Mr. M. consents to a procedure on his left ear. After the patient is anesthetized Dr. W. discovers that the right ear is in greater need of surgery. What should the surgeon do?

Correct Answer: B

Rationale: You must obtain informed consent by specific procedure. Consent for another procedure or clear medical necessity cannot infer consent for another procedure. Neither the medical necessity of the procedure, the seriousness of the condition, nor the assumption that any reasonable person would consent is sufficient to assume that consent is given. The patient is not aware of his surroundings and condition because of the sedation. You cannot have an 'informed consent' without waking up and informing the patient. Another example would be a blood transfusion in a Jehovah's Witness. If, during a procedure, a clear but unexpected necessity for blood transfusion arises, you must wake the patient up and ask about the patient's wishes to have or not have blood. The consent or refusal must be informed. You cannot say that because of the necessity or sedation, that you should just give the blood. On the other hand, just because a patient is a Jehovah's Witness, you cannot assume that he will refuse the blood. A refusal must be informed as well. The patient could, after all, be a Jehovah's Witness who does not agree with that religion's teaching on blood. Each procedure must undergo an individual consent process.

Correct Answer: C

Rationale: In the scenario described, choosing option C, paging the RN trainer for clarification, is the correct course of action. This is because only a registered nurse (RN) or a physician has the authority to authorize changes to medication orders. By contacting the RN trainer, you are following the proper chain of command and seeking guidance from a qualified healthcare professional. Option A, following the home manager's instructions to not give the medication, is incorrect because as a nursing staff member, you must adhere to the established protocols and seek clarification from healthcare professionals responsible for the individual's care. Giving the medication anyway, as suggested in option B, could potentially be harmful to the individual and is a violation of medication administration standards. Option D, giving the medication but marking D/C (discontinued) on the medication administration record (MAR), is not appropriate because marking a medication as discontinued without proper authorization is not within the scope of practice for a nursing staff member. This action could lead to serious consequences and jeopardize the individual's health and well-being. In an educational context, this scenario highlights the importance of clear communication, adherence to protocols, and understanding the chain of command in healthcare settings. It emphasizes the critical role of RNs and physicians in medication administration and the need for all healthcare team members to work collaboratively and follow established procedures to ensure safe and effective care for individuals. By understanding and applying these principles, nursing staff can uphold the highest standards of practice and prioritize patient safety in medication administration.

Correct Answer: C

Rationale: In the context of medication administration in nursing, understanding the concept of systemic medications is crucial for safe and effective practice. The correct answer to the question, "What type of medication action affects the entire body?" is C) systemic. Systemic medications are designed to be absorbed into the bloodstream and distributed throughout the entire body, affecting various organs and tissues. This means that the medication has a widespread impact on the body's physiological processes. Nurses administering systemic medications must be aware of potential systemic side effects, interactions, and contraindications to ensure patient safety. Option A) local medications, on the other hand, have a localized effect on a specific area of the body where they are applied or administered. These medications do not enter the bloodstream and therefore do not have a systemic effect. Option B) primary and option D) cumulative are not directly related to the concept of systemic versus local medications in this context. Educationally, understanding the difference between systemic and local medications is fundamental for nursing students and practicing nurses. It guides clinical decision-making, dosage calculations, and patient education. By grasping this concept, nurses can provide safe and individualized care to their patients, minimizing the risk of adverse effects and promoting optimal therapeutic outcomes.

Correct Answer: D

Rationale: In the context of medications used for hypertension, Quinapril (option D) is the correct answer. Quinapril is an ACE inhibitor that helps to lower blood pressure by relaxing blood vessels. ACE inhibitors are commonly prescribed for hypertension due to their effectiveness in managing high blood pressure. Aminophylline (option A) is a bronchodilator primarily used in the treatment of respiratory conditions like asthma and chronic obstructive pulmonary disease, not for hypertension. Ziprasidone (option B) is an antipsychotic medication used to treat conditions like schizophrenia and bipolar disorder, not hypertension. Ibuprofen (option C) is a nonsteroidal anti-inflammatory drug (NSAID) used for pain relief and reducing inflammation, but it is not indicated for hypertension. In an educational context, understanding the correct medications for hypertension is crucial for nursing practice. Nurses must be knowledgeable about the pharmacological management of hypertension to ensure safe and effective care for patients. By knowing the correct medications and their mechanisms of action, nurses can help patients achieve optimal blood pressure control and prevent complications associated with hypertension. It is essential for nursing students to grasp this knowledge to provide high-quality care and promote positive patient outcomes in their future practice.

Correct Answer: B

Rationale: The correct answer is B) sleeplessness. Sedatives are medications that are specifically designed to promote relaxation and induce sleep. They act on the central nervous system to produce a calming effect, making them effective in managing conditions such as insomnia or sleeplessness. By enhancing the activity of the neurotransmitter gamma-aminobutyric acid (GABA) in the brain, sedatives help to reduce anxiety and promote sedation, ultimately aiding in the initiation and maintenance of sleep. Option A) drowsiness is incorrect because sedatives are not typically given to induce drowsiness. While drowsiness may be a side effect of sedative medications, the primary purpose of administering sedatives is to treat sleeplessness rather than simply causing drowsiness. Option C) emphysema is incorrect because sedatives are not indicated for the treatment of respiratory conditions like emphysema. In fact, sedatives can actually depress the respiratory drive and worsen respiratory conditions such as emphysema. Option D) eye infections is incorrect because sedatives have no direct therapeutic effect on eye infections. Treating eye infections typically requires antimicrobial eye drops or ointments targeted at the specific infectious organism causing the infection. In an educational context, understanding the appropriate use of sedatives is crucial for nursing students and healthcare professionals involved in medication administration. By grasping the specific indications for sedative medications, learners can ensure safe and effective care for patients experiencing sleep disturbances. It is essential for students to recognize the pharmacological actions of sedatives and their intended therapeutic effects to make informed decisions regarding medication administration and patient care.