Kent, a new staff nurse asks her preceptor nurse how to obtain a blood sample from a patient with a

Correct Answer: A

Rationale: The correct way to teach a new staff nurse to obtain a blood sample from a patient with a Portacath is to provide step-by-step instructions and demonstration. Using a Portacath requires specific knowledge and technique to prevent complications such as clot formation or infection. It is important for the preceptor nurse to properly guide and supervise the new staff nurse to ensure patient safety and accurate sample collection.

Correct Answer: D

Rationale: Calcium absorption in the small intestine relies heavily on vitamin D, which enhances the process by increasing the expression of calcium-binding proteins and improving gut uptake efficiency. Without adequate vitamin D, calcium absorption drops significantly, leading to potential bone health issues like osteoporosis or osteomalacia. Intrinsic factor, produced in the stomach, is critical for vitamin B12 absorption, not calcium, as it binds B12 for uptake in the ileum. Coenzymes, while involved in metabolic reactions, don't directly facilitate calcium absorption; their role is broader and unrelated to this specific process. Phosphorus, an abundant mineral, works with calcium in bone formation but doesn't enhance its absorption-in fact, excessive phosphorus can compete with calcium. Vitamin D's active form, calcitriol, regulates calcium levels by promoting its transport across intestinal cells, making it indispensable for maintaining skeletal integrity. This mechanism underscores why vitamin D deficiency impairs calcium utilization, distinguishing it from the other options, which lack a direct link to absorption efficiency.

Correct Answer: D

Rationale: Glyceryl trinitrate is well-absorbed sublingually due to bypassing the first-pass metabolism, providing rapid relief for angina by dilating blood vessels.

Correct Answer: C

Rationale: Morphine, a potent opioid analgesic, is primarily used to manage moderate to severe pain, but its established clinical applications extend beyond analgesia. One well-documented use is in treating pulmonary congestion, particularly in acute pulmonary edema associated with heart failure. Morphine reduces preload by causing vasodilation, alleviating dyspnea and anxiety in these patients, though the exact mechanism is multifaceted and includes central effects on respiration. Managing generalized anxiety disorders is not a standard use, as anxiolytics like benzodiazepines are preferred. While morphine can relieve pain, its use in biliary colic is contraindicated because it causes sphincter of Oddi constriction, potentially worsening the condition. It is not a treatment for ACE inhibitor-induced cough, which is better managed with antitussives or drug discontinuation. Suppression of ethanol withdrawal is also not an established role, as benzodiazepines are the standard. Thus, pulmonary congestion stands out as a recognized therapeutic use.

Correct Answer: A

Rationale: Warfarin is an anticoagulant medication commonly used to prevent blood clots. One of the most severe adverse effects of warfarin is the risk of bleeding. This can occur in various parts of the body, such as the gastrointestinal tract, brain, or other organs. Bleeding complications can range from minor bruising to life-threatening hemorrhages, especially if warfarin levels are not properly monitored. Patients taking warfarin should be closely monitored for signs of bleeding, and their medication dosages should be adjusted as needed to maintain a balance between preventing clotting and avoiding excessive bleeding.