Who should ideally do discharge planning?

Correct Answer: B

Rationale: In the context of pharmacology and medical-surgical care, discharge planning is a critical component of patient care to ensure a smooth transition from the hospital to home. The ideal approach involves the professional nurse and the patient (Option B) collaborating to develop a comprehensive discharge plan. The professional nurse is pivotal in this process due to their clinical expertise in medication management, patient education, and care coordination. They can assess the patient's understanding of their medications, provide important instructions on drug administration, monitor for potential side effects, and address any concerns or questions the patient may have. Involving the patient directly also promotes patient autonomy, empowerment, and compliance with the discharge plan. The other options are not as ideal for discharge planning in pharmacology. Practical nurses (Option A) may not have the same level of clinical knowledge and assessment skills as professional nurses. Involving only the patient and their family (Option C) may lack the expertise needed for complex medication regimens and potential interactions. Public health nurses (Option D) focus more on community health and prevention rather than individualized medication management. Educationally, understanding the importance of involving the professional nurse and the patient in discharge planning reinforces the collaborative nature of healthcare delivery and the need for tailored, patient-centered care in pharmacology and medical-surgical settings. It highlights the significance of effective communication, patient education, and continuity of care in promoting positive patient outcomes post-discharge.

Correct Answer: A

Rationale: The correct answer is A) Prevent damage to nerves and circulation. In the context of a surgical procedure, removing a tightly rolled blanket from under Mrs. West's knees is crucial to prevent damage to nerves and circulation. When a blanket is tightly rolled under the knees, it can exert pressure on the nerves and blood vessels in the popliteal fossa, potentially leading to impaired circulation and nerve damage. This can increase the risk of complications such as pressure ulcers, nerve injury, or compromised blood flow during surgery. Option B) Provide a flat surface for the sterile field is incorrect because while maintaining a flat surface for the sterile field is important in surgery, the primary reason for removing the rolled blanket is to ensure the patient's safety and prevent complications related to nerve and circulation damage. Option C) Stretch lower leg muscles to prevent strain is incorrect as the main concern in this scenario is not about stretching lower leg muscles but rather about preventing nerve and circulation damage due to the pressure from the tightly rolled blanket. Option D) Facilitate access to the surgical site is incorrect because the reason for removing the tightly rolled blanket is primarily related to patient safety and preventing complications, rather than facilitating access to the surgical site. Understanding the rationale behind removing a tightly rolled blanket from under a patient's knees is essential for perioperative nurses and surgical team members to ensure patient safety and optimize surgical outcomes. It highlights the importance of proper positioning and pressure redistribution to prevent patient harm during surgical procedures.

Correct Answer: A

Rationale: In Mrs. West's situation with wound separation and purulent drainage, the best evaluation is option A: "This response is consistent with the inflammatory process." This is the correct answer because wound separation and purulent drainage are signs of inflammation, which is a normal part of the healing process in response to tissue injury or infection. Understanding the inflammatory process is crucial in assessing wound healing and identifying complications. Option B, "Some drainage is to be expected from a surgical incision," is incorrect because while some serous drainage may be expected initially, purulent drainage indicates an infection or inadequate wound healing. Option C, "This response indicates a break in sterile technique has occurred," is incorrect as wound separation and purulent drainage are more indicative of the body's response to infection or inadequate healing rather than solely a sterile technique issue. Option D, "This wound is healing by first intention," is incorrect because wound healing by first intention involves minimal tissue loss and precise wound closure without complications such as wound separation and purulent drainage. Educationally, understanding the different types of wound healing and recognizing signs of inflammation and infection is essential for healthcare professionals to provide appropriate care, prevent complications, and promote optimal patient outcomes in the medical-surgical setting.

Correct Answer: B

Rationale: In this scenario, the most helpful nursing measure to obtain Mr. Smith's compliance with treatment is option B: Teach Mr. Smith about his prescribed medications. Educating the patient about their prescribed medications is crucial as it empowers them to understand the importance of the treatment, potential side effects, and the rationale behind the regimen. This knowledge increases the likelihood of adherence and successful outcomes. Option A (Involving Mrs. Smith in the teaching sessions) could be beneficial in providing additional support, but ultimately, the patient should have a thorough understanding of their own treatment plan to ensure compliance. Option C (Asking the social worker to talk to Mr. Smith) may not directly address the issue of medication compliance and could potentially overlook the importance of patient education. Referring the Smiths to the American Lung Association (Option D) may provide resources but does not address the immediate need for educating Mr. Smith on his medications. In a medical-surgical context, patient education plays a pivotal role in promoting health literacy, self-care management, and treatment adherence. Nurses serve as educators in healthcare settings, guiding patients to make informed decisions about their health. By focusing on educating Mr. Smith about his medications, nurses can enhance his understanding and collaboration in his treatment plan, leading to improved health outcomes.

Correct Answer: C

Rationale: In the context of pharmacology within a medical-surgical setting, the correct answer to the question regarding additional assessments when there is no fluid in Mr. Jones' chest tubes is option C) Auscultate for equal breath sounds bilaterally. This choice is correct because it is crucial to assess for equal breath sounds bilaterally to ensure proper lung function and to monitor for any potential complications such as pneumothorax or lung collapse. Option A) Turn Mr. Jones on his left side and observe for drainage is incorrect because the absence of fluid in the chest tubes does not necessarily indicate a need for drainage, and turning the patient on his left side may not provide relevant information in this scenario. Option B) Clamp the chest tubes and observe Mr. Jones’ breathing pattern is incorrect as clamping the chest tubes without a specific indication can lead to potential complications such as tension pneumothorax, which can be life-threatening. Option D) Monitor vital signs closely for hypotension, tachycardia is incorrect because while monitoring vital signs is important in assessing a patient's condition, in this specific situation of no fluid in the chest tubes, auscultating for breath sounds is a more direct and relevant assessment to evaluate any potential respiratory issues. Educationally, understanding the importance of proper assessment techniques in monitoring patients with chest tubes is vital for providing safe and effective care. This scenario highlights the significance of clinical assessment skills in identifying potential complications and ensuring prompt intervention to optimize patient outcomes.