Nokea
A 46-year-old male has been placed under therapeutic hypothermic care after a myocardial infarction (MI). The nurse correctly explains to the family,
- A. Therapeutic hypothermia increases the production of neurotransmitters in the brain.'
- B. Therapeutic hypothermia will repair damaged cardiac tissue.'
- C. Therapeutic hypothermia will help protect the brain from injury by slowing metabolism.'
- D. Therapeutic hypothermia will slow the heart rate to reduce likelihood of another MI.'
Correct Answer: C
Rationale: Therapeutic hypothermia post-MI slows metabolism, reducing cerebral oxygen demand and protecting the brain from ischemic injury.
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Following insertion of a nasogastric (NG) tube, the nurse aspirates the gastric contents to check the pH to determine if the NG tube is correctly placed. Which of the following pH values is consistent with gastric secretions?
- A. 8
- B. 6
- C. 5
- D. 4
Correct Answer: D
Rationale: Gastric secretions typically have a pH of 1.5-3.5, so a pH of 4 (D) is consistent with correct NG tube placement in the stomach. Higher pH values (A, B, C) suggest placement in the intestines or respiratory tract.
A nurse is at a local swimming pool, and a man collapses with a cardiac arrest after exiting the pool. The man is still wet when the nurse begins cardiopulmonary resuscitation (CPR), and another person brings the automated external defibrillator (AED). Which of the following should the nurse do next?
- A. Apply the AED pads and deliver a shock.
- B. Wipe the chest dry with an available cloth or towel.
- C. Continue CPR because a client who is wet cannot receive a shock.
- D. Wipe the chest with an alcohol hand wipe to speed the evaporation of the water.
Correct Answer: B
Rationale: Wiping the chest dry (B) ensures AED pads adhere properly and deliver an effective shock. Applying pads on a wet chest (A) risks ineffective defibrillation, continuing CPR (C) delays defibrillation, and alcohol wipes (D) are inappropriate.
The priority nursing intervention for a client with sickle cell crisis is to
- A. administer pain medication.
- B. administer packed RBC.
- C. administer oxygen.
- D. administer IV fluids.
Correct Answer: D
Rationale: IV fluids are the priority in sickle cell crisis to reduce blood viscosity, promote perfusion, and prevent organ damage.
The nurse is providing dietary teaching for a client with elevated cholesterol levels. Which cooking oil is not suggested for the client on a low-cholesterol diet?
- A. Safflower oil
- B. Sunflower oil
- C. Coconut oil
- D. Canola oil
Correct Answer: C
Rationale: Coconut oil is high in saturated fats, which raise LDL cholesterol, making it unsuitable for a low-cholesterol diet.
The nurse is making a home visit to an elderly client during the summer. Upon arrival, the nurse notices the refrigerator and freezer doors are open as the client is using both for air conditioning. Which of the following actions by the nurse are most appropriate?
- A. instruct the client to place a fan in front of the freezer to enhance circulation of cool air
- B. hold a meeting with the client and family to advise them of the safety risks of this practice
- C. note this observation in the client's medical record, but do not discuss with the client
- D. report the incident to the nursing supervisor
Correct Answer: B
Rationale: Discussing the risks (e.g., food spoilage, electrical hazards) with the client and family promotes safety and education.