The nurse is completing a medication history for the surgical patient in preadmission testing. Which medication should the nurse instruct the patient to hold (discontinue) in preparation for surgery according to protocol?

Correct Answer: A

Rationale: Step 1: Warfarin is an anticoagulant that increases the risk of bleeding during surgery. Step 2: Holding Warfarin helps normalize the patient's clotting ability before surgery. Step 3: This reduces the risk of excessive bleeding during and after the procedure. Step 4: Vitamin C, Prednisone, and Acetaminophen do not pose the same bleeding risk. Summary: Warfarin is the correct choice due to its anticoagulant properties, making it crucial to discontinue before surgery to minimize bleeding complications. Vitamin C, Prednisone, and Acetaminophen do not have the same impact on clotting and are safe to continue.

Correct Answer: A

Rationale: The correct answer is A: Perform a needle decompression. Tracheal deviation indicates tension pneumothorax, a life-threatening condition that requires immediate decompression. Performing a needle decompression will release the trapped air in the pleural space and relieve the pressure on the heart and lungs, stabilizing the patient's condition. Administering a fluid bolus (B) is not the priority as the hypotension is likely due to the tension pneumothorax. Intubating the patient (C) may worsen the condition by increasing the intrathoracic pressure. Placing the patient on a cardiac monitor (D) is important but not as urgent as addressing the tension pneumothorax.

Correct Answer: C

Rationale: The correct answer is C: Remove the BVM from tube #1 and ventilate through tube #2. This is the correct action because the presence of gastric sounds indicates that the tube is likely in the esophagus, not the trachea. By removing the BVM from tube #1 and ventilating through tube #2, you are ventilating the patient's lungs directly, improving oxygenation. Choice A is incorrect because ventilating through tube #1 will not improve the patient's condition if the tube is in the esophagus. Choice B is incorrect because confirming placement with a CO2 detector before ventilating through tube #1 does not address the issue of gastric sounds indicating esophageal placement. Choice D is incorrect because pulling the combi-tube back 2 cm without addressing the issue of esophageal placement will not improve ventilation.

Correct Answer: B

Rationale: The correct answer is B: Inferior wall. ST elevation in Leads II, III, aVF indicates an inferior wall myocardial infarction, commonly caused by occlusion of the right coronary artery. Lead II views the inferior part of the heart, and Leads III/aVF view the inferior and posterior parts. This pattern suggests damage to the inferior wall supplied by the right coronary artery. Other choices are incorrect as ST elevation in these leads does not correspond to lateral (A), anterior (C), or septal (D) wall infarctions.

Correct Answer: C

Rationale: Congestive heart failure is most likely to cause problems with both internal (heart's pumping ability) and external (lung function) processes of respiration. Step 1: In CHF, the heart struggles to pump blood effectively, leading to fluid accumulation in the lungs (internal process). Step 2: The fluid in the lungs impairs gas exchange, affecting oxygenation and carbon dioxide elimination (external process). Step 3: This dual impact on internal and external respiration distinguishes CHF from other choices (lung cancer, hypertension, emphysema).