Nokea
A patient experiencing wheezing due to an allergic reaction needs immediate treatment. Which medication should be administered first?
- A. Albuterol via nebulizer
- B. Cromolyn via nebulizer
- C. Aminophylline IV
- D. Methylprednisolone IV
Correct Answer: A
Rationale: The correct answer is A: Albuterol via nebulizer. Albuterol is a rapid-acting bronchodilator that helps relieve wheezing by opening up the airways. During an allergic reaction causing wheezing, prompt relief is crucial, making Albuterol the first-line treatment. Choice B, Cromolyn via nebulizer, is used more for preventing asthma symptoms rather than providing immediate relief. Choice C, Aminophylline IV, is a bronchodilator with a slower onset of action compared to Albuterol. Choice D, Methylprednisolone IV, is a corticosteroid used to reduce inflammation and is not the first-line treatment for acute wheezing in an allergic reaction.
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What lab value should be monitored in a patient with HIV?
- A. CD4 T-cell count below 180 cells/mm3
- B. Serum albumin levels
- C. Hemoglobin levels
- D. White blood cell count
Correct Answer: A
Rationale: The correct answer is A: CD4 T-cell count below 180 cells/mm3. Monitoring the CD4 T-cell count is crucial in patients with HIV as it indicates the level of immunocompromise. A CD4 T-cell count below 180 cells/mm3 signifies severe immunosuppression and an increased risk of opportunistic infections. Serum albumin levels (choice B) are important for nutritional status assessment but not specific to HIV monitoring. Hemoglobin levels (choice C) are important for assessing anemia but do not directly reflect HIV disease progression. White blood cell count (choice D) is a general marker of inflammation and infection, but monitoring CD4 T-cell count is more specific and crucial in managing HIV.
When caring for a patient with hypokalemia, what should the nurse monitor for?
- A. Monitor for muscle weakness
- B. Check for cardiac dysrhythmias
- C. Monitor for bradycardia
- D. Monitor for seizures
Correct Answer: A
Rationale: Corrected Answer: Muscle weakness is a common sign of hypokalemia. The nurse should monitor for muscle weakness as potassium plays a crucial role in muscle function. Choices B, C, and D are incorrect because although hypokalemia can lead to cardiac dysrhythmias, bradycardia, and even seizures in severe cases, muscle weakness is a more common and specific sign directly related to potassium levels.
What dietary recommendations should be provided to a patient with GERD?
- A. Avoid mint and spicy foods
- B. Eat large meals before bed
- C. Consume liquids with meals
- D. Avoid foods high in potassium
Correct Answer: A
Rationale: The correct recommendation for a patient with GERD is to avoid mint and spicy foods. These types of foods can trigger acid reflux and worsen GERD symptoms. Choice B is incorrect as eating large meals before bed can increase the likelihood of acid reflux due to increased pressure on the lower esophageal sphincter. Choice C is also incorrect as consuming liquids with meals can cause distension in the stomach, potentially leading to reflux. Choice D is not directly related to GERD, as foods high in potassium are generally healthy and not specifically problematic for GERD patients.
What is a characteristic sign of hypokalemia on an ECG?
- A. Flattened T waves
- B. ST elevation
- C. Prominent U waves
- D. Widened QRS complex
Correct Answer: A
Rationale: Flattened T waves are a characteristic sign of hypokalemia on an ECG. When potassium levels are low, it can lead to changes in the ECG, such as T wave flattening. This alteration is important to recognize as it indicates potential electrolyte imbalances. ST elevation (Choice B) is not typically associated with hypokalemia but can be seen in conditions like myocardial infarction. Prominent U waves (Choice C) are associated with hypokalemia, but flattened T waves are more specific. Widened QRS complex (Choice D) is not a typical ECG finding in hypokalemia but can be seen in conditions like hyperkalemia.
What are the adverse effects of radiation after a mastectomy?
- A. S3 heart sound, fatigue
- B. Pulselessness in the affected extremity
- C. SOB and JVD
- D. Localized pain, swelling, erythema
Correct Answer: A
Rationale: The correct answer is A: S3 heart sound, fatigue. Radiation after a mastectomy can lead to fatigue and symptoms of heart failure, such as the presence of an S3 heart sound. Choices B, C, and D are incorrect. Pulselessness in the affected extremity would be more relevant to vascular complications, shortness of breath (SOB) and jugular venous distention (JVD) could indicate cardiac or respiratory issues unrelated to radiation, and localized pain, swelling, and erythema are more characteristic of a local inflammatory response rather than the systemic effects of radiation post-mastectomy.