A nurse is caring for a client who has ingested a toxic agent.
Which of the following actions should the nurse plan to take?
Perform a mouth sweep.
Induce vomiting.
Instill activated charcoal.
Administer syrup of ipecac.
The Correct Answer is C
Choice A rationale
Performing a mouth sweep is not a recommended action for a client who has ingested a toxic agent. This procedure is typically used for unconscious individuals to clear the airway of solid objects and prevent aspiration. In the context of a toxic ingestion, a mouth sweep would be ineffective and potentially dangerous, as it could push the toxic substance further down the pharynx or cause injury. The primary focus for this type of emergency is to manage the ingested substance directly, not to clear the mouth of solid particles.
Choice B rationale
Inducing vomiting is no longer a recommended first-aid intervention for most poisonings. This practice can be harmful, as it risks aspiration of the toxic substance into the lungs, which could cause chemical pneumonitis or other severe respiratory damage. Furthermore, certain caustic or corrosive agents can cause more damage to the esophagus upon re-exposure during vomiting. Current guidelines from poison control centers and emergency medical services generally advise against inducing vomiting and instead recommend contacting a poison control center immediately for expert guidance.
Choice C rationale
Instilling activated charcoal is the most common and effective intervention for many types of toxic ingestions. Activated charcoal works by a process called adsorption, where the toxic substance binds to the surface of the charcoal particles, preventing its absorption into the bloodstream. This significantly reduces the systemic effects of the poison. It is typically administered orally or via a nasogastric tube within one hour of ingestion to maximize its binding capacity and effectiveness. The dosage and administration must be carefully considered based on the type of toxin and client's condition.
Choice D rationale
Administering syrup of ipecac is not a current recommended treatment for toxic ingestion. This substance, once used to induce vomiting, has been largely discontinued due to its limited effectiveness and potential for significant adverse effects, including lethargy and aspiration pneumonia. The risks associated with its use far outweigh any potential benefits, and its use is now considered contraindicated by most medical authorities. Its role has been replaced by more modern and safer methods of gastric decontamination, such as activated charcoal. *.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale
Clinical skills and expertise are fundamental to a nurse's professional competence and are essential for providing direct patient care. While they form the basis of a nurse's practice, they do not inherently encompass the broader political aspects of the profession, which involve navigating organizational and systemic dynamics beyond the bedside.
Choice B rationale
Collaboration and teamwork are crucial for effective patient care delivery within a healthcare team. While these skills are necessary for professional success, they are a component of interprofessional practice, not the core definition of politics in nursing, which involves understanding and influencing institutional power structures and policy.
Choice C rationale
Patient care and advocacy are core functions of the nursing profession. Advocacy is a political act, but patient care itself is the direct application of clinical knowledge. The broader concept of politics in nursing extends beyond individual patient advocacy to influencing policies that affect entire populations or the nursing profession as a whole.
Choice D rationale
Politics in nursing involves the strategic use of relationships and influence to impact decision-making at various levels, from the unit to the national stage. It encompasses advocating for policies, securing resources, and influencing power structures to improve patient outcomes, enhance professional practice, and shape healthcare systems. *.
Correct Answer is C
Explanation
Choice A rationale
Leading a protest demonstrates resistance rather than effective followership. Effective followership involves proactive and constructive engagement with leadership and peers to achieve common goals. This action would likely be counterproductive, creating conflict and hindering the successful implementation of the new protocol rather than facilitating it.
Choice B rationale
Privately implementing the protocol undermines the goal of collective understanding and consistent care. This action fails to address the team's need for guidance and can create discrepancies in patient care. Effective followership requires collaboration, not individualistic actions that bypass the need for a shared approach and understanding.
Choice C rationale
Sharing knowledge and collaborating with the team demonstrates effective followership. This approach involves taking initiative to support the group's success by providing clarity and working together to overcome obstacles. This action fosters a positive team environment, promotes mutual understanding, and ensures consistent and safe patient care across the unit.
Choice D rationale
Focusing only on individual tasks is a passive approach that does not demonstrate effective followership. A key aspect of effective followership is being a proactive contributor to the team's goals. This action would not help the team overcome its challenges, potentially leading to errors and a failure to properly implement the new protocol
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.