Nokea
A nurse is preparing to assist with a cardiopulmonary resuscitation (CPR) procedure for a patient in cardiac arrest. What action should the nurse prioritize during the initial assessment?
- A. Administering oxygen via nasal cannula at 2 liters per minute
- B. Checking for responsiveness and calling for help immediately
- C. Placing the patient in the recovery position to facilitate breathing
- D. Assessing the patient's airway, breathing, and circulation (ABCs)
Correct Answer: D
Rationale: The correct action to prioritize during the initial assessment when preparing to assist with a cardiopulmonary resuscitation (CPR) procedure for a patient in cardiac arrest is to assess the patient's airway, breathing, and circulation (ABCs). This involves quickly checking the patient's airway for any obstructions, assessing their breathing for signs of breathing difficulties or absence of breathing, and evaluating their circulation by checking for a pulse. This step is crucial in determining the need for immediate intervention, such as clearing the airway, providing rescue breaths, or initiating chest compressions. By prioritizing the assessment of the ABCs, the nurse can promptly identify and address life-threatening issues to improve the patient's chances of survival during a cardiac arrest situation.
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There are pre operative medications given to the patient. Which of the following druugs are given in order to decrease intra-operative anesthetic requirements and pain?
- A. Celebrex (celecoxib)
- B. Acetaminaphen (tylenol)
- C. Ibuprofen (motrin)
- D. Demerol (meperidine HCl)
Correct Answer: B
Rationale: Acetaminophen (Tylenol) is given pre-operatively to decrease intra-operative anesthetic requirements and post-operative pain. It is a common analgesic that can help reduce the amount of intra-operative anesthesia needed and provide some pain relief during the surgery. Unlike drugs like Celebrex, Ibuprofen, and Demerol, Acetaminophen does not have anti-inflammatory properties, but it is effective in managing pain and can contribute to overall pain control before, during, and after surgery. This makes it a preferred choice for pre-operative medication in order to decrease the need for higher doses of anesthetics and reduce post-operative pain levels.
A patient presents with chest pain at rest, unrelated to exertion, and not relieved by nitroglycerin. An electrocardiogram (ECG) shows ST-segment depression. Which cardiovascular disorder is most likely responsible for these symptoms?
- A. Stable angina
- B. Unstable angina
- C. Acute myocardial infarction
- D. Prinzmetal's angina
Correct Answer: B
Rationale: Unstable angina is characterized by chest pain at rest, which is not relieved by nitroglycerin. The ECG findings in unstable angina typically show ST-segment depression or T-wave inversion. It is considered a medical emergency as it can progress to a myocardial infarction. Stable angina, on the other hand, is chest pain or discomfort that occurs with exertion and is relieved by rest or medications like nitroglycerin. Acute myocardial infarction would typically present with ST-segment elevation on ECG, while Prinzmetal's angina is characterized by transient ST-segment elevation due to coronary artery vasospasm.
A woman in active labor requests pain relief. Which pharmacological option is safe and effective for pain management during labor?
- A. Ibuprofen
- B. Nitrous oxide
- C. Morphine
- D. Diazepam
Correct Answer: B
Rationale: Nitrous oxide, also known as "laughing gas," is a safe and effective pharmacological option for pain management during labor. Nitrous oxide is commonly used in labor and delivery settings as it has minimal effects on the baby and allows the woman to remain in control of her pain management. It provides quick pain relief when inhaled and can be adjusted to the woman's needs during labor. Ibuprofen, morphine, and diazepam are not typically used for pain management during labor due to their potential risks and side effects, especially for the baby.
A patient receiving palliative care for end-stage liver disease develops hepatic encephalopathy, presenting with confusion and altered mental status. What intervention should the palliative nurse prioritize to manage the patient's symptoms?
- A. Administer lactulose or other ammonia-lowering agents to reduce ammonia levels.
- B. Initiate intravenous fluid therapy to correct electrolyte imbalances.
- C. Refer the patient to a neurologist for evaluation and treatment of encephalopathy.
- D. Prescribe sedative medications to promote sleep and reduce agitation.
Correct Answer: A
Rationale: The most appropriate intervention for managing hepatic encephalopathy in this patient receiving palliative care for end-stage liver disease is to administer lactulose or other ammonia-lowering agents to reduce ammonia levels. Hepatic encephalopathy is believed to be primarily caused by the accumulation of ammonia in the bloodstream due to compromised liver function. Lactulose works by acidifying the gut lumen, which facilitates the excretion of ammonia in the form of ammonium ions. By reducing ammonia levels, hepatic encephalopathy symptoms, such as confusion and altered mental status, can be improved. Initiating other supportive measures like managing precipitating factors, maintaining hydration, and addressing nutritional issues should also be part of the holistic approach in managing hepatic encephalopathy in palliative care. However, addressing the underlying cause by reducing ammonia levels with lactulose is the priority intervention in this scenario.
Ella states'I will hang my self' this is a manifestation of:
- A. Denial
- B. Suicidal intent
- C. Suicidal threat
- D. Paranoia.
Correct Answer: B
Rationale: Ella's statement "I will hang myself" directly indicates a desire and intent to commit suicide. This is classified as a suicidal intent, which is a serious concern that requires immediate attention and intervention. It is crucial to take any mention or indication of suicide seriously and seek help from mental health professionals or crisis intervention services.