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CNCC - Canadian Critical Care (CNCC) Practice Tests & Test Prep by Exam Edge - Topics


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Canadian Critical Care Nursing Examination - Exam Topics Sample Questions

You are conducting an assessment with a patient who has presented with diarrhea, fever, abdominal pain, and a temperature of 101 F. She says that she has been taking antibiotics for a urinary tract infection for the past week. Her symptoms started several days after she begin the antibiotics. Which of the following conditions does this patient's symptoms indicate?





Correct Answer:
c.difficile


the patient's symptoms of diarrhea, fever, abdominal pain, and elevated temperature, coupled with her recent antibiotic use for a urinary tract infection, suggest the possibility of a clostridium difficile (c. difficile) infection. c. difficile is a bacterium that can cause inflammation of the colon (colitis). although it is present in a small proportion of the general population without causing problems, it can become an issue when the normal gut flora is disrupted, which commonly occurs during antibiotic treatment.

antibiotics, while effective against the bacteria causing the initial infection, can also harm beneficial bacteria that typically reside in the gut. this disruption in the balance of gut flora provides an opportunity for c. difficile to overgrow and produce toxins, leading to symptoms such as diarrhea, abdominal pain, and fever.

the diagnosis of c. difficile infection is typically confirmed through stool tests that detect the presence of the toxins produced by the bacteria. it is important to recognize and treat this condition promptly because it can lead to more severe complications, including severe dehydration, colitis, and even life-threatening inflammation of the colon.

treatment for c. difficile often involves discontinuing the inciting antibiotic, if possible, and commencing a course of antibiotics specifically effective against c. difficile, such as metronidazole or vancomycin. in some cases, probiotics may be recommended to help restore the normal gut flora. supportive care, including hydration and electrolyte replacement, is also crucial to manage symptoms and prevent complications.

given the patient's history and symptoms, it is prudent to consider a c. difficile infection in the differential diagnosis and proceed with appropriate investigations and management. this approach will help ensure the best possible outcome for the patient and minimize the risk of complications.

While caring for a patient with an open wound on her leg, Nurse Jackie notes a moderate amount of drainage from the wound and the bandage. What would be the appropriate action to take?





Correct Answer:
change the dressing and document the action.


when nurse jackie observes a moderate amount of drainage from a patient's leg wound and its bandage, it is crucial to assess the situation promptly and accurately. the presence of drainage can be normal to some extent as it is part of the body’s natural healing process. however, moderate to heavy drainage could indicate potential complications, such as infection or delayed healing. therefore, it is essential for nurse jackie to take appropriate measures.

the first step nurse jackie should take is to change the dressing. this action serves multiple purposes: it helps maintain a clean environment around the wound, minimizes the risk of infection, and allows for a direct assessment of the wound's current condition. by changing the dressing, nurse jackie can inspect the wound for signs of infection like increased redness, swelling, warmth, or an unpleasant odor. it also gives her the opportunity to evaluate the amount and type of drainage, which are critical factors in monitoring the healing process.

after changing the dressing, it is imperative that nurse jackie documents the action taken and her findings. documentation should include details about the appearance of the wound, the type and amount of drainage noted, the condition of the old dressing, and the time and date when the dressing was changed. this record is vital for continuity of care, as it informs other healthcare providers about the wound’s progress and any interventions made. proper documentation ensures that subsequent caregivers will be aware of the patient's current status and can continue to provide appropriate care.

other options, such as leaving the dressing in place, making notes for another nurse to change the dressing later, or removing the dressing and leaving the wound open, are not advisable. leaving the dressing unchanged could lead to increased risk of infection and complicate the wound's healing process. delaying the change of dressing by passing the responsibility to another nurse could result in miscommunication or oversight, jeopardizing patient care. removing the dressing and leaving the wound open exposes the wound to environmental contaminants, increasing the risk of infection and further complications.

in conclusion, the correct and professional action for nurse jackie is to change the dressing immediately upon noticing moderate drainage and to document the intervention and her observations. this approach ensures high standards of care, supports effective healing, and maintains thorough communication within the healthcare team.