Nokea
A patient in the ICU develops acute respiratory distress syndrome (ARDS) with severe hypoxemia refractory to conventional oxygen therapy. What intervention should the healthcare team prioritize to improve the patient's oxygenation?
- A. Initiate prone positioning to optimize lung recruitment.
- B. Administer inhaled pulmonary vasodilators for vasodilation.
- C. Perform recruitment maneuvers to open collapsed alveoli.
- D. Recommend extracorporeal membrane oxygenation (ECMO) for respiratory support.
Correct Answer: D
Rationale: In the scenario described, the patient is experiencing severe hypoxemia refractory to conventional oxygen therapy, indicating a need for advanced respiratory support. When a patient with ARDS fails to respond to conservative management, including mechanical ventilation strategies, prone positioning, and recruitment maneuvers, the next step may involve extracorporeal membrane oxygenation (ECMO). ECMO provides a way to bypass the lungs and oxygenate the blood directly, allowing for enhanced gas exchange and support for severely compromised respiratory function. Therefore, in this critical situation, prioritizing the recommendation for ECMO can offer the patient the best chance of improving oxygenation and survival.
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Choose the step of nursing process that identiffies the famiilyy health seeking behavior.
- A. Assesment
- B. Planning
- C. Implementation
- D. Evaluation Situation
Correct Answer: A
Rationale: The step of the nursing process that identifies the family's health-seeking behavior is Assessment. During the assessment phase, the nurse gathers information about the family's health practices, beliefs, priorities, and past experiences related to seeking healthcare. This helps the nurse understand how the family approaches health and healthcare, which is crucial for providing tailored and effective care. By assessing the family's health-seeking behavior, the nurse can better collaborate with them to address their health needs and promote positive health outcomes.
A patient with a history of sickle cell disease presents with severe abdominal pain, fever, and jaundice. Laboratory tests reveal anemia, reticulocytosis, elevated indirect bilirubin, and presence of Howell-Jolly bodies on peripheral blood smear. Which of the following conditions is most likely to cause these findings?
- A. Acute splenic sequestration crisis
- B. Aplastic crisis
- C. Hemolytic crisis
- D. Vaso-occlusive crisis
Correct Answer: A
Rationale: Acute splenic sequestration crisis is a complication seen in patients with sickle cell disease characterized by the sudden pooling of sickled red blood cells in the spleen, leading to splenic enlargement, severe anemia, and hypovolemic shock. This pooling results in a rapid drop in hemoglobin levels, causing anemia. The spleen's sequestration of large numbers of red blood cells can cause a sudden rise in the number of immature red blood cells (reticulocytes) in the blood (reticulocytosis). The destruction of these trapped red blood cells in the spleen leads to hemolysis, evidenced by elevated indirect bilirubin levels and the presence of Howell-Jolly bodies (nuclear remnants of erythrocytes) on peripheral blood smear. Patients may present with severe abdominal pain, fever, jaundice, and signs of hemodynamic instability, which
A nurse is caring for a patient who is expressing concerns about their upcoming surgical procedure. What action demonstrates therapeutic communication by the nurse?
- A. Providing minimal responses to the patient's questions
- B. Offering reassurance and encouragement to the patient
- C. Ignoring the patient's concerns and focusing on tasks
- D. Interrupting the patient to redirect the conversation
Correct Answer: B
Rationale: Offering reassurance and encouragement to the patient demonstrates therapeutic communication by the nurse. In this situation, the nurse shows empathy and understanding towards the patient's concerns about the upcoming surgical procedure, which can help alleviate anxiety and build trust. Providing reassurance and encouragement can help the patient feel supported and understood, creating a positive and therapeutic interaction between the nurse and the patient. This approach fosters open communication and helps establish a therapeutic nurse-patient relationship, which is essential for effective patient care.
A nurse is communicating with attending physician about the Intervention prescribed for a patient-post-spine surge statement is INDICATIVE of a collaborative relationship?
- A. "Can we talk about Mrs. Santos?"
- B. " I am Worried about Mrs. Santos blood pressure. It is not decreasing even with the new antihypertensive medication"
- C. "That new medication you prescribed for Mrs.-Santos ineffective"
- D. "We do not need to talk about Mrs. Santos blood pressure."
Correct Answer: A
Rationale: Option A, "Can we talk about Mrs. Santos?" is indicative of a collaborative relationship between the nurse and the attending physician. It shows open communication and a willingness to discuss the patient's case together, which is essential for optimal patient care. This statement implies teamwork and a shared responsibility for the patient's well-being. The other options either lack a collaborative tone, show concern without inviting discussion, or suggest a dismissive attitude towards addressing the patient's needs.
A patient with asthma experiences nocturnal cough, wheezing, and chest tightness several times per week. Which of the following medications is most appropriate for long-term control of asthma symptoms and prevention of exacerbations?
- A. Fluticasone/salmeterol (Advair)
- B. Albuterol (salbutamol)
- C. Ipratropium bromide (Atrovent)
- D. Prednisone
Correct Answer: A
Rationale: Fluticasone/salmeterol (Advair) is a combination medication consisting of an inhaled corticosteroid (fluticasone) and a long-acting beta-agonist (salmeterol). This combination medication is recommended for long-term control of asthma symptoms and for the prevention of exacerbations. Fluticasone reduces airway inflammation, while salmeterol helps to relax the muscles of the airways, improving breathing. Using this combination medication regularly can help manage asthma symptoms and reduce the risk of asthma attacks. It is not appropriate to use short-acting beta-agonists like albuterol (salbutamol) on a long-term basis for asthma control. Ipratropium bromide (Atrovent) is an anticholinergic bronchodilator that is more commonly used for chronic obstructive pulmonary disease (COPD