Donna is a healthy, 46-year-old woman scheduled for elective surgery next week. You would include in her preoperative preparation

Correct Answer: B

Rationale: In preparing a healthy adult woman like Donna for elective surgery, it is crucial to assess her baseline health status to ensure a safe surgical outcome. Option B, which includes a complete blood count (CBC), chemistry panel, and pregnancy test, is the most appropriate choice for preoperative preparation. A CBC provides information about Donna's overall health, including her red and white blood cell counts, which can help identify any underlying infections or anemia. A chemistry panel assesses her electrolyte levels, kidney function, and liver function, which are essential for monitoring organ health before surgery. The pregnancy test is important to rule out the possibility of pregnancy, which can impact anesthesia and surgical planning. Options A, C, and D are not necessary for routine preoperative preparation for a healthy adult undergoing elective surgery. Pulmonary function tests, chest x-rays, urine cultures, thyroid panels, cortisol levels, glucose tolerance tests, ankle-brachial indices, and electrocardiograms are typically reserved for patients with specific risk factors or medical conditions that warrant further investigation. In an educational context, understanding the rationale behind preoperative testing is essential for nurses and healthcare providers to provide safe and individualized care to their patients. By selecting the appropriate tests based on the patient's health status and surgical procedure, healthcare professionals can help mitigate risks and ensure a smooth perioperative experience for the patient.

Correct Answer: C

Rationale: In the treatment of a patient with appendicitis, the correct option is C) Surgical removal of appendix. This is the gold standard treatment for appendicitis to prevent complications such as rupture and peritonitis. Option A) Transfusion to replace blood loss is not typically indicated as the primary treatment for appendicitis. While blood loss can occur if the appendix ruptures, transfusion is a supportive measure and not a definitive treatment. Option B) Bowel preparation for cleansing is not a standard treatment for appendicitis. Bowel preparation is more commonly used before certain procedures like colonoscopy or surgery in other parts of the intestines. Option D) Medications to lower pH within the stomach are not effective in treating appendicitis, as the condition involves inflammation of the appendix rather than the stomach lining. Educationally, it is crucial for healthcare providers to understand the appropriate management of appendicitis to provide timely and effective care to patients. Surgical removal of the appendix, known as an appendectomy, is essential to prevent complications and resolve the underlying issue. This knowledge helps ensure optimal patient outcomes and highlights the importance of evidence-based practice in medical-surgical care.

Correct Answer: B

Rationale: In the context of a patient who has undergone a transurethral resection of the prostate with continuous bladder irrigation, it is crucial to monitor the characteristics of the urinary output. The correct answer, option B, stating a change from clear red output to thicker, bright red output, is the most concerning sign that should prompt notification of the physician. This change could indicate possible clot formation or bleeding complications, which require immediate medical attention to prevent obstruction or other serious complications. Option A, any signs of hematuria, is a general term for blood in the urine and may not specifically indicate a change in the character of the output as described in the correct answer. Option C, a decrease in the amount of blood in the urine, is actually a positive sign as it suggests improvement in the patient's condition rather than a complication requiring immediate notification. Option D, the development of uremic pruritis, is not directly related to the scenario described and is more commonly associated with advanced kidney disease. Educationally, this question emphasizes the importance of close monitoring and assessment of patients postoperatively, especially those undergoing procedures with potential complications like transurethral resection of the prostate. It highlights the significance of recognizing subtle changes in urinary output and understanding the implications for patient care and intervention. Nurses and healthcare providers need to be vigilant in their assessments to ensure timely and appropriate interventions to promote positive patient outcomes.

Correct Answer: B

Rationale: In the Operating Room (OR), the circulating nurse is the member of the surgical team who does not scrub in. The circulating nurse plays a crucial role in ensuring the smooth functioning of the surgical procedure by managing the overall flow of the OR, obtaining additional supplies or equipment as needed, documenting the procedure, and maintaining communication between the OR team and other areas of the hospital. The surgeon (option A) is directly involved in the surgery and must scrub in to maintain a sterile environment. The scrub nurse or surgical tech (option C) assists the surgeon during the procedure and is responsible for maintaining the sterile field. The holding area nurse (option D) cares for the patient before they are taken into the OR and is not a member of the surgical team in the OR. Understanding the roles of each member of the surgical team is essential for providing safe and effective patient care in the perioperative setting. Educating healthcare professionals on these roles ensures that they can work collaboratively and efficiently to deliver optimal patient outcomes during surgical procedures.

Correct Answer: C

Rationale: In the case of a patient diagnosed with deep vein thrombosis (DVT), the first intervention should be to monitor platelet counts daily (Option C). This is the correct answer because DVT involves the formation of blood clots in deep veins, which can lead to serious complications like pulmonary embolism. Monitoring platelet counts is crucial in managing DVT as platelets are involved in the formation of blood clots. By monitoring platelet counts, healthcare providers can assess the risk of clot formation and adjust treatment accordingly. Option A, applying ice packs, is incorrect because cold therapy is not recommended for DVT as it can potentially worsen the condition by constricting blood vessels. Option B, increasing dietary intake of vitamin K, is also incorrect as vitamin K promotes blood clotting and can exacerbate DVT. Option D, using warm soaks, is not the initial intervention for DVT as warmth can increase blood flow and potentially dislodge a clot, leading to complications. In an educational context, understanding the rationale behind the correct intervention for DVT is essential for nurses and healthcare professionals to provide safe and effective care to patients with this condition. Monitoring platelet counts helps in early detection of changes that may indicate an increased risk of clot formation, allowing for timely interventions and prevention of complications.