During CPR, which of the following actions should be performed immediately after activating the emergency response system?

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Question 1 of 9

During CPR, which of the following actions should be performed immediately after activating the emergency response system?

Correct Answer: A

Rationale: After activating the emergency response system, the immediate priority in CPR is to begin chest compressions to support blood circulation. High-quality chest compressions are crucial in providing oxygen to vital organs, especially the brain, during cardiac arrest. Starting chest compressions promptly can improve the chances of survival for the person in need of CPR. Checking for breathing, performing abdominal thrusts, or assessing pulse should only be done after initiating chest compressions in the CPR sequence.

Question 2 of 9

A postpartum client reports severe headache, visual disturbances, and epigastric pain. Which nursing action is most appropriate?

Correct Answer: C

Rationale: The most appropriate nursing action in this situation is to assess the client's blood pressure and other vital signs. The client's symptoms of severe headache, visual disturbances, and epigastric pain could be indicative of preeclampsia or eclampsia, which are serious conditions that require immediate medical attention. Checking the blood pressure and other vital signs will help determine if the client's symptoms are related to abnormal blood pressure levels, which is critical in identifying and managing hypertensive disorders in postpartum clients. Once the assessment is completed, appropriate medical interventions can be initiated promptly if necessary.

Question 3 of 9

The mother asks why she has a gush of blood coming out from the vagina that occurs when she first arises from bed. The nurse's CORRECT response should be

Correct Answer: C

Rationale: The correct response is "Because of the normal pooling of blood in the vagina when the woman lies down to rest or sleep." This phenomenon occurs due to gravity when a woman lies down, and the blood tends to pool at the top of the vagina. When she first arises from bed, the pooled blood is released, resulting in a gush of blood. This is a normal physiological process and not typically a cause for concern.

Question 4 of 9

A patient presents with a pruritic, annular rash with central clearing and a raised, scaly border. The lesions have a tendency to spread outward in a centrifugal pattern. Which of the following conditions is most likely responsible for this presentation?

Correct Answer: A

Rationale: The described presentation of a pruritic, annular rash with central clearing and a raised, scaly border that spreads outward in a centrifugal pattern is characteristic of tinea corporis, commonly known as ringworm. This fungal infection affects the skin and is typically ring-shaped, with a well-defined, slightly raised, and scaly border. The central area often clears as the lesion enlarges peripherally, resembling a ring. It is important to note that ringworm is not caused by a worm but by a fungus. Treatment typically involves antifungal medications applied topically or taken orally, depending on the severity of the infection.

Question 5 of 9

Which of the following can be a MAJOR PROBLEM for a patient with tracheostomy?

Correct Answer: A

Rationale: Having a tracheostomy means that a patient has an artificial opening in their neck to help them breathe. Therefore, any issues related to breathing, such as blockages in the tracheostomy tube or difficulty in clearing secretions, can pose a major problem for a patient with a tracheostomy. It is crucial to monitor the patient's respiratory status closely and intervene promptly if any breathing difficulties arise to prevent potential respiratory distress or complications.

Question 6 of 9

Elmo asks the nurse to explain his condition (BPH) Which statements are CORRECT explanations by the nurse? I It blocks the urethra. II It obstructs the bladder. III. It spreads to other parts of the body. IV. It leads to urinary retention

Correct Answer: A

Rationale: I. It blocks the urethra: Benign Prostatic Hyperplasia (BPH) is a condition in which the prostate gland enlarges and can squeeze the urethra, leading to urinary symptoms such as difficulty urinating. This statement correctly explains one of the effects of BPH on the urinary system.

Question 7 of 9

Which of the following conditions is characterized by chronic hypoxemia, pulmonary hypertension, and right heart failure?

Correct Answer: D

Rationale: Cor pulmonale is a condition characterized by right heart failure secondary to pulmonary hypertension, which is often caused by chronic hypoxemia. Chronic hypoxemia occurs in conditions such as chronic obstructive pulmonary disease (COPD) where there is limited airflow in and out of the lungs, leading to low oxygen levels in the blood. However, the specific characteristic of pulmonary hypertension leading to right heart failure distinguishes cor pulmonale from COPD. Other conditions like idiopathic pulmonary fibrosis (IPF) and pulmonary embolism (PE) may also lead to hypoxemia but are not primarily associated with pulmonary hypertension and right heart failure as in cor pulmonale.

Question 8 of 9

The patient made the following statement to the nurse, my doctor just told me that he cannot save my Leg and that I need to have an above-the-knee-amputation. Which response by the nurse is MOST APPROPRIATE?

Correct Answer: C

Rationale: The most appropriate response by the nurse is, "If I were you, I will get a second opinion." This response acknowledges the seriousness of the situation and the life-changing decision the patient has been told to make. Suggesting the patient seek a second opinion is essential as it encourages the patient to explore all options and ensures they have considered all possibilities before proceeding with a major surgery like an above-the-knee amputation. It shows the nurse's support for the patient while also advocating for the patient's right to make an informed decision about their healthcare.

Question 9 of 9

Where should the nurse dispose used wet diaper and gloves?

Correct Answer: C

Rationale: Used wet diapers and gloves should be disposed of in a black waste bin. Black waste bins are designated for general waste, which includes non-infectious materials that do not pose a risk of infection to others. Wet diapers and gloves fall under this category as they are considered non-infectious waste. Proper disposal in the black bin helps in maintaining cleanliness and hygiene in the healthcare setting.

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