Nokea
A patient in the ICU develops acute kidney injury (AKI) secondary to hypovolemic shock. What intervention should the healthcare team prioritize to manage the patient's renal function?
- A. Administer intravenous fluids to restore circulating volume.
- B. Initiate continuous renal replacement therapy (CRRT) for RRT.
- C. Implement strict dietary restrictions to reduce renal workload.
- D. Recommend nephrotoxic medications for therapeutic purposes.
Correct Answer: A
Rationale: In a patient with acute kidney injury (AKI) secondary to hypovolemic shock, the priority intervention to manage the patient's renal function is to administer intravenous fluids to restore circulating volume. Hypovolemic shock leads to decreased blood flow to the kidneys, resulting in hypoperfusion and ischemic damage to the renal tubules. Prompt correction of hypovolemia with intravenous fluids helps improve renal perfusion and function by increasing blood flow to the kidneys. Adequate fluid resuscitation can potentially prevent further kidney damage and support kidney function recovery. It is crucial to address the underlying cause of AKI (hypovolemia in this case) to prevent complications and improve patient outcomes. Initiating renal replacement therapy or recommending nephrotoxic medications would not be the initial interventions for managing AKI in this scenario.
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A patient presents with chest pain that worsens with swallowing and is relieved by leaning forward. An electrocardiogram (ECG) shows diffuse ST-segment elevation. Which cardiovascular disorder is most likely responsible for these symptoms?
- A. Stable angina
- B. Unstable angina
- C. Acute myocardial infarction
- D. Pericarditis
Correct Answer: D
Rationale: The given clinical presentation of chest pain that worsens with swallowing and is relieved by leaning forward along with diffuse ST-segment elevation on an ECG is highly suggestive of pericarditis. Pericarditis is the inflammation of the pericardium, the thin sac surrounding the heart. The symptoms of pericarditis can mimic those of myocardial infarction (heart attack) but can also be differentiated by certain characteristics such as the described positional chest pain, which is worsened by swallowing and relieved by leaning forward.
A patient expresses fear of needles before a scheduled blood draw. What is the nurse's best approach to address this fear?
- A. Dismiss the patient's fear and proceed with the blood draw.
- B. Provide the patient with information about relaxation techniques and distraction methods.
- C. Ignore the patient's fear and proceed with the blood draw quickly.
- D. Tell the patient that fear of needles is irrational and unfounded.
Correct Answer: B
Rationale: The nurse's best approach to address the patient's fear of needles before a blood draw is to provide the patient with information about relaxation techniques and distraction methods (Option B). Dismissing the patient's fear (Option A), ignoring the fear and proceeding quickly (Option C), or telling the patient that the fear is irrational and unfounded (Option D) would not be helpful and could potentially escalate the patient's anxiety. Providing information on relaxation techniques such as deep breathing or visualization, as well as distraction methods like listening to music or engaging in conversation, can help the patient feel more comfortable and reduce their fear and anxiety during the blood draw procedure. It is important for the nurse to acknowledge and address the patient's concerns in a supportive and empathetic manner to build trust and ensure a successful blood draw experience.
What is the ultimate purpose of record keeping
- A. Safeguard information
- B. History
- C. Archive
- D. Store information
Correct Answer: A
Rationale: The ultimate purpose of record-keeping is to safeguard information. While history, archiving, and storing information are all important functions of record-keeping, safeguarding information stands out as the primary goal. Keeping accurate and accessible records ensures that essential information is secured, protected from unauthorized access, loss, and damage. Safeguarding information also promotes transparency, accountability, and compliance with legal and ethical standards. In the case of Nurse Mely's consideration of teamwork and collaboration in community health nursing, safeguarding the relevant information through precise and organized record-keeping is crucial for effective communication, continuity of care, and successful health outcomes.
A patient presents with gradual-onset memory loss, confusion, and difficulty with complex tasks such as managing finances and planning. Over time, the patient develops disorientation to time and place and requires assistance with activities of daily living. Which of the following neurological conditions is most likely responsible for these symptoms?
- A. Alzheimer's disease
- B. Parkinson's disease
- C. Huntington's disease
- D. Frontotemporal dementia
Correct Answer: A
Rationale: The patient's presentation of gradual-onset memory loss, confusion, difficulty with complex tasks, disorientation, and functional decline are all classic features of Alzheimer's disease. Alzheimer's disease is a progressive neurodegenerative disorder characterized by the accumulation of abnormal protein deposits in the brain, leading to widespread neuronal damage and cognitive decline. As the disease progresses, patients typically experience worsening memory loss, cognitive impairment, and deficits in activities of daily living, ultimately requiring full-time care and assistance. Other neurodegenerative diseases such as Parkinson's disease, Huntington's disease, and frontotemporal dementia may present with cognitive impairment and behavioral changes, but the specific constellation of symptoms described in the case is most indicative of Alzheimer's disease.
A patient presents with a sudden onset of severe vertigo, nausea, vomiting, and nystagmus. The patient reports a recent upper respiratory tract infection. Which of the following conditions is most likely responsible for this presentation?
- A. Vestibular neuritis
- B. Benign paroxysmal positional vertigo (BPPV)
- C. Ménière's disease
- D. Acoustic neuroma
Correct Answer: A
Rationale: The patient's sudden onset of severe vertigo, nausea, vomiting, and nystagmus following a recent upper respiratory tract infection is consistent with vestibular neuritis. Vestibular neuritis is characterized by acute onset vertigo, often severe, which is typically associated with nausea, vomiting, and nystagmus. The condition is thought to be caused by inflammation of the vestibular nerve, often viral in nature, which can occur following an upper respiratory tract infection. This inflammation leads to dysfunction of the vestibular system in the inner ear, resulting in the symptoms described. Benign paroxysmal positional vertigo (BPPV), characterized by brief episodes of vertigo triggered by specific head movements, is less likely in this case given the sudden onset of symptoms not triggered by head movements. Meniere's disease is characterized by recurrent episodes of vertigo accompanied by hearing loss, tinnitus, and a feeling of fullness