Sixty-five-year-old Dominic is being transferred into the postanesthesia care unit (PACU) from the OR. Once there, initial assessment will focus on

Correct Answer: A

Rationale: The correct answer is A) Airway, breathing, circulation, and wound site. When a patient like Dominic is transferred to the PACU from the OR, the initial assessment should prioritize the ABCs (Airway, Breathing, Circulation) to ensure his vital functions are stable post-surgery. Checking the wound site is crucial to monitor for any signs of bleeding, infection, or complications from the surgical procedure. Option B) Intake, output, and intravenous access focuses more on fluid balance and monitoring, which is important but not the priority immediately post-surgery. Option C) Abdominal sounds, oxygen level, and level of consciousness are important assessments but should come after ensuring the patient's airway, breathing, and circulation are stable. Option D) Pulse oximetry, pupil responses, and deep tendon reflexes are valuable assessments but are secondary to the immediate concerns of airway, breathing, circulation, and wound site evaluation in the PACU. Understanding the prioritization of assessments in the PACU is crucial for nurses and healthcare providers to ensure patient safety and prompt intervention if any issues arise post-surgery, making option A the most appropriate choice for Dominic's initial assessment.

Correct Answer: A

Rationale: In the context of patient teaching for skin cancer risk reduction, option A, which advises having suspicious moles checked by a dermatologist, is the correct choice. This is because early detection of skin cancer is crucial for successful treatment and improved outcomes. By regularly monitoring moles and seeking professional evaluation, patients can identify any potential signs of skin cancer early on, leading to prompt intervention if needed. Options B and C, advocating for daily sun exposure either every half hour or for an hour to build tolerance, are incorrect and potentially harmful. Excessive sun exposure is a well-known risk factor for skin cancer development, particularly melanoma. Encouraging prolonged sun exposure without protection or in excess can increase the risk of skin damage and skin cancer, rather than reducing it. Option D, which suggests applying moisturizer, is also not directly related to skin cancer risk reduction. While moisturizing the skin is important for overall skin health, it does not specifically address the primary preventive measures needed to reduce the risk of developing skin cancer. In an educational setting, it is crucial to emphasize evidence-based practices for skin cancer prevention. Teaching patients about the importance of regular skin self-exams, seeking professional evaluation of suspicious moles, using sun protection measures like sunscreen, protective clothing, and seeking shade, are fundamental components of skin cancer prevention education. By focusing on these key strategies, patients can actively participate in their skin health and reduce their risk of skin cancer.

Correct Answer: C

Rationale: The correct answer is option C: First thing in the morning on an empty stomach with a full glass of water, 30 to 60 minutes before eating, and without lying down. This is because bisphosphonate medications have specific instructions for optimal absorption and effectiveness. Taking them on an empty stomach ensures proper absorption as food can interfere with the absorption of these medications. Additionally, the patient should remain upright for at least 30 minutes after taking bisphosphonates to prevent esophageal irritation. Option A (On a full stomach) is incorrect as taking bisphosphonates with food can decrease their absorption and effectiveness. Option B (Just before getting into bed) is also incorrect as lying down immediately after taking bisphosphonates can increase the risk of esophageal irritation. Educationally, it is crucial for healthcare professionals to understand the administration guidelines for medications to ensure their therapeutic effects. Teaching patients the correct timing and conditions for taking bisphosphonates is essential for optimal treatment outcomes in osteoporosis management. This knowledge helps prevent potential side effects and ensures the medication works as intended to improve bone health.

Correct Answer: B

Rationale: In treating cellulitis, the appropriate option is B) Antibiotics, such as cephalexin, and over-the-counter analgesics. Cellulitis is a bacterial skin infection that requires antibiotics to target and eradicate the bacterial infection. Antibiotics like cephalexin are effective against the most common bacteria causing cellulitis. Over-the-counter analgesics help manage pain and inflammation associated with the infection. Option A) Petrolatum and vitamin A and D ointment is incorrect because these do not treat the underlying bacterial infection in cellulitis. Option C) Weight-bearing exercises and diuretics like furosemide are unrelated and not appropriate for treating cellulitis. Option D) Wet to dry dressings and steroids are not recommended for cellulitis treatment as wet to dry dressings can be too harsh on the skin, and steroids can suppress the immune response needed to fight the infection. Educationally, understanding the appropriate treatment for cellulitis is crucial for healthcare providers to effectively manage and treat patients with this condition. It is important to recognize the signs and symptoms of cellulitis, initiate proper treatment promptly, and monitor the patient's response to therapy to prevent complications and promote recovery.

Correct Answer: D

Rationale: In caring for a patient with a new fracture, the first priority is to assess circulation and sensation distal to the fracture site. This is crucial to ensure adequate blood flow and nerve function, which are essential for tissue viability. By assessing circulation and sensation, healthcare providers can quickly identify any signs of compromised blood flow or nerve damage, which could lead to serious complications if not addressed promptly. Option A, assessing respiratory rate and effort, as well as pulse, is important but not the first priority in the care of a new fracture. While these parameters are vital for overall patient assessment, they do not directly impact the immediate care needed for a new fracture. Option B, checking the fracture site for bleeding, is also important but typically comes after assessing circulation and sensation distal to the fracture site. Bleeding can be managed effectively once circulation and sensation are assessed and any immediate threats to limb viability are addressed. Option C, looking for signs of infection at the wound site of an open fracture, is also important but falls lower in priority compared to assessing circulation and sensation. Infection control is crucial in fracture care, but immediate attention to circulation and nerve function is paramount to prevent further tissue damage or complications. In an educational context, understanding the rationale behind the prioritization of care in a patient with a new fracture is essential for healthcare providers to deliver effective and timely interventions. This knowledge ensures that critical assessments are made promptly to prevent complications and optimize patient outcomes.