Jim is a 60-year-old man who presents with vomiting. He denies seeing any blood with emesis, which has been occurring for 2 days. He does note a dark, granular substance resembling the coffee left in the filter after brewing. What do you suspect?

Correct Answer: B

Rationale: When blood is exposed to the environment of the stomach, it often resembles 'coffee grounds.' This is not always recognized by patients as blood, so it is important to inquire about this. This symptom is not common in cholecystitis, and the other possibilities occur lower in the intestine. It should be noted that conversely, rapid bleeding from the stomach or other upper gastrointestinal source can produce bright red blood in the stool. Do not rule out proximal bleeding on the basis of the absence of 'coffee grounds.' Likewise, bright red blood seen with emesis may originate from the stomach. Black, sticky stools also can accompany upper GI bleeding.

Correct Answer: B

Rationale: In the context of a client with bacterial meningitis, the best choice for a hospital room is Option B) An isolation room three doors from the nurses' station. This option is correct because bacterial meningitis is highly contagious and requires strict isolation precautions to prevent the spread of infection to other patients and healthcare workers. Placing the client in an isolation room helps contain the infectious agent and reduces the risk of transmission. Option A) A private room down the hall from the nurses' station is not the best choice because it does not provide the necessary isolation needed for a client with bacterial meningitis. Option C) A semiprivate room with a 32-year-old client who has viral meningitis is also not appropriate as it can increase the risk of cross-infection between the two clients. Option D) A two-bed room with a client who previously had bacterial meningitis is not ideal as the client may still be a carrier of the bacteria and pose a risk of reinfection. From an educational standpoint, this scenario highlights the importance of understanding the specific isolation requirements for infectious diseases and the critical role of infection control measures in preventing the spread of communicable diseases in healthcare settings. Healthcare professionals must be knowledgeable about proper isolation protocols to ensure the safety of both patients and staff members.

Correct Answer: C

Rationale: The correct answer is C) A 46-year-old patient who was admitted 48 hours ago with bacterial meningitis and has an antibiotic dose due. This patient is the best choice for the RN floated from the medical unit because they require timely administration of antibiotics for their bacterial meningitis. This task aligns closely with the medical unit's scope of practice, as administering medications is a common nursing responsibility in that setting. Option A) involves a patient with a basilar skull fracture and clear drainage, which may require neurologic assessments and interventions beyond the typical scope of a medical unit RN. Option B) presents a patient with a ruptured berry aneurysm, a complex neurologic condition that necessitates specialized care and monitoring. Option D) features a patient with an astrocytoma post-craniotomy, requiring neurologic surveillance and expertise that exceed the capabilities of a medical unit RN. By selecting option C, the RN from the medical unit can effectively contribute to the care of a patient needing medication administration, a task well within their competency level. This scenario provides a valuable educational context by highlighting the importance of aligning nursing assignments with staff competencies to ensure safe and effective patient care.

Correct Answer: C

Rationale: In this scenario, the correct answer is C) Prosthetic valve replacement. The reason for this is that individuals with certain metallic implants or devices, such as prosthetic heart valves, pacemakers, or other metallic objects in their bodies, may not be eligible for magnetic resonance imaging (MRI) due to the risk of interference with the magnetic field of the machine. Option A) Hypertension, Option B) Heart failure, and Option D) Chronic obstructive pulmonary disorder do not typically preclude a patient from undergoing an MRI procedure. Hypertension, heart failure, and COPD are common health conditions that are not contraindications for MRI. Educationally, this question highlights the importance of understanding contraindications to specific diagnostic procedures based on a patient's medical history. Nurses need to be aware of these contraindications to ensure patient safety and the accuracy of diagnostic tests. This knowledge helps in providing optimal care and preventing potential risks or complications for patients undergoing medical procedures.

Correct Answer: B

Rationale: In this scenario, the correct answer is B) eccentric contraction. When a patient moves from standing to sitting, the hip extensors are lengthening while controlling the descent, which is characteristic of an eccentric contraction. An eccentric contraction occurs when a muscle lengthens under load, providing controlled movement and deceleration. In the case of the hip extensors during the described activity, they are contracting eccentrically to support the patient's lowering to a seated position. Now, let's address why the other options are incorrect: A) Concentric contraction involves a muscle shortening while generating force. This is not the case when the hip extensors are controlling the descent from standing to sitting. C) Isometric contraction occurs when a muscle generates force without changing in length. In this scenario, the hip extensors are definitely changing length during the movement. D) Isokinetic contraction involves a constant speed of contraction, which is not specifically indicated in the described activity of moving from standing to sitting. Understanding the type of muscle contraction involved in various movements is crucial for healthcare professionals like physical therapists to assess functional strength accurately and design appropriate rehabilitation programs. Knowledge of different contraction types helps in tailoring exercises to improve strength, mobility, and overall function effectively.