Nokea
A 60 year old lady presents with a skin tear to her left shin on her coffee table. She is unsure of her previous immunization status. How should this be managed?
- A. ADT only
- B. ADT plus immunoglobulin
- C. Immunoglobulin only
- D. Neither
Correct Answer: A
Rationale: Skin tear, unknown shots ADT boosts, no Ig needed for clean cuts, antibiotics if dirty. Nurses jab this chronic tetanus shield solo.
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The emergency management of the patient with acute asthma does not include:
- A. Performing a rapid physical examination
- B. Performing spirometry or peak flow on arrival
- C. Giving oxygen and short acting bronchodilator
- D. Close monitoring to determine efficacy of treatment and improvement or deterioration
Correct Answer: B
Rationale: Acute asthma's rush exam, O2, bronchodilators, tight watch saves breath fast. Spirometry's a no too tough mid-wheeze, delays care. Nurses skip it, a chronic flare's urgent dodge.
The nurse is arriving at the beginning of her shift and has taken report on four clients on a medical surgical unit. Which client should the nurse see first?
- A. A Client with pyelonephritis with nausea and vomiting
- B. A client with chronic obstructive pulmonary disease with an oxygen saturation of $90 \%$ on room air
- C. A client post vaginoplasty with bright red blood and clots in her catheter
- D. A client post-total abdominal hysterectomy with 9/10 pain
Correct Answer: C
Rationale: Bright red blood and clots post-vaginoplasty scream hemorrhage ABCs prioritize circulation, needing instant check for shock or transfusion. Pyelonephritis nags, COPD's stable at 90\%, pain's urgent but not bleeding. Nurses hit bleeding first, a life-line call in this post-op rush.
The nurse knows which of the following is the most common problem for a client with valvular heart disease?
- A. Altered body image
- B. Difficulty coping
- C. Bradycardia
- D. Decreased cardiac output
Correct Answer: D
Rationale: Valvular disease stenosis or regurgitation slashes flow; decreased cardiac output reigns as pump falters, driving fatigue and dyspnea, the top issue. Body image or coping lag; bradycardia's rare. Nurses peg output drop, targeting meds or surgery, a core fight in this valve-wrecked heart.
You are caring for a patient who has just been told that her stage IV colon cancer has recurred and metastasized to the liver. The oncologist offers the patient the option of surgery to treat the progression of this disease. What type of surgery does the oncologist offer?
- A. Palliative
- B. Reconstructive
- C. Salvage
- D. Prophylactic
Correct Answer: A
Rationale: Stage IV colon cancer with liver mets is endgame surgery here's palliative, easing pain, obstruction, or bleeding, not curing. Reconstructive fixes form post-cure, irrelevant now. Salvage hits recurrence after lighter tries, not this late stage. Prophylactic's preemptive, not reactive. Palliative's about comfort, aligning with oncology's shift to quality of life when cure's off the table, a tough but real talk nurses navigate.
A nurse is caring for a client who presented to the emergency department with complaints of fatigue, palpitations, and chest pains. Upon assessment, the provider notes an S3 and S4 gallop, weak peripheral pulses, and tachycardia. The provider orders a chest x-ray and echocardiogram, which reveals left ventricular dilation. Which of the following disorder is consistent with these findings?
- A. Cardiac tamponade
- B. Dilated cardiomyopathy
- C. Pericarditis
- D. Restrictive cardiomyopathy
Correct Answer: B
Rationale: Left ventricular dilation with S3, S4, weak pulses, and tachycardia paints dilated cardiomyopathy heart muscle stretches, weakening pump, causing fatigue and palpitations. Tamponade compresses, not dilates. Pericarditis inflames without dilation. Restrictive stiffens, resisting stretch. Nurses tie this to DCM's systolic flop, anticipating meds like ACE inhibitors, a fit for this stretched-out heart.