A patient with a history of injection drug use has been diagnosed with chronic hepatitis C. When collaborating with the care team to plan this patient's treatment, the nurse should anticipate what intervention?
Rest and watchful waiting.
Administration of immune globulins.
A regimen of antiviral medications.
Administration of fresh-frozen plasma (FFP).
The Correct Answer is C
Choice A rationale
Rest and watchful waiting are typically management strategies used for acute hepatitis A or sometimes acute hepatitis B, but they are not the standard of care for chronic hepatitis C. Chronic hepatitis C is a progressive viral infection that leads to liver fibrosis, cirrhosis, and hepatocellular carcinoma if left untreated. Because the virus continuously replicates and causes ongoing inflammatory damage to the hepatocytes, a passive approach is scientifically inadequate to prevent long term liver failure and mortality.
Choice B rationale
Immune globulins provide passive immunity and are used for post-exposure prophylaxis in hepatitis A or hepatitis B to prevent the development of an active infection. However, immune globulin has no proven efficacy in treating a well-established chronic hepatitis C infection. The hepatitis C virus has high genetic variability and undergoes rapid mutation, making it an ineffective target for standard immune globulin preparations. Treatment requires direct action against the viral replication cycle rather than a temporary immune boost.
Choice C rationale
Antiviral medications, specifically direct-acting antivirals, are the definitive treatment for chronic hepatitis C. These drugs work by targeting specific nonstructural proteins of the virus, such as NS3/4A, NS5A, or NS5B, which are essential for viral RNA replication and assembly. Modern regimens can achieve a sustained virologic response, which is effectively a cure, in over 95 percent of patients. Clearing the virus stops the progression of liver inflammation and allows the hepatic tissue to begin healing.
Choice D rationale
Fresh-frozen plasma is a blood product used to replace clotting factors in patients with severe coagulopathy or active bleeding, often seen in end-stage liver disease. While a patient with chronic hepatitis C might eventually need fresh-frozen plasma if they develop advanced cirrhosis and liver failure, it is not a treatment for the hepatitis C virus itself. It only manages the symptomatic complications of liver dysfunction rather than addressing the underlying viral etiology responsible for the hepatic damage.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale
Urgent triage is reserved for stable patients who require intervention within a few hours but are not currently in a life-threatening or limb-threatening state. This gardener has signs of neurovascular compromise, including absent capillary refill, pallor, and loss of sensation and motor function distal to the injury. These findings, combined with signs of early shock like tachycardia and hypotension, indicate a severity that far exceeds the urgent category in standard emergency triage systems.
Choice B rationale
None of the above is incorrect because the patient's clinical presentation clearly fits the established criteria for the highest level of triage priority. In the Emergency Severity Index or similar systems, a patient with active arterial bleeding, unstable vital signs, and evidence of limb ischemia is a textbook case for immediate care. Choosing this option would ignore the standardized medical protocols used to ensure that the most critically ill patients receive the fastest medical attention.
Choice C rationale
Non-urgent triage is appropriate for patients with minor injuries or illnesses that can wait several hours for treatment without risk of deterioration. Examples include minor abrasions or cold symptoms. This patient has a deep chainsaw laceration with active bleeding and abnormal vital signs, including a blood pressure of 96/60 and a heart rate of 110. Categorizing this injury as non-urgent would be a critical failure in assessment that would likely lead to permanent limb loss or death.
Choice D rationale
Emergent triage is necessary for conditions that are life-threatening or pose an immediate threat to a limb. The patient exhibits signs of hypovolemic shock, including a low blood pressure of 96/60, tachycardia of 110, and diaphoresis. Furthermore, the lack of capillary refill and sensation in the hand suggests a surgical emergency. Normal capillary refill is less than 2 seconds, and its absence here signifies a lack of perfusion that requires immediate surgical and hemodynamic stabilization. .
Correct Answer is A
Explanation
Choice A rationale
The patient is currently hemodynamically stable with a blood pressure of 102/68, which is within an acceptable range for an adult. A racing heart and nervousness can stem from numerous non-cardiac causes such as caffeine intake, anxiety, electrolyte imbalances, or fever. Obtaining further information allows the nurse to identify potential triggers or underlying conditions before initiating invasive or pharmacological interventions that could potentially harm the patient if the cause is benign.
Choice B rationale
Administering a beta-blocker is a significant pharmacological intervention used to decrease the heart rate and myocardial oxygen demand. However, medications should not be administered until the underlying rhythm is clearly identified and the cause of the tachycardia is understood. Giving a beta-blocker to a patient who might have a compensatory tachycardia due to an underlying issue like dehydration or pulmonary embolism could lead to severe hypotension or clinical deterioration in the emergency department.
Choice C rationale
Electrical cardioversion is a highly invasive procedure reserved for patients who are hemodynamically unstable, showing signs of poor perfusion, or experiencing life-threatening tachyarrhythmias. Since this patient has a stable blood pressure of 102/68 and is only reporting nervousness and a racing heart, cardioversion is not indicated as the next step. Performing this procedure unnecessarily exposes the patient to risks associated with sedation and electrical discharge without a clear clinical justification based on stability.
Choice D rationale
The Valsalva maneuver is a vagal maneuver used specifically to terminate supraventricular tachycardia by increasing intrathoracic pressure and stimulating the vagus nerve. While it is a non-invasive option, the nurse must first determine the exact heart rhythm from the ECG tracing before attempting any maneuver to alter it. Performing a Valsalva maneuver on a rhythm that is not a vagal-responsive supraventricular tachycardia would be inappropriate and potentially delay the correct diagnostic workup.
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