A patient with advanced dementia is bedbound and at risk of developing pressure ulcers. What intervention should the palliative nurse prioritize to prevent pressure ulcer formation?

Correct Answer: C

Rationale: The most effective intervention to prevent pressure ulcers in bedbound patients at risk, such as those with advanced dementia, is to use pressure-relieving support surfaces like specialized mattresses or cushions. These surfaces help distribute the pressure evenly, reducing the risk of pressure ulcer formation on bony prominences. Turning the patient every 2 hours (choice A) can also help relieve pressure, but it may not be sufficient to prevent pressure ulcers in high-risk individuals. Applying barrier creams or moisture barriers (choice B) can help protect the skin but may not address the underlying issue of pressure on vulnerable areas. Administering prophylactic antibiotics (choice D) is not recommended for preventing pressure ulcers as it does not address the root cause of the problem and can lead to antibiotic resistance. Therefore, the priority intervention should be to use pressure-relieving support surfaces to minimize the risk of pressure ulcers in

Correct Answer: A

Rationale: The healthcare team should prioritize administering lactulose or other ammonia-lowering agents to manage hepatic encephalopathy in a patient with acute liver failure. Hepatic encephalopathy is a neuropsychiatric syndrome that occurs in patients with liver dysfunction, leading to the accumulation of ammonia and other neurotoxic metabolites in the bloodstream. Lactulose works by acidifying the colon, which promotes the conversion of ammonia to ammonium, a less toxic form that can be excreted in the stool. By reducing the levels of ammonia, lactulose helps improve the neurological symptoms associated with hepatic encephalopathy.

Correct Answer: C

Rationale: In a critically ill patient admitted to the ICU with acute renal failure requiring renal replacement therapy (RRT), the healthcare team should prioritize the initiation of continuous renal replacement therapy (CRRT). CRRT is preferred in critically ill patients with hemodynamic instability as it allows for slow and continuous removal of solutes and fluids, making it a safer option compared to intermittent hemodialysis. CRRT can also provide better control of volume status and electrolyte imbalances over a longer period, which is beneficial in critically ill patients who are hemodynamically unstable. Peritoneal dialysis is not commonly used in the ICU setting for acute renal failure requiring RRT, and loop diuretics are not effective in treating acute renal failure. Temporary hemodialysis catheters may also be used, but CRRT is generally preferred in critically ill patients for better hemodynamic tolerance and control of solute and fluid removal.

Correct Answer: A

Rationale: Total knee arthroplasty (TKA), also known as total knee replacement, is a surgical procedure commonly performed to alleviate symptoms and improve function in patients with advanced osteoarthritis of the knee that has not responded to conservative management. During TKA, the damaged cartilage and bone in the knee joint are removed and replaced with prosthetic components. This procedure aims to reduce pain, restore function, and improve the quality of life for individuals with severe osteoarthritis of the knee. High tibial osteotomy (HTO) is typically performed in younger patients with unicompartmental osteoarthritis, while knee arthroscopy and meniscectomy are more targeted towards specific knee conditions and may not provide significant relief in cases of advanced osteoarthritis.

Correct Answer: B

Rationale: Carpal tunnel syndrome is a condition caused by compression of the median nerve in the wrist. The surgical procedure commonly performed to treat carpal tunnel syndrome is called median nerve release or carpal tunnel release. During this surgery, the transverse carpal ligament is divided to relieve pressure on the median nerve, reducing symptoms such as pain, numbness, and tingling in the hand and fingers. The goal of this procedure is to improve nerve function and reduce symptoms associated with carpal tunnel syndrome.