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The nurse is caring for a patient who requires administration of a neuromuscular blocking (NMB) agent to facilitate ventilation with non-traditional m odes. The nurse understands that neuromuscular blocking agents provide what outcome?
- A. Lessened antianxiety
- B. Complete analgesia.
- C. High levels of sedation.
- D. No sedation or analgesia.
Correct Answer: D
Rationale: The correct answer is D: No sedation or analgesia. Neuromuscular blocking agents do not provide sedation or pain relief; they solely act on skeletal muscles to induce paralysis for procedures like intubation. Choice A is incorrect because NMB agents do not affect anxiety levels. Choice B is incorrect because NMB agents do not provide analgesia. Choice C is incorrect because NMB agents do not induce sedation. The primary purpose of NMB agents is to induce muscle paralysis without affecting consciousness or pain perception.
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A 28-year-old patient who has deep human bite wounds on the left hand is being treated in the urgent care center. Which action will the nurse plan to take?
- A. Prepare to administer rabies immune globulin (BayRab).
- B. Assist the health care provider with suturing the bite wounds.
- C. Teach the patient the reason for the use of prophylactic antibiotics.
- D. Keep the wounds dry until the health care provider can assess them.
Correct Answer: C
Rationale: The correct answer is C: Teach the patient the reason for the use of prophylactic antibiotics. This is the most important action because human bites can introduce harmful bacteria into the wound, leading to infection. Prophylactic antibiotics help prevent infection in deep human bite wounds.
Choice A is incorrect because rabies immune globulin is not indicated for human bite wounds. Choice B is incorrect because suturing human bite wounds can trap bacteria and increase the risk of infection. Choice D is incorrect because keeping the wounds dry is not sufficient; proper wound cleaning and antibiotic treatment are essential in this case.
A mode of pressure-targeted ventilation that provides posiatbivirbe. cporme/tsessut re to decrease the workload of spontaneous breathing through what action by the endotracheal tube?
- A. Continuous positive airway pressure
- B. Positive end-expiratory pressure
- C. Pressure support ventilation
- D. T-piece adapter
Correct Answer: C
Rationale: The correct answer is C: Pressure support ventilation. This mode delivers a set pressure to support each spontaneous breath, decreasing the workload of breathing. Pressure support ventilation assists the patient's inspiratory efforts without providing a set tidal volume like in volume-targeted ventilation. Continuous positive airway pressure (Choice A) maintains a constant level of positive pressure throughout the respiratory cycle but does not actively support spontaneous breathing efforts. Positive end-expiratory pressure (Choice B) maintains positive pressure at the end of expiration to prevent alveolar collapse but does not directly support spontaneous breathing. T-piece adapter (Choice D) is a weaning device that allows the patient to breathe spontaneously without ventilatory support.
Noninvasive diagnostic procedures used to determine kidney function include which of the following? (Select all that apply.)
- A. Kidney, ureter, bladder (KUB) x-ray
- B. Renal ultrasound
- C. Magnetic resonance imaging (MRI)
- D. Intravenous pyelography (IVP)
Correct Answer: A
Rationale: The correct answer is A: Kidney, ureter, bladder (KUB) x-ray. This procedure is noninvasive and commonly used to assess kidney function by visualizing the size, shape, and position of the kidneys. Renal ultrasound is also noninvasive and can provide detailed images of the kidneys. However, MRI and IVP are more invasive procedures that involve the use of contrast agents and are not typically used solely for diagnostic purposes to assess kidney function. Overall, KUB x-ray and renal ultrasound are the preferred noninvasive options for evaluating kidney function.
The nurse is caring for a 100-kg patient being monitored with a pulmonary artery catheter. The nurse assesses a blood pressure of 90/60 mm Hg, hear t rate 110 beats/min, respirations 36/min, oxygen saturation of 89% on 3 L of oxygen via nasal cannula. Bilateral crackles are audible upon auscultation. Which hemodynamic value reqaubiirrbe.sco imm/temste diate action by the nurse?
- A. Cardiac index (CI) of 1.2 L/min/m3
- B. Cardiac output (CO) of 4 L/min
- C. Pulmonary vascular resistance (PVR) of 80 dynes/sec/cm5
- D. Systemic vascular resistance (SVR) of 1800 dynes/sec /cm5
Correct Answer: B
Rationale: The correct answer is B: Cardiac output (CO) of 4 L/min. In this scenario, the patient is presenting with signs of pulmonary congestion and hypoxemia, indicating possible cardiogenic pulmonary edema. As the cardiac output is a key indicator of how well the heart is functioning and delivering blood to the body, a low cardiac output can lead to inadequate tissue perfusion and worsen the patient's condition. Therefore, immediate action is required to address the low cardiac output to improve tissue perfusion and oxygenation.
Choices A, C, and D are incorrect as they do not directly address the primary concern of inadequate cardiac output in this patient. Cardiac index, pulmonary vascular resistance, and systemic vascular resistance are important parameters to monitor, but in this case, the priority is to address the low cardiac output to improve the patient's condition.
When assisting with the placement of a pulmonary artery (PA) catheter, the nurse notes that the catheter is correctly placed when the monitor shows a:
- A. Typical PA pressure waveform.
- B. Tracing of the systemic arterial pressure.
- C. Tracing of the systemic vascular resistance.
- D. Typical PA wedge pressure (PAWP) tracing.
Correct Answer: D
Rationale: Step-by-step rationale for Answer D being correct:
1. PA catheter measures PA pressures.
2. PAWP reflects left atrial pressure.
3. Correct placement shows typical PAWP tracing.
4. PA pressure waveform (A) is not specific to PAWP.
5. Systemic arterial pressure tracing (B) is unrelated.
6. Systemic vascular resistance tracing (C) is not monitored by PA catheter.