In planning their care Nurse Gina should consider _______.

Correct Answer: B

Rationale: In planning their care, Nurse Gina should consider holistic care, which emphasizes treating the patient as a whole person - including their physical, mental, emotional, and spiritual needs. By addressing all aspects of the patient's well-being, Nurse Gina can provide comprehensive care that promotes overall health and wellness. This approach recognizes that physical health is interconnected with other aspects of a person's life and aims to support the individual in achieving balance and harmony in all areas. Holistic care also encourages the patient to be actively involved in their own healing process, fostering a sense of empowerment and self-awareness.

Correct Answer: A

Rationale: The first step in the management of a chemical splash to the eyes is to irrigate the eyes with clean water. Flushing the affected eye with water helps to remove the chemical and minimize any potential injury. It is important to continue irrigation for at least 15-20 minutes to ensure thorough removal of the chemical. This prompt action can help prevent further damage to the eye and surrounding tissue. It is crucial to remember not to delay irrigation to seek medical advice first, as immediate irrigation is vital in such situations. After irrigating the eyes, further assessment and treatment can be carried out based on the severity of the injury.

Correct Answer: C

Rationale: The patient is likely infected with Cryptosporidium parvum based on the symptoms of watery diarrhea, abdominal cramps, and nausea after consuming contaminated water. Cryptosporidium is a protozoan parasite that can be transmitted through contaminated water sources, such as streams. Laboratory tests revealing oocysts in the stool sample further support the diagnosis of Cryptosporidium infection, as these oocysts are characteristic of this parasite. Giardia lamblia is another common protozoan parasite that can cause similar symptoms but is usually associated with more foul-smelling, greasy diarrhea. Entamoeba histolytica causes amoebic dysentery, which presents with bloody diarrhea and abdominal pain. Cyclospora cayetanensis also causes watery diarrhea, but it is usually associated with foodborne outbreaks rather than waterborne transmission.

Correct Answer: B

Rationale: The correct information for the nurse to include in patient education about aspirin therapy is to advise the patient to avoid using nonsteroidal anti-inflammatory drugs (NSAIDs) while taking aspirin. NSAIDs can increase the risk of gastrointestinal bleeding when taken along with aspirin, which is already a blood-thinning medication due to its antiplatelet effects. Patients with coronary artery disease are typically prescribed aspirin for its antiplatelet properties to prevent blood clot formation in the arteries. Avoiding NSAIDs will help reduce the risk of gastrointestinal complications and ensure the effectiveness of aspirin therapy in preventing cardiovascular events. Taking aspirin with a full glass of milk (Option A) is not a necessary instruction for aspirin therapy. Discontinuing aspirin therapy if a patient develops a fever (Option C) is not a standard practice unless advised by a healthcare provider. Taking aspir

Correct Answer: D

Rationale: Calcium channel blockers are often prescribed for the management of hypertension because they can help relax blood vessels and slow the heart rate, thus reducing blood pressure. One of the major adverse effects associated with calcium channel blockers is bradycardia (slow heart rate) or even more rarely, tachycardia (fast heart rate). Therefore, in a patient prescribed a calcium channel blocker for hypertension, the nurse should closely monitor for any signs and symptoms of tachycardia as it can be a serious adverse effect that needs prompt evaluation and intervention to prevent complications.

Correct Answer: B

Rationale: Thrombotic thrombocytopenic purpura (TTP) is a rare blood disorder characterized by microangiopathic hemolytic anemia, thrombocytopenia, fever, neurological abnormalities, and renal dysfunction. The peripheral blood smear in TTP typically shows fragmented red blood cells (schistocytes) due to mechanical destruction within small blood vessels. Laboratory findings in TTP commonly include elevated lactate dehydrogenase (LDH), decreased haptoglobin (as it is consumed in the clearance of free hemoglobin), and increased indirect bilirubin due to increased red blood cell breakdown. This combination of clinical presentation and laboratory abnormalities is classic for TTP. Hemolytic uremic syndrome (HUS) may present similarly but is more commonly associated with renal dysfunction and is often triggered by infection with Shiga toxin-producing E. coli.

Correct Answer: A

Rationale: The response indicating Annie's present condition would be option A. This is because the symptoms mentioned in option A, such as experiencing vertigo, nausea, and nystagmus when sitting, point towards a vestibular disorder. These are symptoms commonly associated with conditions like Meniere's disease or vestibular neuritis, which can cause balance issues and feelings of dizziness. These symptoms are more indicative of Annie's current health status compared to the other options which focus on past or unrelated issues, such as ear pain during travel or impaired hearing since birth. The information provided in option A gives a more direct insight into Annie's present condition, making it the most appropriate response.

Correct Answer: B

Rationale: The priority nursing diagnosis for a patient undergoing surgery (closure of the sac) would be risk for infection. This is because surgical procedures increase the risk of infection due to the breach in the skin and introduction of microorganisms. Infection can lead to serious complications, delay healing, and prolong recovery time. Therefore, prevention, early detection, and prompt treatment of infections are essential in the perioperative period to ensure the best possible outcomes for the patient.

Correct Answer: A

Rationale: When a patient is in a somnolent status and still under the effect of anesthesia, the most appropriate position to place the patient is in a supine position with the head of the bed slightly elevated. This position helps prevent any obstruction of the airway and promotes optimal ventilation. Elevating the head of the bed ensures that the patient's airway remains clear and allows for proper breathing. Additionally, this position helps prevent aspiration and promotes proper circulation. Overall, the supine position with the head bed slightly elevated is the safest and most effective position for a patient in this condition.