A. Find the fire extinguisher.

B. Close all doors in the area.

C. Remove oxygen devices.

D. Begin evacuating the clients.

Answer: B
In a fire emergency in a hospital setting, the nurse should follow the RACE protocol, which includes ensuring patient safety, raising the alarm, confining the fire, and preparing for evacuation. In this order, the nurse should first close all doors to confine the fire.

Explanation:
When a fire alarm sounds in a healthcare setting such as a hospital, the nurse’s priority is the safety of the clients or patients. According to general guidelines known as the RACE protocol (Rescue, Alarm, Confine, and Extinguish/Evacuate), the nurse should first ensure the safety of clients (rescue), next, raise the alarm if not already done, then try to confine the fire by closing all doors in the area and finally extinguish the fire (if it is safe to do so) or begin evacuation. Therefore, as per this protocol, the nurse should first close all doors in the area to confine the fire before moving to other responses.

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A. Keep a time log for what was done during the hours worked

B. Complete each task before beginning another activity

C . Ask for additional assistance when necessary to complete tasks

D. Set daily goals with the establishment of priorities

CORRECT ANSWER

A. Keep a time log for what was done during the hours worked

The first step in planning for time management is to establish what tasks were done and when they were completed. This provides a baseline for needed changes in any activities and time use log. The key words in this question are “time management,” “most effective,” and “initial development.” Remember the first step in the nursing process is data collection – this applies to both caring for clients and developing management skills.

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A. Take the medication with juice

B. Take the medication before going to bed

C. Avoid exposure to sunlight when taking the medication

D. Take propylthiouracil (PTU) after taking Lugol solution

Correct Answer: A. 
Take the medication with juice
 

The thyroid gland absorbs dietary iodine, found in many foods, combines it with the amino acid tyrosine, and converts it into thyroid hormones thyroxine (T4) and triiodothyronine (T3). Although iodine is necessary for synthesis of thyroid hormone in individuals with normal thyroid function, it inhibits synthesis and release of thyroid hormone in individuals with hyperthyroidism.

Lugol solution is a solution of potassium iodide and iodine that is given prior to a thyroidectomy. The client should be instructed to take 5-7 drops 3 times a day for 10 days before the surgery. In clients who are hyperthyroid, the iodine will inhibit synthesis of thyroid hormone and secretion into the circulation while decreasing the size and vascularity of the gland to reduce the risk of complications of surgery. The solution has a bitter taste and should be given with juice. Lugol solution is also used for treatment of thyroid storm and for short-term treatment of hyperthyroidism. It should not be taken after PTU, methimazole, or radioactive iodine.

Incorrect Answers:
B. Lugol solution drops are taken 3 times a day.

C. Photosensitivity does not occur with Lugol solution.

D. PTU, methimazole, or radioactive iodine should not be taken after Lugol solution.

Vital Concept:
Lugol solution, a potassium iodide-iodine solution, inhibits synthesis and release of thyroid hormone in individuals with hyperthyroidism. It is prescribed for individuals with hyperthyroidism for ten days prior to thyroidectomy, to decrease serum levels of thyroid hormone and reduce the size and vascularity of the thyroid gland. It is also used in conjunction with other medications to treat thyroid storm.

 
References:
Ignatavicius DD, et al. (2017). Medical-surgical Nursing: Patient-centered Collaborative Care. Philadelphia, PA: WB Saunders Co.

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A. Tuberculosis

B. Cryptosporidiosis

C. Candidiasis

D. Pneumocystis carinii

post your answer in the comment section

Correct Answer: B. 

Cryptosporidiosis

AIDS (acquired immunodeficiency syndrome) occurs in the last stage of HIV (human immunodeficiency virus) infection. The CD4 T-cell that fights infection fall below 200/mm. Various opportunistic infections arise due to the insufficient number of T-cells and the overall immunocompromised status of the infected client. Opportunistic infections include tuberculosis, cryptosporidiosis, candidiasis, and pneumocystis carinii. Cryptosporidiosis is the major cause of wasting syndrome. It is caused by the Cryptosporidium parasite that thrives in the intestine. It absorbs nutrients causing weight loss and eventual wasting of body tissues. Typical symptoms of this opportunistic infection include nausea, vomiting, abdominal cramps, and diarrhea.

Incorrect Answers:

A, C, D. Tuberculosis, candidiasis, and pneumocystis carinii are less likely to be associated with diarrhea.

Vital Concept:

Cryptosporidium is a parasite that is associated with severe diarrhea with weight loss and malabsorption in immunocompromised clients. In clients with AIDS and cryptosporidium infection, antiretroviral therapy should be instituted. Loperamide is frequently used for control of diarrhea. Electrolyte losses should be replaced by either oral or intravenous routes in clients who experience significant volume loss associated with severe diarrhea. Cholera-like diarrhea seen with cryptosporidium can be life-threatening without aggressive replacement therapy. Total parenteral nutrition should be considered in clients with chronic disease associated with weight loss.

References:

Lemone PT, Burke KM, Bauldoff G, Gubrud P. Medical-Surgical Nursing: Clinical Reasoning in Patient Care, 6th Edition. Pearson 2014.

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1. Hypoglycemia.
2. Hyperpigmentation.
3. Weight loss.
4. Blood pressure increased.

1) INCORRECT – Hypoglycemia is a clinical manifestation of adrenal crisis. This symptom does not indicate that the client is responding positively to treatment.
2) INCORRECT – Hyperpigmentation is a clinical manifestation of adrenal crisis. This symptom does not indicates that the client is responding positively to treatment.
3) INCORRECT – Weight loss indicates a continuing loss of water and a continuing lack of hormones.
4) CORRECT – One sign of adrenal insufficiency is hypotension, so an increase in blood pressure would indicate that the condition is improving.

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