Nokea
A patient in the ICU develops acute exacerbation of chronic obstructive pulmonary disease (COPD) characterized by worsening dyspnea and increased sputum production. What intervention should the healthcare team prioritize to manage the patient's exacerbation?
- A. Administer bronchodilator medications via nebulization for bronchodilation.
- B. Initiate non-invasive positive pressure ventilation (NIPPV) for respiratory support.
- C. Perform arterial blood gas analysis to assess oxygenation and ventilation.
- D. Recommend chest physiotherapy to promote airway clearance.
Correct Answer: B
Rationale: The correct answer is B: Initiate non-invasive positive pressure ventilation (NIPPV) for respiratory support. In acute exacerbations of COPD, NIPPV helps improve ventilation and oxygenation, reducing the work of breathing and preventing the need for intubation. This intervention is a priority as it can rapidly stabilize the patient's respiratory status.
A: Administering bronchodilator medications is important in COPD management, but in severe exacerbations, NIPPV takes precedence.
C: Arterial blood gas analysis is important for assessing oxygenation and ventilation status, but it does not directly address the acute respiratory distress.
D: Chest physiotherapy can help with airway clearance in COPD, but in acute exacerbations, respiratory support with NIPPV is more urgent.
You may also like to solve these questions
Nurse Pedrito is teaching a client with Parkinson's disease on ways to prevent curvatures of the spine associated with the disease. To prevent spinal flexion, the nurse should tell the client to _________.
- A. Rest in supine position with his head elevated.
- B. Sleep only in dorsal recumbent position.
- C. Periodically lie in prone position without a neck pillow.
- D. Sleep on either side, but keep his back straight.
Correct Answer: C
Rationale: The correct answer is C: Periodically lie in prone position without a neck pillow. This position helps to prevent spinal flexion by promoting extension of the spine and stretching of the hip flexors. Prone positioning also helps maintain alignment of the spine and prevents contractures. Resting in supine position (choice A) with the head elevated does not promote spinal extension. Sleeping only in dorsal recumbent position (choice B) may lead to spinal flexion. Sleeping on either side (choice D) does not specifically address spinal flexion prevention.
As an individual, which of the following is an INTERNAL variable affecting health status, belief, or practices
- A. Genetics
- B. Family structure
- C. Socioeconomic status
- D. Living situation
Correct Answer: A
Rationale: Correct Answer: A - Genetics
Rationale:
1. Genetics refer to an individual's inherited traits which can influence health conditions and predispositions.
2. Genetic factors can impact an individual's susceptibility to certain diseases and conditions.
3. Health beliefs and practices may be influenced by knowledge of one's genetic predispositions.
4. Family structure, socioeconomic status, and living situation are external variables that may influence health but are not inherent to the individual like genetics.
A patient presents with chest pain, dyspnea, and hemoptysis. A ventilation-perfusion (V/Q) scan reveals a mismatched defect. Which cardiovascular disorder is most likely responsible for these symptoms?
- A. Pulmonary embolism
- B. Pericarditis
- C. Acute myocardial infarction
- D. Aortic dissection
Correct Answer: A
Rationale: The correct answer is A: Pulmonary embolism. This is the most likely cause of the symptoms based on the presentation of chest pain, dyspnea, hemoptysis, and a mismatched defect on the V/Q scan. A pulmonary embolism occurs when a blood clot travels to the lungs, causing a blockage in the pulmonary artery. This can lead to symptoms like chest pain, shortness of breath, and coughing up blood. The V/Q scan showing a mismatched defect indicates a ventilation-perfusion mismatch, which is a classic finding in pulmonary embolism. Pericarditis (B), acute myocardial infarction (C), and aortic dissection (D) typically present with different sets of symptoms and do not match the V/Q scan findings in this case.
A patient with a history of stroke is prescribed clopidogrel (Plavix) for secondary prevention of thrombotic events. Which laboratory test should the nurse monitor closely during clopidogrel therapy?
- A. Prothrombin time (PT)
- B. Activated partial thromboplastin time (aPTT)
- C. Platelet count
- D. International normalized ratio (INR)
Correct Answer: C
Rationale: The correct answer is C: Platelet count. Platelet count should be monitored closely during clopidogrel therapy because it works by inhibiting platelet aggregation, reducing the risk of clot formation. Monitoring platelet count helps assess the drug's effectiveness and prevent potential complications like bleeding or clotting events. Prothrombin time (A), activated partial thromboplastin time (B), and international normalized ratio (D) are tests that primarily assess the coagulation factors and are not directly affected by clopidogrel therapy, making them less relevant for monitoring this specific medication.
A patient with a history of nephrolithiasis presents with sudden-onset severe colicky flank pain radiating to the groin. On physical examination, there is tenderness over the costovertebral angle and hematuria. What is the most likely diagnosis?
- A. Acute pyelonephritis
- B. Renal artery embolism
- C. Renal colic due to ureteral calculus
- D. Renal infarction
Correct Answer: C
Rationale: The correct answer is C: Renal colic due to ureteral calculus. The sudden-onset severe colicky flank pain radiating to the groin along with tenderness over the costovertebral angle and hematuria are classic symptoms of kidney stones (ureteral calculus). The pain results from the obstruction of urine flow by the stone, leading to increased pressure and spasm in the ureter. Acute pyelonephritis (choice A) presents with fever, chills, and systemic symptoms. Renal artery embolism (choice B) typically presents with acute onset severe flank pain but is associated with risk factors like atrial fibrillation. Renal infarction (choice D) presents with sudden-onset severe flank pain but is less likely than ureteral calculus in a patient with a history of nephrolithiasis.