatment regimen.

Correct Answer: D

Rationale: In the scenario described, the patient is experiencing severe hypoxemia refractory to conventional oxygen therapy, indicating a need for advanced respiratory support. When a patient with ARDS fails to respond to conservative management, including mechanical ventilation strategies, prone positioning, and recruitment maneuvers, the next step may involve extracorporeal membrane oxygenation (ECMO). ECMO provides a way to bypass the lungs and oxygenate the blood directly, allowing for enhanced gas exchange and support for severely compromised respiratory function. Therefore, in this critical situation, prioritizing the recommendation for ECMO can offer the patient the best chance of improving oxygenation and survival.

Correct Answer: B

Rationale: Marlene opening up to the nurse about their financial difficulty indicates that she feels comfortable enough to share personal information with the nurse. This signals the establishment of a trusting relationship between Marlene and the nurse, as Marlene feels safe and supported enough to disclose sensitive information. Building trust is a crucial aspect of any professional relationship, especially in healthcare settings, as it fosters open communication, encourages honesty, and ultimately leads to better outcomes for the patient. It is an essential foundation for providing effective care and support to individuals in need.