Nokea
A nurse reviewed the arterial blood gas reading of a 25 year-old male. The nurse should be able to conclude the patient is experiencing which of the following conditions?
- A. metabolic acidosis
- B. respiratory acidosis
- C. metabolic alkalosis
- D. respiratory alkalosis
Correct Answer: D
Rationale: Respiratory alkalosis is indicated by elevated pH and low carbon dioxide levels, with no compensation noted.
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A patient has recently been diagnosed with symptomatic bradycardia. Which of the following medications is the most recognized for treatment of symptomatic bradycardia?
- A. Questran
- B. Digitalis
- C. Nitroglycerin
- D. Atropine
Correct Answer: D
Rationale: Atropine encourages increased rate of conduction in the AV node.
The primary organ for drug elimination is the:
- A. Skin
- B. Lung(s)
- C. Kidney(s)
- D. Liver
Correct Answer: C
Rationale: The kidneys are the primary organ for drug elimination, excreting most drugs or their metabolites in urine.
When a client with a major burn experiences body image disturbance, which of the following is an appropriate nursing intervention classification?
- A. Grief work facilitation
- B. Vital signs monitoring
- C. Medication administration: skin
- D. Anxiety reduction
Correct Answer: A
Rationale: Grief work facilitation helps address body image disturbance in burn clients by supporting grief resolution related to altered appearance.
Some drugs are excreted into bile and delivered to the intestines. Prior to elimination from the body, the drug might be absorbed. This process is known as:
- A. hepatic clearance.
- B. total clearance.
- C. enterohepatic cycling.
- D. first-pass effect.
Correct Answer: C
Rationale: Drugs and drug metabolites with molecular weights higher than 300 can be excreted via the bile, stored in the gallbladder, delivered to the intestines by the bile duct, and then reabsorbed into the circulation. This process reduces the elimination of drugs and prolongs their half-life and duration of action in the body. Hepatic clearance is the amount of drug eliminated by the liver. Total clearance is the sum of all types of clearance including renal, hepatic, and respiratory. First-pass effect is the amount of drug absorbed from the GI tract, then metabolized by the liver (reducing the amount of drug that makes it into circulation).
When a couple experiencing infertility presents for a fertility workup, which of the following procedures should the nurse prepare the couple to have first?
- A. hysterosalpingography
- B. semen analysis
- C. endometrial biopsy
- D. transvaginal ultrasound
Correct Answer: B
Rationale: Because semen analysis is the least invasive of the tests listed and because in 35% of the cases the infertility is related to a male factor, semen analysis should be one of the first diagnostic tests performed. Hysterosalpingography fills the uterus and fallopian tubes with a radiopaque substance that can be seen with an X ray. It demonstrates tubal patency or any distortion of the uterine cavity. Endometrial biopsy provides information about the effects of progesterone after ovulation and the endometrial receptivity. Transvaginal ultrasound is mostly used in the treatment of infertility. For diagnosis it allows the endocrinologist to evaluate the developing follicle, assess oocyte maturity, and diagnose luteal phase defects. All the tests listed in Choices 1, 3, and 4 are more invasive, require greater expertise to evaluate and treat, and are more costly. If the semen analysis is normal, the couple can expect to progress through these tests as well.