Nokea
Which of the following interventions is most appropriate for managing a patient with acute respiratory failure and hypercapnia due to chronic obstructive pulmonary disease (COPD) exacerbation?
- A. Administration of supplemental oxygen via non-rebreather mask
- B. Initiation of non-invasive positive pressure ventilation (NIPPV)
- C. Placement of an indwelling arterial catheter for continuous monitoring
- D. Titration of inhaled bronchodilators and corticosteroids
Correct Answer: B
Rationale: In a patient with acute respiratory failure and hypercapnia due to a COPD exacerbation, the most appropriate intervention is the initiation of non-invasive positive pressure ventilation (NIPPV). NIPPV helps improve ventilation and oxygenation by providing mechanical support to the patient's breathing without the need for endotracheal intubation. It can reduce the work of breathing, decrease carbon dioxide retention, and improve respiratory muscle function. This intervention is particularly beneficial for COPD exacerbations as it can help alleviate hypercapnia and hypoxemia, leading to improved outcomes and potentially reducing the need for invasive ventilation methods. Therefore, NIPPV is the recommended management strategy in this scenario.
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A client is admitted with acute gouty arthritis. Which medication does the nurse anticipate the health care provider may prescribe to prevent and treat an acute attack of gout?
- A. Ibuprofen (Motrin)
- B. Probenecid (Benemid)
- C. Colchicine (Colsalide)
- D. Hydrocortisone (Cortef)
Correct Answer: C
Rationale: Colchicine is a medication commonly prescribed to prevent and treat acute attacks of gout. It works by reducing inflammation caused by the buildup of uric acid crystals in the joints. Colchicine is effective in relieving pain and reducing swelling during gout attacks. It is important to follow the prescribed dosage due to potential side effects such as gastrointestinal upset. Ibuprofen is a nonsteroidal anti-inflammatory drug that can be used for pain relief but is not specific for gout treatment. Probenecid is used for chronic gout by helping the kidneys remove uric acid, not for acute gout attacks. Hydrocortisone is a steroid that may be used in some cases but is not a first-line treatment for acute gouty arthritis.
Dina is taking human Insulin injection for diabetes. Which of the following health instructions should you APPROPRIATELY emphasized in order to avoid hypoglycemia? Inject insulin into the _______.
- A. Anterior part of the leg muscle intramuscularly
- B. Gluteal region subcutaneously and rotate
- C. Abdominal wall subcutaneously and then rotate
- D. Deltoid muscle intramuscularly and rotate
Correct Answer: C
Rationale: The appropriate and recommended site for insulin injection to help avoid hypoglycemia is the abdominal wall subcutaneously. This site offers a consistent and reliable rate of absorption of insulin into the bloodstream. By injecting insulin into the abdominal wall subcutaneously, it allows for better control of blood sugar levels and reduces the risk of hypoglycemia. Additionally, it is important to rotate injection sites within the chosen area to prevent the development of lipohypertrophy (thickened, rubbery areas under the skin), which can affect insulin absorption.
A nurse is preparing to perform a bedside bronchoscopy procedure for a patient. What action should the nurse take to ensure patient safety during the procedure?
- A. Administering sedation to the patient before the bronchoscopy
- B. Obtaining informed consent from the patient or their legal representative
- C. Skipping the use of topical anesthesia to minimize patient discomfort
- D. Allowing the patient to eat or drink up to one hour before the procedure
Correct Answer: B
Rationale: The correct action for the nurse to ensure patient safety during a bedside bronchoscopy procedure is to obtain informed consent from the patient or their legal representative. Informed consent is a vital ethical and legal requirement before any medical procedure. It ensures that the patient understands the risks, benefits, and alternatives of the procedure, as well as gives the patient the authority to make decisions about their healthcare. By obtaining informed consent, the nurse ensures that the patient has been properly informed and agrees to undergo the bronchoscopy, which promotes patient autonomy and safety. Administering sedation, using topical anesthesia, and restricting food intake are also important aspects of bronchoscopy preparation, but obtaining informed consent is the primary action to prioritize patient safety.
A patient with a history of heart failure is prescribed spironolactone. Which electrolyte imbalance is the patient at risk for developing with spironolactone therapy?
- A. Hypernatremia
- B. Hyperkalemia
- C. Hypokalemia
- D. Hyponatremia
Correct Answer: B
Rationale: Spironolactone is a potassium-sparing diuretic commonly used in the management of heart failure. One of the significant side effects of spironolactone is hyperkalemia, which is an elevated level of potassium in the bloodstream. Spironolactone works by blocking the action of aldosterone, a hormone that regulates potassium and sodium balance in the body. By inhibiting aldosterone, spironolactone reduces potassium excretion in the urine, leading to potential accumulation of potassium in the body.
Which of the following definition MOST accurately describes meningomyelocele? It is _______.
- A. Spinal cord tumor containing nerve roots.
- B. Complete exposure of the spinal cord and meninges.
- C. Herniation of spinal cord, cerebro-spinal fluid and meninges into a sac.
- D. Sac formation containing meninges and spinal fluid.
Correct Answer: C
Rationale: Meningomyelocele is a type of neural tube defect where there is a protrusion of the spinal cord, cerebrospinal fluid, and meninges through a defect in the vertebrae, forming a sac on the surface of the back. This condition occurs during fetal development when the neural tube fails to close completely, leading to the exposure of the spinal cord and its coverings. This herniation can result in a range of neurological deficits and complications, requiring surgical repair shortly after birth to prevent further damage and infections.