Which of the following actions is appropriate for managing a conscious patient with a suspected stroke?

Correct Answer: D

Rationale: Activating emergency medical services (EMS) for rapid transport to a stroke center is the most appropriate action for managing a conscious patient with a suspected stroke. Time is critical in stroke care, and receiving specialized treatment at a stroke center as soon as possible can significantly improve outcomes for stroke patients. EMS providers are trained to recognize the signs of stroke and can begin essential pre-hospital care measures while en route to the hospital. Administering aspirin immediately is not recommended without medical evaluation, as certain types of strokes (such as hemorrhagic strokes) can be worsened by aspirin. Placing the patient in a supine position may not be ideal, as maintaining an elevated position can help prevent aspiration in stroke patients. Encouraging the patient to eat and drink is not appropriate, as swallowing difficulties are common in stroke patients and can lead to aspiration pneumonia.

Correct Answer: B

Rationale: The most appropriate nursing diagnosis for the individual described is "Ineffective individual coping." This is because the individual has been facing challenges in both academic (failing math class) and personal (substance dependence) aspects of his life. The repeated failures in his math class and the substance dependence for three years indicate that he might be struggling to cope with stressors and challenges in his life effectively. By identifying this nursing diagnosis, the nurse can focus on helping the individual develop effective coping strategies to manage and overcome these difficulties.

Correct Answer: D

Rationale: The cough of a patient with lung cancer typically starts off as dry and persistent. This is because lung cancer can irritate the airways, leading to a persistent dry cough as an early symptom. As the cancer progresses, the cough may become more productive with blood-tinged or dark yellow sputum. However, in the early stages, the cough is often dry and persistent, which can be a warning sign for healthcare providers to further investigate potential underlying issues such as lung cancer.

Correct Answer: A

Rationale: Magnetic Resonance Imaging (MRI) is a specialized medical imaging technique that uses magnetic fields and radio waves to create detailed images of the organs and tissues within the body. In the context of the scenario provided, an MRI is ordered by the attending physician to validate the medical impression.

Correct Answer: C

Rationale: Verbal abuse is the most common form of abuse experienced by nurses in their workplace. This may include insults, yelling, threats, or intimidation directed towards the nurse. Verbal abuse can have a significant impact on the nurse's mental and emotional well-being, leading to stress, anxiety, and burnout. It is important for healthcare institutions to address and prevent verbal abuse to create a safe and respectful work environment for nurses and other healthcare professionals.

Correct Answer: B

Rationale: Nitrous oxide, also known as "laughing gas," is a safe and effective pharmacological option for pain management during labor. Nitrous oxide is commonly used in labor and delivery settings as it has minimal effects on the baby and allows the woman to remain in control of her pain management. It provides quick pain relief when inhaled and can be adjusted to the woman's needs during labor. Ibuprofen, morphine, and diazepam are not typically used for pain management during labor due to their potential risks and side effects, especially for the baby.

Correct Answer: A

Rationale: In a patient with acute gastrointestinal bleeding requiring urgent intervention, the healthcare team should prioritize performing endoscopic hemostasis with mechanical or thermal techniques. Endoscopy allows for direct visualization of the source of bleeding in the gastrointestinal tract, enabling targeted interventions such as clipping, cauterization, or injection of epinephrine to achieve hemostasis. This approach is effective in managing acute bleeds and can help stop the bleeding quickly, reducing the need for more invasive procedures or surgeries. Administering proton pump inhibitors (PPIs) may be considered for acid-related bleeding, but it is not the primary intervention for acute bleeding requiring urgent management. Strict bed rest may not be necessary and can increase the risk of complications such as deep vein thrombosis. Transfusion of fresh frozen plasma may be indicated if there is evidence of coagulopathy, but addressing the bleeding source should be the initial priority to

Correct Answer: C

Rationale: When discharging a suicidal patient who has been taking tricyclic antidepressant drugs, it is crucial for the nurse to evaluate the risk for suicide by overdose of the medication. Tricyclic antidepressants have a narrow therapeutic index, meaning that the difference between a therapeutic dose and a toxic dose can be quite small. This makes them particularly dangerous in cases of overdose, as they can lead to severe toxic effects, including cardiac arrhythmias, seizures, and death.

Correct Answer: A

Rationale: Tricyclic antidepressants (TCAs) are known to have anticholinergic effects, which can lead to various cardiovascular side effects, including orthostatic hypotension, tachycardia, and potential hypertension. While hypotension is a possible adverse effect, hypertension is more commonly associated with TCAs. Therefore, it is essential for the nurse to monitor the patient for signs of hypertension, such as elevated blood pressure readings, to prevent any adverse outcomes and ensure the patient's safety while on this medication.