During surgery, the nurse notices an abnormal heart rhythm on the patient's cardiac monitor. What is the nurse's priority action?

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: B

Rationale: Encouraging the patient to practice controlled coughing techniques would be the most appropriate intervention to address the symptoms of chronic cough and excessive sputum production in a patient with end-stage COPD receiving palliative care. Controlled coughing techniques can help the patient effectively clear respiratory secretions and improve airway clearance without the need for additional medications or interventions. This approach focuses on optimizing the patient's ability to manage their symptoms and maintain comfort, which aligns with the goals of palliative care. Administering bronchodilator medications, prescribing mucolytic medications, or referring the patient to a respiratory therapist for breathing exercises may have limited effectiveness in this advanced stage of the disease, and controlled coughing techniques would be a more practical and patient-centered approach to symptom management.

Correct Answer: B

Rationale: Long-term aspirin therapy, especially at higher doses, can increase the risk of gastrointestinal bleeding. Aspirin irreversibly inhibits cyclooxygenase enzyme, which is essential for the production of prostaglandins involved in mucosal protection of the gastrointestinal tract. Without these protective prostaglandins, the stomach lining becomes more susceptible to damage from gastric acid, leading to potential ulcer formation and bleeding. Patients with a history of coronary artery disease may be on aspirin for secondary prevention, and it is crucial to monitor for signs of bleeding such as black, tarry stools or abdominal pain. The benefits of aspirin in preventing cardiovascular events need to be weighed against the risk of adverse effects like gastrointestinal bleeding, especially in patients on long-term therapy.

Correct Answer: C

Rationale: The nurse should prioritize removing the old dressing and applying a new dressing using sterile technique to minimize the risk of infection during a central venous catheter (CVC) dressing change. This is because the most critical step in preventing infection is maintaining a clean and sterile environment around the CVC insertion site. By using sterile technique, the nurse can reduce the introduction of microorganisms that could potentially lead to infection. Wearing sterile gloves and cleaning the insertion site with an alcohol-based antiseptic solution are important steps as well, but the key priority lies in applying the new dressing using sterile technique to prevent contamination and reduce the risk of infection.

Correct Answer: A

Rationale: The presentation of a palpable, non-tender mass in the right neck, just below the angle of the mandible, along with ultrasound imaging findings of a well-defined, hypoechoic lesion with cystic components, is classic for a branchial cleft cyst. Branchial cleft cysts are congenital anomalies that arise from remnants of the branchial clefts or pouches during embryonic development. They are typically located along the anterior border of the sternocleidomastoid muscle, just below the mandible. Ultrasound imaging often shows a cystic lesion with well-defined borders and hypoechoic content, which is consistent with the described findings. Thyroglossal duct cysts usually present as midline neck masses that move with swallowing or tongue protrusion, not in the location described in the scenario. Lymphadenopathy would present as enlarged lymph nodes that may be tender and associated with systemic symptoms.

Correct Answer: A

Rationale: Fluticasone/salmeterol (Advair) is a combination medication consisting of an inhaled corticosteroid (fluticasone) and a long-acting beta-agonist (salmeterol). This combination medication is recommended for long-term control of asthma symptoms and for the prevention of exacerbations. Fluticasone reduces airway inflammation, while salmeterol helps to relax the muscles of the airways, improving breathing. Using this combination medication regularly can help manage asthma symptoms and reduce the risk of asthma attacks. It is not appropriate to use short-acting beta-agonists like albuterol (salbutamol) on a long-term basis for asthma control. Ipratropium bromide (Atrovent) is an anticholinergic bronchodilator that is more commonly used for chronic obstructive pulmonary disease (COPD

Correct Answer: D

Rationale: Nursing diagnosis is the tool used by nurses in the community setting for assessing health needs and problems of families that is similar to the family coping index. Nursing diagnosis involves systematic assessment of a patient's health status, analysis of data, and identification of actual or potential health problems. Just like the family coping index, nursing diagnosis helps nurses to identify key issues and develop a plan of care that addresses the specific needs and challenges faced by the family. This process allows nurses to provide individualized care that supports the family in coping with their health needs and improving their overall well-being.

Correct Answer: B

Rationale: The 5's strategy to prevent dengue infection includes Search and Destroy mosquito breeding places, seek early consultation at the nearest health care facility, say no to fogging spraying, and misting in hot spot areas. While using mosquito repellent on exposed skin is a common preventive measure against mosquito bites, applying it all over your body is not included in the official 5's strategy for dengue prevention. The focus of the 5's strategy is on eliminating mosquito breeding sites, seeking medical advice early in case of symptoms, and avoiding certain mosquito control methods like fogging in hot spot areas.

Correct Answer: C

Rationale: When a patient with terminal cancer experiences dyspnea (difficulty breathing) and anxiety, opioid medications are often prioritized by palliative care providers for symptom management. Opioids are effective in relieving dyspnea by acting as respiratory depressants and reducing the feeling of air hunger. Additionally, opioids have sedative effects that can help alleviate anxiety and promote relaxation. Therefore, in this situation, prescribing opioid medications would be the most appropriate intervention to address both the dyspnea and anxiety symptoms simultaneously. Oxygen therapy, relaxation techniques, and breathing exercises may also be useful adjunctive interventions, but opioid medications are typically prioritized for immediate symptom relief in this context.