Correct Answer: B

Rationale: The nurse's priority action when noticing an abnormal heart rhythm on the patient's cardiac monitor during surgery is to assess the patient's vital signs and symptoms. This is important because the nurse needs to gather more information about the patient's condition to determine the significance of the abnormal rhythm and the potential impact on the patient's health. By assessing the vital signs and symptoms, the nurse can obtain a more complete picture of the situation and make informed decisions about the next steps in caring for the patient. Once the assessment is done, appropriate actions such as administering medication or notifying the anesthesiologist can be taken based on the findings.

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: B

Rationale: The type of incontinence that Patient Tita is demonstrating, with involuntary loss of urine occurring as a result of activities such as sneezing, coughing, or changing position, is known as stress incontinence. Stress incontinence occurs when there is increased pressure on the bladder, causing the sphincter muscles to weaken and leading to urine leakage. Activities that physically stress or put pressure on the bladder, such as the ones mentioned, can trigger episodes of stress incontinence.

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: D

Rationale: The initial step in the process of change for the senior nurse should be to identify the inefficiency that needs improvement or correction. Before setting goals, planning strategies, or identifying solutions, it is essential to first pinpoint the specific area or aspect that requires change. By identifying the inefficiency, the senior nurse can gain a clear understanding of the root cause of the issue and focus efforts on addressing it effectively. This step lays the foundation for the rest of the change process by providing a specific target for improvement.