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A patient in the intensive care unit (ICU) develops acute respiratory distress syndrome (ARDS) characterized by hypoxemia and bilateral pulmonary infiltrates. What intervention should the healthcare team prioritize to manage the patient's condition?
- A. Initiate mechanical ventilation with low tidal volume strategy.
- B. Administer intravenous fluids to maintain hemodynamic stability.
- C. Prescribe broad-spectrum antibiotics for suspected pneumonia.
- D. Perform chest physiotherapy to promote airway clearance.
Correct Answer: A
Rationale: Acute Respiratory Distress Syndrome (ARDS) is a severe form of acute lung injury that is characterized by hypoxemia, bilateral pulmonary infiltrates, and noncardiogenic pulmonary edema. When managing a patient with ARDS in the ICU, the priority intervention is to provide adequate oxygenation and ventilation. Mechanical ventilation is often necessary to support gas exchange in these patients.
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A patient with a history of chronic kidney disease is prescribed a low-phosphorus diet. Which dietary choice indicates understanding of the prescribed diet?
- A. Grilled chicken breast
- B. Cheese omelet
- C. Whole wheat toast with peanut butter
- D. Spinach salad with almonds
Correct Answer: A
Rationale: Grilled chicken breast is a suitable choice for a low-phosphorus diet because poultry is typically lower in phosphorus compared to dairy products (like cheese), nuts (like almonds), and whole grains (like wheat toast). This option indicates an understanding of the need to restrict phosphorus intake, which is important for individuals with chronic kidney disease to prevent complications.
A patient is exhibiting classic sign of a hemorrhagic stroke. What report from the patient would be an indicator of this type of stroke?
- A. Numbness of an arm or leg
- B. Severe headache
- C. Double vision
- D. Dizziness and tinnitus
Correct Answer: B
Rationale: A severe headache is a classic sign of a hemorrhagic stroke. Hemorrhagic stroke occurs when a blood vessel in the brain ruptures and causes bleeding. This bleeding can lead to increased pressure within the skull, resulting in a sudden and severe headache. Other symptoms of a hemorrhagic stroke may include nausea, vomiting, sudden weakness or numbness on one side of the body, difficulty speaking or understanding speech, and loss of coordination. It is important to seek immediate medical attention if someone is experiencing symptoms of a stroke, including a severe headache, as prompt treatment is crucial in minimizing damage and improving outcomes.
A patient with chronic respiratory failure secondary to severe restrictive lung disease requires long-term oxygen therapy to maintain adequate oxygenation. Which of the following oxygen delivery devices is most appropriate for delivering continuous supplemental oxygen in this patient?
- A. Nasal cannula
- B. Venturi mask
- C. Partial rebreather mask
- D. Non-rebreather mask
Correct Answer: D
Rationale: The most appropriate oxygen delivery device for a patient with chronic respiratory failure secondary to severe restrictive lung disease requiring continuous supplemental oxygen is a non-rebreather mask. A non-rebreather mask is designed to deliver high-flow oxygen and is typically used for short-term medical treatment in emergency situations or for critically ill patients. It is ideal for providing the highest concentration of oxygen available for inhalation, making it suitable for patients with severe hypoxemia.
Which of the following actions is INAPPROPRIATE for a nurse leader to apply in a work setting?
- A. Ask staff members of their opinion on the natter.
- B. Modifies his own behavior favoring the needs of individual staff .
- C. Gives equal consideration to each staff members
- D. Plans and organizes group activities of staff members.
Correct Answer: A
Rationale: While it is important for nurse leaders to seek input and feedback from staff members, the inappropriate aspect of this action lies in the lack of clarity. The option contains a typographical error "natter" instead of "matter," which may lead to confusion and hinder effective communication. Additionally, the word choice of "opinion" instead of a more structured and strategic approach like "feedback" or "input" could be improved for professional communication in the workplace. Therefore, this action may not be considered appropriate in a work setting due to potential misunderstandings that can arise from the lack of clarity in communication.
Her parents usually become anxious and confused during late in the afternoon and after dark. What do you call this phenomenon?
- A. Agitation
- B. Sundowning
- C. Dark retreat
- D. Dark reaction
Correct Answer: B
Rationale: Sundowning is a phenomenon commonly seen in elderly individuals, particularly those with cognitive impairments like dementia, where they become more restless, anxious, confused, or agitated during late afternoon and evening hours, typically around sunset. This change in behavior can manifest as increased confusion, wandering, aggression, or vocalization. The exact cause of sundowning is not completely understood but may involve a combination of factors such as disruptions in the sleep-wake cycle, fatigue, decreased lighting, and hormonal imbalances. Managing sundowning behaviors may involve environmental modifications, maintaining a regular routine, ensuring proper lighting, and addressing any underlying medical conditions contributing to the behavior changes.