Nokea
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.
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A Patients to take regularly Lithium after discharged. The MOST important information to impart to the patient and his family is that the patient should
- A. not eat foods which has high tyramine content like cheese, wine, liver
- B. limit his fluid intake
- C. have a limited intake of sodium
- D. have an adequate intake of sodium
Correct Answer: C
Rationale: The correct answer is C, to have a limited intake of sodium. Lithium can lead to increased sodium levels in the body, potentially causing toxicity. By limiting sodium intake, the patient can maintain a balance and prevent adverse effects. Choice A is incorrect as tyramine content is not directly related to lithium intake. Choice B is incorrect as fluid intake does not have a significant impact on lithium levels. Choice D is incorrect because an adequate intake of sodium can lead to worsening lithium toxicity.
A woman in active labor is receiving an epidural analgesic for pain relief. What assessment findings indicate a potential complication of epidural analgesia?
- A. Maternal hypotension
- B. Uterine hyperstimulation
- C. Fetal tachycardia
- D. Respiratory depression
Correct Answer: A
Rationale: One potential complication of epidural analgesia in labor is maternal hypotension. The epidural analgesic can cause vasodilation, leading to a decrease in blood pressure. Maternal hypotension can result in decreased placental perfusion, which may jeopardize fetal well-being. It is important for healthcare providers to monitor the maternal blood pressure closely and intervene promptly if hypotension occurs by providing IV fluids or administering medication to raise blood pressure. Uterine hyperstimulation, fetal tachycardia, and respiratory depression are not typically associated with epidural analgesia as complications.
A patient presents with severe sore throat, fever, and enlarged tonsils with exudate. Rapid antigen testing confirms group A beta-hemolytic Streptococcus (GAS) infection. Which of the following medications is the first-line treatment for this condition?
- A. Amoxicillin
- B. Azithromycin
- C. Cephalexin
- D. Clindamycin
Correct Answer: A
Rationale: The correct answer is A: Amoxicillin. Amoxicillin is the first-line treatment for GAS pharyngitis due to its effectiveness against Streptococcus bacteria. It is a penicillin-class antibiotic recommended by guidelines. Azithromycin is an alternative for patients allergic to penicillin. Cephalexin is not the first-line choice for GAS. Clindamycin is reserved for patients allergic to both penicillin and macrolides.
A patient with a history of congestive heart failure is prescribed furosemide. Which electrolyte imbalance is the patient at risk for developing with furosemide therapy?
- A. Hyperkalemia
- B. Hypokalemia
- C. Hyponatremia
- D. Hypernatremia nd potassium. Therefore, patients taking furosemide are at risk for developing hypokalemia due to increased potassium excretion.
Correct Answer: B
Rationale: Step 1: Furosemide is a loop diuretic that works in the ascending loop of Henle to inhibit sodium and chloride reabsorption.
Step 2: Inhibition of sodium reabsorption leads to increased water and electrolyte excretion, including potassium.
Step 3: Increased potassium excretion can lead to hypokalemia, which is a common side effect of loop diuretics like furosemide.
Step 4: Hypokalemia can be dangerous, especially in patients with congestive heart failure, as it can worsen cardiac function and lead to arrhythmias.
Step 5: Therefore, patients with a history of congestive heart failure prescribed furosemide are at risk for developing hypokalemia due to increased potassium excretion.
For the past 6 months, several nurses are resigning. Some have verbalized in the exit interview that there are not happy anymore. Which of the following descriptions manifest BEST, a nurse who has job satisfaction?
- A. Competitive, self-centered, euphoric.
- B. Empowered, enthusiastic, ethical.
- C. Loner, egoistic, reactive.
- D. Outgoing, sensitive, competitive.
Correct Answer: B
Rationale: The correct answer is B because an empowered nurse feels in control and valued, leading to job satisfaction. Enthusiasm shows motivation and engagement with their work. Being ethical indicates a commitment to moral principles, contributing to a sense of fulfillment.
Choice A is incorrect as competitiveness and self-centeredness do not necessarily equate to job satisfaction. Euphoria may not be a sustainable indicator of satisfaction.
Choice C is incorrect because being a loner and egoistic are not traits associated with job satisfaction. Reactivity may suggest a lack of control or frustration.
Choice D is incorrect as being outgoing and competitive might not directly translate to job satisfaction. Sensitivity alone does not guarantee satisfaction in the workplace.