This is a test that measures the oxygen saturation level in the blood, often used to assess respiratory function.
- A. Pulse oximetry
- B. Spirometry
- C. Arterial blood gas (ABG)
- D. Lung function test
Correct Answer: A
Rationale: The correct answer is A: Pulse oximetry. Pulse oximetry measures oxygen saturation levels in the blood by using a non-invasive method to determine the percentage of hemoglobin carrying oxygen. This test is commonly used to assess respiratory function quickly and efficiently.
Summary of incorrect options:
B: Spirometry measures lung function by assessing airflow and volume.
C: ABG measures oxygen and carbon dioxide levels in the blood.
D: Lung function test is a broad term that can include various tests, such as spirometry and imaging studies.
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What is a condition where the heart is unable to pump blood effectively, leading to a buildup of fluid in the lungs and other parts of the body?
- A. Heart failure
- B. Cardiomyopathy
- C. Myocardial infarction
- D. Pulmonary edema
Correct Answer: A
Rationale: Rationale for Correct Answer (A): Heart failure is the correct answer because it is a condition where the heart is unable to pump blood effectively, leading to fluid buildup in the lungs and other parts of the body. This occurs due to the heart's inability to adequately circulate blood, causing congestion and fluid retention. Symptoms include shortness of breath, fatigue, and swelling. Treatment aims to improve heart function and manage symptoms.
Summary of Incorrect Choices:
B (Cardiomyopathy): Cardiomyopathy is a disease of the heart muscle, which can lead to heart failure, but it is not the specific condition described in the question.
C (Myocardial infarction): Myocardial infarction, commonly known as a heart attack, results from a blockage in a coronary artery causing damage to the heart muscle, but it does not directly lead to fluid buildup in the lungs and body.
D (Pulmonary edema): Pulmonary edema is a condition characterized by fluid
During a home visit to an 88-year-old patient who is taking digoxin (Lanoxin) 0.25 mg daily to help control the rate of atrial fibrillation, you obtain this assessment information. Which assessment indicates that you need to notify the physician?
- A. The patient's apical pulse is 68 and very irregular.
- B. The patient takes the digoxin with meals.
- C. The patient's vision is becoming 'fuzzy'.
- D. The patient has lung crackles that clear after coughing.
Correct Answer: C
Rationale: Visual disturbances can indicate digoxin toxicity, necessitating physician notification.
The nurse determines that the treatment of heart failure has been successful when the patient experiences
- A. Weight loss and diuresis
- B. Warm skin and less fatigue
- C. Clear lung sounds and decreased heart rate
- D. Absence of chest pain and improved LOC
Correct Answer: C
Rationale: Successful treatment of heart failure is indicated by an absence of symptoms of pulmonary edema and hypoxemia, such as clear lung sounds and a normal heart rate.
In auscultating over a peripheral artery, what sound would suggest obstruction of the artery?
- A. Dullness
- B. Tympany
- C. Bruit
- D. Vibrations
Correct Answer: C
Rationale: A bruit is an abnormal sound heard over an artery due to turbulent blood flow, often indicating partial obstruction.
Discuss the strategies to prevent ventilator-associated pneumonia.
- A. Oral hygiene
- B. Elevation of head
- C. Both A and B
- D. None of the above
Correct Answer: C
Rationale: Prevention includes maintaining oral hygiene and elevating the head of the bed.