The post-anesthesia care unit nurse receives a patient from the operating room. Which assessment will the nurse perform first?

Check intravenous lines for patency or redness.

Check nasogastric tube and presence of bowel sounds.

Check airway, lung sounds, and pulse oximetry.

Check Foley catheter and surgical fluid intake.

Answer and Explanation

The Correct Answer is C

Choice A rationale:

While checking intravenous lines for patency and redness is important, it's not the most immediate priority in the post- anesthesia care unit (PACU). Ensuring airway patency and adequate oxygenation takes precedence over IV assessment. Issues with IV lines can usually be addressed quickly if they arise, whereas compromised airway or breathing can rapidly lead to life- threatening complications.

Choice B rationale:

Assessment of nasogastric tubes and bowel sounds is also important, but it's not as urgent as checking the airway and breathing. Bowel sounds may be absent immediately after surgery due to anesthesia and bowel manipulation, and their presence or absence doesn't necessarily indicate an immediate problem. Similarly, nasogastric tubes can be checked and adjusted as needed after ensuring the patient's airway and breathing are stable.

Choice D rationale:

Checking the Foley catheter and surgical fluid intake is essential for monitoring fluid balance and renal function, but it's not a priority over assessing airway, breathing, and circulation (ABCs). Fluid status can be assessed and managed after ensuring the patient's respiratory and circulatory systems are functioning adequately.

Choice C rationale:

Checking the airway, lung sounds, and pulse oximetry is the most critical assessment in the PACU because it ensures that the patient is breathing effectively and has adequate oxygen saturation. This assessment addresses the primary ABCs of patient care:

Airway: The nurse will assess for any obstructions or potential for obstruction, such as swelling, secretions, or the tongue blocking the airway. They will also ensure proper positioning of the head and neck to maintain airway patency.

Breathing: The nurse will listen to lung sounds to evaluate air entry and identify any signs of respiratory distress, such as wheezing, crackles, or decreased breath sounds. They will also monitor respiratory rate and effort.

Circulation: Pulse oximetry measures oxygen saturation in the blood, providing a quick and non-invasive assessment of oxygenation status. It's essential to ensure adequate oxygen delivery to tissues and organs.

By prioritizing the assessment of airway, lung sounds, and pulse oximetry, the nurse can quickly identify and intervene in any respiratory or oxygenation issues, preventing potentially life-threatening complications.

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Correct Answer is A

Explanation

Choice A rationale:

Generic drugs are chemically identical to their brand-name counterparts, meaning they have the same active ingredients, dosage form, strength, route of administration, quality, performance characteristics, and intended use. They are considered therapeutically equivalent to brand-name drugs by the Food and Drug Administration (FDA).

Here are the key reasons why a patient would likely receive a generic version if the insurance company declines to cover the brand-name drug:

Cost: Generic drugs are significantly less expensive than brand-name drugs. This is because generic drug manufacturers do not have to repeat the extensive research and development costs associated with the original brand-name drug. They can enter the market after the brand-name drug's patent expires, leading to substantial cost savings.

Insurance Coverage: Insurance companies often have preferred drug lists (formularies) that prioritize generic drugs due to their cost-effectiveness. If a brand-name drug is not on the formulary or requires a high co-pay, the insurance company may encourage or even require the use of a generic alternative to manage costs.

Availability: Generic drugs are often widely available in pharmacies, making them readily accessible to patients. This availability further contributes to their cost-effectiveness and convenience.

I'm unable to provide lengthy rationales for the other choices as they are not relevant to the correct answer.

A. Metformin 0.5 g PO B. Methotrexate 15.0 mg PO C. Meropenem 1.0 g IV D. None of the above

Correct Answer is C

Explanation

Choice A rationale:

Incorrect dosage form: Metformin is typically administered orally as a tablet or liquid suspension, not as a powder for reconstitution (PO).

Missing route of administration: The medication order does not specify the route of administration, such as oral (PO), intravenous (IV), or intramuscular (IM).

Potential for medication errors: The lack of clarity in the medication order could lead to errors in administration, such as giving the wrong dose or administering the medication by the wrong route.

Choice B rationale:

Incorrect dosage unit: Methotrexate is typically administered in milligrams (mg), not grams (g).

Potential for overdose: The order for 15.0 g of methotrexate is a very high dose that could lead to serious adverse effects, including toxicity and death.

Choice C rationale:

Correctly written: The medication order specifies the drug name (meropenem), the dose (1.0 g), the dosage form (IV), and the route of administration (IV).

Appropriate dosage range: The dose of 1.0 g of meropenem is within the typical dosage range for this antibiotic.

Clear and concise: The medication order is clear, concise, and easy to understand, which helps to reduce the risk of medication errors.

Choice D rationale:

Incorrect: While choices A and B are both incorrect, choice C is a correctly written medication order.

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The post-anesthesia care unit nurse receives a patient from the operating room. Which assessment will the nurse perform first?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

If a patient’s insurance company declines to cover the cost of a brand-name drug, which version of the drug will the patient likely receive instead?

Correct Answer is A

Explanation

Which medication order is written appropriately?

Correct Answer is C

Explanation

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