Nokea
A patient admitted to the ICU develops acute intracerebral hemorrhage (ICH) with elevated intracranial pressure (ICP). What intervention should the healthcare team prioritize to manage the patient's ICP?
- A. Initiate hypertonic saline therapy for osmotic diuresis.
- B. Perform emergent craniotomy for hematoma evacuation.
- C. Implement head-of-bed elevation to promote cerebral venous drainage.
- D. Recommend sedative medications to reduce agitation and anxiety.
Correct Answer: B
Rationale: In cases of acute intracerebral hemorrhage (ICH) with elevated intracranial pressure (ICP), a significant factor contributing to the elevated ICP is often the mass effect caused by the hematoma within the brain. Performing an emergent craniotomy for hematoma evacuation is a critical intervention to relieve the pressure within the intracranial space, thereby mitigating the risk of herniation and further neurological damage. While other interventions such as hypertonic saline therapy, head-of-bed elevation, and sedative medications may have supporting roles in managing ICP, none address the primary cause of elevated ICP in cases of acute intracerebral hemorrhage as effectively as hematoma evacuation through craniotomy.
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The nurse would determine that her teaching goal one the use of a decongestant nasal spray has been met when the client says ______..
- A. "The spray should be used round-the-clock at equally spaced intervals"
- B. "Nasal sprays must be combined with an oral antihistamine to achieve relief"
- C. "Overuse can result in nosebleeds and mucosal ulceration"
- D. "Rebound rhinitis (rhinitis medicamentosa) is common with continued use"
Correct Answer: A
Rationale: The correct statement that indicates the teaching goal has been met is when the client says, "The spray should be used round-the-clock at equally spaced intervals." This statement shows an understanding of how to properly use the decongestant nasal spray as instructed by the nurse. Using the spray round-the-clock at equally spaced intervals helps maintain consistent relief from congestion without the risk of overuse or rebound effects. This response indicates that the client has grasped the correct usage instructions for the decongestant nasal spray, which is the goal of the teaching.
The best prevention management of contact latex allergy is ______.
- A. applying lotion before gloving
- B. avoidance of latex products
- C. avoiding rubberized goods
- D. resigning from the job
Correct Answer: B
Rationale: The best prevention management of contact latex allergy is to avoid latex products entirely. Latex allergies can range from mild skin irritation to severe reactions such as anaphylaxis. This means that even applying lotion before using latex gloves may not be sufficient to prevent an allergic reaction in individuals who are sensitized to latex. It is important for individuals with latex allergy to completely avoid exposure to latex products, including rubberized goods, to prevent triggering an allergic response. Resigning from the job is not a practical solution and should not be necessary if proper precautions are taken to avoid latex exposure.
A patient presents with polyuria, polydipsia, and polyphagia. Laboratory tests reveal hyperglycemia and glycosuria. Which endocrine disorder is most likely responsible for these symptoms?
- A. Hyperthyroidism
- B. Hypothyroidism
- C. Diabetes mellitus
- D. Cushing's syndrome
Correct Answer: C
Rationale: The symptoms of polyuria (excessive urination), polydipsia (excessive thirst), and polyphagia (excessive hunger) are classic signs of diabetes mellitus. In this case, the presence of hyperglycemia (high blood sugar) and glycosuria (glucose in the urine) further support the diagnosis of diabetes mellitus. Insulin deficiency or resistance in diabetes leads to impaired glucose utilization and excessive glucose in the bloodstream, causing the classic symptoms observed in the patient. Hyperthyroidism, hypothyroidism, and Cushing's syndrome do not typically present with the hallmark symptoms of polyuria, polydipsia, and polyphagia associated with uncontrolled diabetes mellitus.
A pregnant woman presents with sudden onset of severe abdominal pain and vaginal bleeding. On examination, her abdomen is rigid, and fetal parts are palpable abdominally. Which of the following conditions is the most likely cause of these symptoms?
- A. Ectopic pregnancy
- B. Pelvic inflammatory disease
- C. Uterine rupture
- D. Ovarian torsion
Correct Answer: C
Rationale: Uterine rupture is the most likely cause of these symptoms in a pregnant woman presenting with sudden onset of severe abdominal pain, vaginal bleeding, rigidity of the abdomen, and palpable fetal parts abdominally. Uterine rupture is a rare but serious complication of pregnancy, typically occurring during labor in women with a previous cesarean delivery or other uterine scars. The sudden onset of severe abdominal pain can be associated with vaginal bleeding due to the tearing of the uterine wall, causing fetal parts to be palpable abdominally. This is a life-threatening emergency that requires immediate medical intervention. Ectopic pregnancy, pelvic inflammatory disease, and ovarian torsion may present with abdominal pain and vaginal bleeding but would not typically present with palpable fetal parts abdominally in a pregnant woman.
A patient expresses frustration with the healthcare system's inefficiencies. What is the nurse's best response?
- A. Dismiss the patient's frustration and assure them that the system is functioning optimally.
- B. Listen actively to the patient's concerns, acknowledge the challenges, and offer support.
- C. Ignore the patient's frustration and proceed with providing care.
- D. Tell the patient that their frustration is unwarranted and unnecessary.
Correct Answer: B
Rationale: The nurse's best response when a patient expresses frustration with the healthcare system's inefficiencies is to listen actively to the patient's concerns, acknowledge the challenges they are facing, and offer support. It is important for the nurse to validate the patient's feelings and demonstrate empathy, rather than dismissing or ignoring their frustrations. By offering support and showing understanding, the nurse can help the patient feel heard and valued, which is an essential aspect of providing patient-centered care. This approach can also help to strengthen the nurse-patient relationship and build trust, ultimately leading to better outcomes for the patient's overall healthcare experience.