Nursing Education Capstone (C947)

Correct Answer

B. Elevate the head of the bed to 30 degrees

Explanation

Elevating the head of the bed to 30 degrees is the recommended position for a patient with increased intracranial pressure (ICP) because it promotes venous drainage from the brain without compromising cerebral perfusion. This positioning helps to decrease ICP and improve oxygenation by enhancing respiratory mechanics. It is a standard intervention in the management of increased ICP.

Why other options are wrong

A. Keep the head of the bed flat

Keeping the bed flat can impair venous outflow from the brain, potentially worsening ICP by allowing cerebral blood to pool. This position is not typically recommended for patients with increased ICP unless otherwise indicated due to specific conditions like hypotension.

C. Left side lying with the head supported on a pillow

While side-lying can be a safe position in general, it does not optimize venous drainage and can increase ICP if the neck is not properly aligned. It is not the preferred position for reducing ICP.

D. Trendelenburg

The Trendelenburg position increases venous return to the brain, potentially worsening ICP. This position is contraindicated in patients with elevated ICP as it can lead to cerebral edema and further complications.

Correct Answer

C) Between 9:30 am and 3 pm

Explanation

Alcohol withdrawal symptoms typically begin within 6-12 hours after the last drink. In this case, since the client had their last drink at 9:30 am, withdrawal symptoms are most likely to begin between 9:30 am and 3 pm. Symptoms can include anxiety, tremors, sweating, and agitation. Severe withdrawal symptoms, such as seizures or delirium tremens, can occur later, but initial symptoms generally start within this time window.

Why other options are wrong

A) Between 1 pm and 6 pm

This time window may be too late to expect the onset of withdrawal symptoms for this patient, as symptoms typically begin within the first 6-12 hours after the last drink.

B) Around 9:30 am the following day

Withdrawal symptoms do not usually occur 24 hours after the last drink. Symptoms typically emerge within the first 6-12 hours and peak within 24-48 hours after the last drink.

D) Before 1:00 pm

Symptoms may not appear as early as before 1:00 pm, as they generally start later, within a 6-12 hour period following the last drink.

Correct Answer:

C) Increased water intake

Explanation:

Polycystic kidney disease (PKD) is a genetic disorder that causes cysts to form in the kidneys, leading to kidney damage over time. The treatment plan typically includes measures to manage the symptoms, such as controlling blood pressure and avoiding excessive sodium intake. Increased water intake is generally not recommended in PKD, as it could exacerbate fluid retention and place additional strain on the kidneys. The goal is to manage kidney function and avoid overhydration or dehydration.

Why other options are wrong:

A) Genetic counseling: Genetic counseling is an important part of managing polycystic kidney disease because the condition is inherited, and counseling helps patients and their families understand the risks and the inheritance pattern.

B) Sodium restriction: Sodium restriction is a common part of the treatment for polycystic kidney disease to help manage blood pressure and reduce kidney strain. Excess sodium can worsen kidney damage by increasing fluid retention and blood pressure.

D) Antihypertensive medications: Antihypertensive medications are often part of the treatment plan for polycystic kidney disease since high blood pressure is a common complication of the disease and needs to be controlled to prevent further kidney damage.

Correct Answer

B. To evaluate the strengths, weaknesses, opportunities, and threats of a business

Explanation

A SWOT analysis is a strategic planning tool used by businesses to evaluate their internal strengths and weaknesses, as well as external opportunities and threats. By analyzing these four aspects, companies can make informed decisions, capitalize on strengths, address weaknesses, exploit opportunities, and defend against potential threats, ultimately improving their strategic positioning.

Why other options are wrong

A. To analyze financial statements

SWOT analysis does not focus on financial statements. While financial analysis is essential for business decision-making, SWOT analysis is specifically designed to assess the broader business environment, including factors beyond financial performance. Financial statement analysis is a different process involving balance sheets, income statements, and cash flow analysis.

C. To identify potential customers

Identifying potential customers is a task often carried out through market research or customer segmentation, not through a SWOT analysis. While a SWOT analysis can help a business understand its position and identify market opportunities, it is not directly used to identify specific customer segments or prospects.

D. To create product designs

SWOT analysis is not concerned with the design process of products. Product design typically falls under product development or design departments, while SWOT is a tool for evaluating the broader business context and strategy. Product design is one of many areas that may be impacted by insights gained from a SWOT analysis.

Correct Answer

B) Loosen the child's clothing, and call for help.

Explanation

The priority during a seizure is to ensure the child's safety. Loosening the child's clothing helps prevent any restriction to their breathing, and calling for help ensures that the parent can receive assistance if needed. It is also important to stay with the child and monitor them until the seizure resolves. The child should not be moved unless in immediate danger, and no objects, including tongue blades, should be placed in the child's mouth.

Why other options are wrong

A) Administer the child's rescue dose of oral diazepam (Valium).

While administering a rescue medication like oral diazepam may be necessary if prescribed, it is not the first priority during the seizure. The first action should be ensuring the child's immediate safety, such as loosening their clothing and calling for help.

C) Place a tongue blade in the child's mouth to prevent aspiration.

Placing a tongue blade or any object in the child's mouth is dangerous and should never be done. This can lead to injury, choking, or aspiration, and does not prevent the child from biting their tongue.

D) Carry the child to the car and then call 911.

Carrying the child during a seizure is unsafe, as it may cause injury or worsen the situation. The best approach is to allow the seizure to happen safely on the ground, ensuring there is nothing around the child that could cause harm. The parent should call for help, but not move the child unnecessarily.

Correct Answer

C. Naloxone (Narcan)

Explanation

Naloxone (Narcan) is the antidote for opioid overdose, including morphine sulfate. It works by binding to opioid receptors in the brain, reversing the effects of opioids like morphine and restoring normal respiratory function. This medication is vital in managing life-threatening respiratory depression caused by opioid overdose.

Why other options are wrong

A. Phenytoin (Dilantin)

Phenytoin is used to manage seizures and is not effective for opioid overdose. While it may treat seizure activity, it does not address the respiratory depression caused by morphine overdose.

B. Tramadol (Ultram)

Tramadol is an opioid analgesic and would not counteract the effects of a morphine overdose. It could actually worsen the overdose situation by further depressing the respiratory system.

D. Atropine sulfate (Atropine)

Atropine is used to treat bradycardia (low heart rate) and some types of poisoning but is not effective for opioid overdose. It does not reverse the central nervous system depression caused by opioids like morphine.

Correct Answer

c. How long the seizure lasted

Explanation

The nurse's first priority when charting a seizure is to document the duration of the seizure. The length of a seizure is crucial for assessing whether it was a generalized or focal seizure, if it required medical intervention, and to help determine the appropriate treatment or need for emergency care. It is also important for monitoring the patient’s neurological status and ensuring proper follow-up care. Documenting the seizure duration is the most immediate and clinically relevant information.

Why other options are wrong

a. Blood pressure

While blood pressure is an important part of post-seizure assessment, it is not the first priority to chart immediately after a seizure. The duration of the seizure provides critical information about the patient's condition and needs to be documented first. Blood pressure can be assessed afterward as part of a more comprehensive post-seizure evaluation.

b. Pain assessment

Pain assessment is important for general patient care, but it is not a priority immediately following a seizure. The focus immediately after a seizure should be on neurological parameters, especially the duration and characteristics of the seizure. Pain assessment may be done once the patient is stable and able to communicate effectively.

d. Oxygen saturation

Oxygen saturation is also important, particularly if the patient has a history of respiratory issues or the seizure may have led to hypoxia. However, the priority for documentation after a seizure is to report the duration, as this helps in understanding the severity and type of seizure, which has more immediate clinical relevance. Oxygen saturation should be checked, but its documentation can come after the seizure duration is recorded.

Correct Answer

B) End-stage renal disease

Explanation

The most serious complication of polycystic kidney disease (PKD) is end-stage renal disease (ESRD). PKD is characterized by the development of fluid-filled cysts in the kidneys, which over time leads to a decline in kidney function. As the kidneys become more damaged, they can eventually fail, requiring dialysis or kidney transplantation. This is the most life-threatening complication of the disorder.

Why other options are wrong

A) Diabetes insipidus

Diabetes insipidus is not a typical complication of PKD. This condition is characterized by an inability to concentrate urine due to a lack of antidiuretic hormone or kidney resistance to it, and it is unrelated to PKD.

C) Chronic UTI

Chronic urinary tract infections (UTIs) are a concern for individuals with PKD due to cysts in the kidneys and urinary tract, but they are not the most serious complication. Although UTIs should be managed, they do not carry the same level of risk as end-stage renal disease.

D) Syndrome of inappropriate antidiuretic hormone secretion

Syndrome of inappropriate antidiuretic hormone secretion (SIADH) involves excessive release of antidiuretic hormone, leading to water retention and dilutional hyponatremia. While it may occasionally occur in various disorders, it is not a common or serious complication of polycystic kidney disease.

Correct Answer:

B) Level of consciousness

Explanation:

The Glasgow Coma Scale (GCS) is specifically designed to assess a patient's level of consciousness by evaluating three key aspects: eye opening, verbal response, and motor response. It helps to determine the severity of brain injury and monitor changes in the patient's neurological status. The GCS is a widely used tool in assessing a patient's level of consciousness, which can provide crucial information about the patient's neurological function.

Why other options are wrong:

A) Reflex activity: The GCS does not assess reflex activity. Reflexes may be assessed separately through other neurological exams, such as checking deep tendon reflexes.

C) Cognitive ability: While GCS scores may give some indirect information about cognitive function, it is primarily a measure of consciousness rather than cognitive abilities, such as memory or problem-solving.

D) Sensory involvement: Sensory involvement, such as touch, temperature, or pain perception, is not specifically assessed through the GCS. Sensory tests are usually done through a separate neurological assessment.