You would expect that after an abdominal perineal resection, the type of colostomy that will be use is?

Correct Answer: D

Rationale: In the context of an abdominal perineal resection, the correct type of colostomy that would be used is an ileostomy (Option D). This is because an ileostomy involves bringing the end of the small intestine through a surgical opening in the abdomen, creating a stoma through which waste is eliminated. The other options can be ruled out based on the specific scenario presented: - A double barrel colostomy (Option A) involves two separate stomas created from the colon, which is not typically indicated after an abdominal perineal resection. - A temporary colostomy (Option B) is used for temporary diversion of stool, usually to allow a portion of the colon to heal. In the case of abdominal perineal resection, a permanent diversion may be needed. - A permanent colostomy (Option C) may be considered in certain situations but is not the most common choice after an abdominal perineal resection, where an ileostomy is often preferred for better fecal diversion and wound healing. In an educational context, understanding the rationale behind selecting the appropriate type of colostomy is crucial for nursing students and healthcare professionals involved in post-operative care. This knowledge ensures proper management of stomas, prevention of complications, and promotion of patient comfort and recovery.

Correct Answer: C

Rationale: In this scenario, the correct answer is C) to decongest. The rationale behind this is that after a thoracentesis, where fluid is removed from the pleural space, a chest x-ray may be ordered to assess the re-expansion of the lung and to ensure that there is no fluid accumulation or complications. This helps in monitoring the effectiveness of the procedure and the overall lung health. Option A) to rule out pneumothorax is incorrect because a chest x-ray is typically not needed to diagnose a pneumothorax immediately after a thoracentesis, as this complication would be evident during the procedure itself. Option B) to rule out any possible perforation is incorrect because perforation would typically be suspected during the thoracentesis procedure itself, and immediate intervention would be taken if this were the case. Option D) to rule out any foreign body is incorrect as well because a chest x-ray would not be the primary diagnostic tool for detecting a foreign body in this context; other imaging modalities or procedures would be more appropriate for this purpose. Educationally, understanding the rationale behind post-thoracentesis care and monitoring is crucial for nurses and healthcare providers involved in the management of patients undergoing such procedures. It reinforces the importance of appropriate diagnostic tests and monitoring to ensure patient safety and optimal outcomes.

Correct Answer: C

Rationale: In the context of pharmacology and the study of infectious diseases, understanding the causative agents of specific infections is crucial for effective treatment and prevention strategies. In the case of Pyelonephritis in hospitalized patients with prolonged catheterization, the most common causative agent is Proteus mirabilis. The correct answer, Option C, is Proteus mirabilis. This bacterium is known to ascend through the urinary tract, colonize the bladder, and subsequently infect the kidneys, causing Pyelonephritis. Its ability to form urease enzymes contributes to its pathogenicity in catheterized patients. Option A, E. coli, is a common cause of urinary tract infections but is not specifically associated with Pyelonephritis in catheterized patients. Option B, Klebsiella, is more commonly linked to pneumonia and other respiratory infections. Option D, Staphylococcus, is a common cause of skin and soft tissue infections but is not a typical causative agent of Pyelonephritis in catheterized patients. Educationally, understanding the specific pathogens associated with different infections is crucial for pharmacology students and healthcare professionals when selecting appropriate antimicrobial therapies and implementing infection control measures. By knowing the typical causative agents of Pyelonephritis in specific patient populations, such as those with prolonged catheterization, clinicians can tailor treatment regimens to target the most likely pathogens, improving patient outcomes and reducing the development of antimicrobial resistance.

Correct Answer: C

Rationale: In this situation, the first step should be to report the matter to your supervisor. It is essential to notify the appropriate authority immediately to address the discrepancy in the narcotics cabinet. Choice A is not the first step as reporting to the nursing director should follow after informing the supervisor. Keeping the findings to yourself (Choice B) is not appropriate as it may jeopardize patient safety and is against ethical standards. While finding out which patient received narcotics (Choice D) is important, it is not the immediate action to take in this scenario.

Correct Answer: C

Rationale: In caring for a patient like Conrad with a brain tumor and increased Intracranial Pressure (ICP), providing sensory stimulation (Option C) is the most appropriate intervention to include in the plan to reduce ICP. Sensory stimulation helps to prevent sensory deprivation and promote brain activity without increasing ICP, unlike other interventions. Administering a bowel softener (Option A) may be important for overall patient comfort and preventing straining during bowel movements, but it does not directly address reducing ICP. Positioning Conrad with his head turned toward the side of the tumor (Option B) may increase ICP by potentially obstructing blood flow or causing increased pressure on the tumor. Encouraging coughing and deep breathing (Option D) can also increase ICP due to the increased intrathoracic pressure associated with these actions. Educationally, understanding the rationale behind interventions for patients with increased ICP is crucial for nurses and healthcare providers to ensure optimal patient care and outcomes. By selecting the correct intervention, patient safety and well-being are prioritized while minimizing risks associated with treatments that could potentially worsen the patient's condition.