A patient undergoing mechanical ventilation in the ICU develops ventilator-associated pneumonia (VAP) caused by multidrug-resistant organisms (MDROs). What intervention should the healthcare team prioritize to manage the patient's infection?

Correct Answer: A

Rationale: The most appropriate intervention for managing ventilator-associated pneumonia (VAP) caused by multidrug-resistant organisms (MDROs) is to administer combination antibiotic therapy targeting the specific resistant pathogens identified in the patient's culture results. MDROs are often resistant to multiple antibiotics, so combination therapy is required to maximize the chances of effectively treating the infection. Identifying the specific pathogens causing the VAP through cultures is crucial in tailoring the antibiotic therapy to target these organisms effectively. Implementing appropriate antibiotic therapy promptly is essential to improve outcomes and prevent further complications in patients with VAP caused by MDROs. Option A is the priority intervention in this case to address the multidrug-resistant nature of the infection and provide targeted treatment for the patient.

Correct Answer: C

Rationale: Beta-adrenergic agonists stimulate beta-adrenergic receptors in the heart, leading to an increase in heart rate (tachycardia). This is a common adverse effect associated with the use of beta-adrenergic agonists in the management of conditions such as asthma. Monitoring for tachycardia is important because it can potentially lead to other complications such as palpitations, arrhythmias, and exacerbation of underlying cardiovascular conditions. It is essential for the nurse to closely monitor the patient for any signs or symptoms of tachycardia and report any abnormalities to the healthcare provider promptly to ensure appropriate management and prevent further complications.

Correct Answer: D

Rationale: Nurse Rey can be liable of committing malpractice by performing circumcisions without the proper training, qualifications, and legal authority to do so. Malpractice refers to negligence or failure to provide a standard level of care that results in harm to a patient. In this case, Nurse Rey participating in performing circumcisions may not have the necessary skills and expertise compared to the doctors who are trained to perform such procedures. This can lead to potential harm or complications for the patients, making it a case of malpractice.

Correct Answer: A

Rationale: Providing education on techniques to enhance milk production and supply should be prioritized to address the client's concerns about milk supply and meeting the baby's nutritional needs. By educating the client on proper breastfeeding techniques, frequent nursing sessions, skin-to-skin contact, and the importance of staying hydrated, the nurse can help promote successful breastfeeding and potentially increase milk production. Supplemental formula feedings are not the first line of intervention, as breastfeeding should be encouraged, especially for a preterm infant who may benefit significantly from breast milk. Encouraging the client to avoid breastfeeding until the infant reaches full term is not appropriate, as breastfeeding can still be beneficial for a preterm infant. Referring the client to a dietitian for specialized nutritional support may be beneficial, but addressing milk supply concerns through education should be prioritized initially to support breastfeeding success.

Correct Answer: C

Rationale: In cases of persistent fetal malpresentation, such as a transverse lie position, a cesarean section is often the safest and most effective intervention to address the abnormal labor presentation. Delivering a baby in a transverse lie position vaginally is associated with high risks, including fetal complications such as umbilical cord prolapse and head entrapment. Therefore, to ensure the safety of both the mother and the baby, a cesarean section is usually the most appropriate and timely intervention to address this situation. It is crucial to prioritize the immediate preparation and facilitation of a cesarean section in cases of persistent fetal malpresentation to prevent potential complications and ensure the best outcome for the mother and the baby.

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: B

Rationale: The presentation of knee pain and swelling following a fall onto a flexed knee, along with a palpable effusion and tenderness along the joint line, is highly suggestive of a meniscus injury. The McMurray's test specifically evaluates for meniscal tears. In this case, the presence of pain and clicking with passive knee flexion and internal rotation indicates a medial meniscus tear as the most likely diagnosis. Patellar tendinitis usually presents with anterior knee pain that is worsened by activities such as jumping or running. Lateral collateral ligament (LCL) sprain typically presents with lateral knee pain and instability. Quadriceps tendon rupture would present with significant weakness and inability to fully extend the knee, which is not described in this scenario.

Correct Answer: D

Rationale: The primary goal of enhancing communication skills for a nurse is to establish rapport with patients, which can lead to better outcomes, increased patient satisfaction, and improved quality of care. Generating a threat between the nurse and the patient is counterproductive to building rapport and does not align with the intention of enhancing communication skills in healthcare settings.

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.