Nokea
A patient in the ICU develops acute myocardial infarction (MI) with cardiogenic shock. What intervention should the healthcare team prioritize to manage the patient's shock?
- A. Perform emergent percutaneous coronary intervention (PCI).
- B. Administer inotropic medications to improve cardiac contractility.
- C. Initiate therapeutic hypothermia to reduce myocardial oxygen demand.
- D. Recommend anticoagulant therapy to prevent thromboembolism.
Correct Answer: A
Rationale: In a patient with acute myocardial infarction (MI) complicated by cardiogenic shock, the primary intervention to manage shock is emergent percutaneous coronary intervention (PCI). PCI is a procedure performed to restore blood flow in an occluded coronary artery that is causing the MI. By opening up the blocked artery and restoring blood flow to the heart muscle, PCI can help reduce myocardial damage, improve cardiac function, and stabilize the patient's condition. Prompt reperfusion via PCI is crucial in the setting of cardiogenic shock to improve survival outcomes and reduce the risk of further complications. Administering inotropic medications, initiating therapeutic hypothermia, or recommending anticoagulant therapy may be components of management in specific cases but are not the primary intervention for managing shock in a patient with acute MI and cardiogenic shock.
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One GOOD nursing intervention of the nurse for Almira would be to do which of the following?
- A. Advise her to eat her meals.
- B. Put her on absolute bed rest.
- C. Take the vital signs q 4 hours.
- D. Advise her to take care of Jay.
Correct Answer: A
Rationale: The correct nursing intervention for Almira would be to advise her to eat her meals. This is important in promoting her health and well-being, especially if she has been neglecting her own nutrition due to stress or caring for her son, Jay. Providing proper nutrition is a basic aspect of nursing care that supports the overall health and recovery of the patient. By encouraging Almira to prioritize her own nutrition, the nurse can help ensure that she has the physical strength and energy needed to take care of herself and her son effectively.
A community clinic does primary care for patients. Most often the one who manages this is which of the following?
- A. Physician
- B. Nurse
- C. Barangay health worker
- D. Midwife
Correct Answer: A
Rationale: In a community clinic providing primary care for patients, the most common healthcare professional who manages patient care is a physician. Physicians, also known as doctors, are trained and licensed to diagnose and treat a wide range of medical conditions. They are responsible for conducting exams, prescribing medications, ordering tests, and developing treatment plans for patients. While other healthcare professionals such as nurses, midwives, and barangay health workers also play important roles in providing care, physicians typically lead the team, make critical decisions, and provide overall management of patient care in a primary care setting like a community clinic.
A patient with a displaced femoral neck fracture is scheduled for surgical intervention. Which surgical procedure is most appropriate for this type of fracture?
- A. Closed reduction and internal fixation (CRIF)
- B. Open reduction and internal fixation (ORIF)
- C. Closed reduction and external fixation (CREF)
- D. Closed reduction alone
Correct Answer: B
Rationale: For a displaced femoral neck fracture, the most appropriate surgical procedure is usually an open reduction and internal fixation (ORIF). This procedure involves making an incision to reposition the fractured bone fragments and securing them in place with screws or other fixation devices. ORIF allows for better alignment of the fracture, which is crucial for proper healing and minimizing the risk of complications like avascular necrosis or nonunion. Closed reduction and internal fixation (CRIF) may not be as effective for displaced femoral neck fractures due to the complex nature of the fracture and the need for precise realignment and stability provided by an open surgical approach. External fixation is less commonly used for femoral neck fractures and is typically reserved for certain specific cases where internal fixation is not feasible. Closed reduction alone is unlikely to provide adequate stability for a displaced femoral neck fracture and is generally not recommended as the primary surgical treatment for this type of injury.
Nurses are taught as students that the ideal and PROPER time for recording vital signs and notes on the patient is __________.
- A. to wait for lunch break to do the recording
- B. after al11 the tasks are done, in order to conserve time
- C. as Soon as they obtain the signs or observations on the patient
- D. to wait for lunch break to do the recording
Correct Answer: C
Rationale: It is essential for nurses to record vital signs and notes on a patient as soon as they obtain them. This allows for accurate and timely documentation of crucial information related to the patient's health status. By recording the information promptly, nurses can ensure that they do not forget important details and can provide effective care based on accurate data. Waiting for lunch break or after completing other tasks can lead to delays in documentation, which may compromise patient care and safety. Therefore, the ideal and proper time for recording vital signs and notes is immediately after obtaining them.
A patient presents with fatigue, weakness, and jaundice. Laboratory tests reveal hemolytic anemia, elevated LDH, decreased haptoglobin, and presence of schistocytes on peripheral blood smear. Which of the following conditions is most likely to cause these findings?
- A. Hereditary spherocytosis
- B. Glucose-6-phosphate dehydrogenase (G6PD) deficiency
- C. Autoimmune hemolytic anemia (AIHA)
- D. Thalassemia
Correct Answer: B
Rationale: Glucose-6-phosphate dehydrogenase (G6PD) deficiency is an X-linked recessive disorder that leads to hemolytic anemia in response to oxidative stress. The patient's presentation of fatigue, weakness, and jaundice along with laboratory findings of hemolytic anemia (evidenced by schistocytes), elevated LDH, and decreased haptoglobin are all characteristic of G6PD deficiency. The oxidative stress causes red blood cell destruction, resulting in the release of LDH and bilirubin, leading to jaundice. Decreased haptoglobin is seen due to its consumption in binding free hemoglobin released from the lysed red blood cells. Additionally, the presence of schistocytes on a peripheral blood smear is indicative of red blood cell fragmentation, a common finding in hemolytic anemias including G6PD deficiency