Nokea
A patient admitted to the ICU develops acute myocardial infarction (MI) with ST-segment elevation on electrocardiogram (ECG). What intervention should the healthcare team prioritize to manage the patient's MI?
- A. Perform emergent coronary angiography for revascularization.
- B. Administer fibrinolytic therapy to restore coronary blood flow.
- C. Implement strict bed rest to minimize cardiac workload.
- D. Recommend beta-blocker medications to reduce myocardial oxygen demand.
Correct Answer: A
Rationale: In a patient with acute myocardial infarction (MI) presenting with ST-segment elevation on ECG, the healthcare team should prioritize performing emergent coronary angiography for revascularization. This intervention, also known as primary percutaneous coronary intervention (PCI), involves opening up the blocked coronary artery responsible for the MI. Timely reperfusion of the affected artery is crucial in reducing myocardial damage and improving outcomes in acute MI patients. PCI is considered the preferred method for revascularization in patients with ST-segment elevation MI, as it has been shown to be more effective and associated with better outcomes compared to fibrinolytic therapy.
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A patient presents with progressive weakness, muscle atrophy, and fasciculations, primarily involving the upper and lower extremities. Over time, the patient develops difficulty swallowing and breathing. Which of the following neurological conditions is most likely responsible for these symptoms?
- A. Parkinson's disease
- B. Guillain-Barré syndrome (GBS)
- C. Amyotrophic lateral sclerosis (ALS)
- D. Myasthenia gravis
Correct Answer: C
Rationale: The symptoms described are classic for amyotrophic lateral sclerosis (ALS), also known as Lou Gehrig's disease. ALS is a progressive neurodegenerative disease that affects nerve cells in the brain and spinal cord, leading to muscle weakness and atrophy. Patients typically present with weakness, muscle atrophy, fasciculations (muscle twitching), and eventually develop difficulty swallowing and breathing due to involvement of the muscles responsible for these functions. Parkinson's disease (Choice A) is a neurodegenerative disorder characterized by tremors, rigidity, and bradykinesia but does not typically present with muscle atrophy or fasciculations as described in the case. Guillain-Barré syndrome (GBS) (Choice B) is an acute inflammatory condition affecting peripheral nerves, leading to ascending paralysis, which is usually reversible. Myasthenia gravis (Choice D) is an autoimmune disorder that affects neu
As a nurse, which of the following are the critical factors for successful integration of loss during the grieving process?
- A. The patient 's predictable and steady movement form one stage of the process to the next
- B. Accurate assessment and intervention by the nurse or helping person
- C. The nurse trustworthiness and healthy attitude about grief
- D. The patient's adequate perception, adequate support, and adequate coping
Correct Answer: B
Rationale: Accurate assessment and intervention by the nurse or helping person are critical factors for successful integration of loss during the grieving process. This involves the nurse's ability to assess the patient's grieving process effectively, identify their needs, provide appropriate support, and intervene when necessary. By utilizing proper assessment techniques and offering timely interventions, the nurse helps facilitate the patient's journey through the grieving process, promoting healthy coping mechanisms and ultimately assisting in achieving successful integration of their loss. Trustworthiness and a healthy attitude about grief are important qualities for a nurse, but without accurate assessment and intervention, the grieving process may not progress smoothly.
A nurse is caring for a patient who refuses to comply with a prescribed treatment regimen. What ethical principle should guide the nurse's approach to addressing the patient's refusal?
- A. Beneficence
- B. Autonomy
- C. Nonmaleficence
- D. Justice
Correct Answer: B
Rationale: The ethical principle of autonomy emphasizes respecting the patient's right to make their own decisions regarding their treatment. In this scenario, the patient has the right to refuse treatment, and the nurse should respect that decision while also providing information and guidance to help the patient make informed choices. By upholding the principle of autonomy, the nurse can support the patient's decision-making process and work collaboratively with them to address any concerns or barriers to compliance with the treatment regimen. This approach honors the patient's right to self-determination and promotes a trusting relationship between the nurse and the patient.
The first standard-step-in oxygen therapy that the nurse should do is which of the following?
- A. Prepare the patient for the oxygen treatment
- B. Check the chart for ordered flow rate and oxygen delivery method.
- C. Gather all the equipment and supplies.
- D. Assess patient's condition.
Correct Answer: D
Rationale: Before initiating any oxygen therapy, it is crucial for the nurse to first assess the patient's condition. This step allows the nurse to determine the patient's oxygen saturation levels, respiratory rate, lung sounds, and overall respiratory status. Understanding the patient's baseline condition helps in selecting the appropriate oxygen delivery method and flow rate that will best meet the patient's needs. Additionally, assessing the patient's condition allows the nurse to monitor the effectiveness of the oxygen therapy and make any necessary adjustments throughout the treatment process. Therefore, assessing the patient's condition is the necessary first step in providing safe and effective oxygen therapy.
Which assessment by the nurse would cause a concern for Meperidine Overdosed?
- A. Respiration rate of 12 bpm.
- B. Dryness of the skin.
- C. Hypercapnia
- D. Pinpoint pupils.
Correct Answer: C
Rationale: Meperidine (Demerol) is an opioid analgesic. Overdose of Meperidine can lead to respiratory depression, characterized by slow and shallow breathing. As a result of respiratory depression, hypercapnia, which is an increased level of carbon dioxide in the blood, can occur. This is a serious concern and requires immediate medical intervention to support respiratory function. Therefore, hypercapnia would be the assessment by the nurse that causes a concern for Meperidine overdose.