Nokea
A 65-year-old male client is brought via EMS to the emergency department with chest pain. He rates the pain as a 10 on a scale from 0-10; the pain is located mid-sternum and radiates to his left arm. His heart rate is 126 beats/minute and blood pressure are 96/60 mm Hg. A 12-lead electrocardiogram is performed and reveals ST-segment elevation. Which of the following interventions does the nurse anticipate performing immediately?
- A. Administer oxygen
- B. Administer morphine
- C. Administer a statin
- D. Administer nitroglycerin
Correct Answer: A
Rationale: ST-elevation MI (STEMI) signals acute coronary occlusion severe chest pain, tachycardia, and hypotension demand oxygen first to counter hypoxia, per ABCs, buying time for reperfusion. Morphine eases pain, nitroglycerin dilates (if BP allows), but oxygen's immediate. Statins aid long-term, not now. Nurses prioritize oxygen, anticipating cath lab prep, a critical step in this time-sensitive infarct emergency.
You may also like to solve these questions
Your junior trainee has been in theatre for 5 h with a patient undergoing a femorodistal bypass procedure. He is yawning and seems withdrawn. The trainee's fatigue is likely to be improved by:
- A. Imbibing one 60 ml shot of espresso coffee.
- B. Taking a 1-h nap.
- C. Increasing the brightness of the theatre lighting.
- D. Walking around and chatting to other members of staff.
Correct Answer: B
Rationale: Fatigue during long procedures impairs performance. A 60 ml espresso shot (50-100 mg caffeine) boosts alertness temporarily (20-30 minutes onset), but its effect wanes after 5 hours of sustained effort. A 1-hour nap restores cognitive function and vigilance significantly, countering sleep pressure per sleep research (e.g., NASA nap studies), with benefits lasting hours. Bright lighting enhances alertness via circadian stimulation but is less effective mid-fatigue. Walking and chatting provide a break, mildly boosting arousal, but lack restorative depth. Microsleeps signal severe fatigue, worsening performance. A nap's superiority lies in addressing accumulated sleep debt, critical in high-stakes settings like surgery, offering sustained recovery over stimulants or environmental tweaks.
The movement patterns of 80 students who participated in a training programme have been measured. One of the measurement variables is the number of hours the student plays sports per week. This variable is measured both after and before the training programme. Subsequently, the average number of hours the student played sports before the training programme is compared with the number of hours the student plays sports after the training programme. Question: Which test is suitable to compare these two average values?
- A. Chi-square test
- B. Fisher's exact test
- C. Two-sample t-test
- D. Paired t-test
Correct Answer: D
Rationale: Same kids, before-after sports hours paired t-test ties each shift, not chi-square's counts, Fisher's tables, or two-sample splits. Nurses stat this, a chronic match check.
During general anaesthesia for orthognathic surgery:
- A. A head-down supine position is popular to minimize the risk of airway soiling.
- B. Lidocaine with adrenaline 1:80000 is used for infiltration.
- C. Non-steroidal anti-inflammatory drugs (NSAIDs) are avoided even after haemostasis is achieved.
- D. Blocks of both mandibular and maxillary nerves are possible and useful.
Correct Answer: D
Rationale: Anaesthesia for orthognathic surgery balances airway and bleeding risks. Head-up positioning, not head-down, reduces venous congestion and airway soiling from blood head-down risks aspiration. Lidocaine with adrenaline (typically 1:80,000-1:200,000) minimizes bleeding via vasoconstriction, a standard infiltration. NSAIDs are used post-haemostasis for analgesia, not universally avoided, unless bleeding risk persists. Mandibular and maxillary nerve blocks (e.g., V2, V3) reduce opioid needs and enhance pain control, leveraging regional anaesthesia's precision in jaw surgery. Propofol TIVA may improve recovery versus volatiles, per studies, but isn't definitive. Nerve blocks' utility optimizes perioperative pain management, critical in extensive osteotomies.
The nurse is caring for a patient with an advanced stage of breast cancer and the patient has recently learned that her cancer has metastasized. The nurse enters the room and finds the patient struggling to breathe and the nurse's rapid assessment reveals that the patient's jugular veins are distended. The nurse should suspect the development of what oncologic emergency?
- A. Increased intracranial pressure
- B. Superior vena cava syndrome (SVCS)
- C. Spinal cord compression
- D. Metastatic tumor of the neck
Correct Answer: B
Rationale: Dyspnea plus distended jugulars scream SVCS breast cancer's mets can squeeze the vena cava, blocking venous return from the head and chest. It's an oncology emergency, fast-tracking to edema and airway issues if unchecked. Intracranial pressure needs brain involvement less likely here. Spinal compression hits legs and bladder, not breathing. Neck tumors might press locally, but SVCS fits this picture. Nurses jump on this, pushing for steroids or stenting, knowing seconds count.
What is an independent risk factor for the development of type 2 diabetes mellitus?
- A. Age
- B. Waist circumference
- C. Smoking
- D. All three options above
Correct Answer: D
Rationale: Type 2 diabetes brews from age cells tire; waist fat resists insulin; smoking inflammation tweaks glucose. All hit independently, stacking odds, a chronic trio nurses flag in every patient check, not just one picking off the list.