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A patient presents with chest pain that occurs at rest and is relieved by nitroglycerin. An electrocardiogram (ECG) may show transient ST-segment elevation. Which cardiovascular disorder is most likely responsible for these symptoms?
- A. Stable angina
- B. Unstable angina
- C. Acute myocardial infarction
- D. Prinzmetal's angina
Correct Answer: D
Rationale: Prinzmetal's angina, also known as variant angina, is characterized by episodes of chest pain that occur at rest and are relieved by nitroglycerin. Patients with Prinzmetal's angina may also have transient ST-segment elevation on an electrocardiogram (ECG) during episodes of chest pain. This is due to coronary artery vasospasm, which causes temporary obstruction of blood flow to the heart muscle. Stable angina typically presents with chest pain on exertion that resolves with rest, while unstable angina and acute myocardial infarction present with chest pain that is not relieved with nitroglycerin and are associated with more severe coronary artery disease.
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A patient admitted to the ICU develops acute pancreatitis with severe abdominal pain and elevated pancreatic enzymes. What intervention should the healthcare team prioritize to manage the patient's pancreatitis?
- A. Administer intravenous fluids to maintain adequate hydration.
- B. Perform an abdominal ultrasound to assess pancreatic morphology.
- C. Implement total parenteral nutrition (TPN) to meet nutritional needs.
- D. Recommend proton pump inhibitors (PPIs) for gastric acid suppression.
Correct Answer: A
Rationale: The priority intervention in managing acute pancreatitis is to administer intravenous fluids to maintain adequate hydration. Acute pancreatitis can lead to significant fluid loss and dehydration due to factors such as vomiting and third-spacing of fluids into the retroperitoneal space. Adequate hydration helps to optimize perfusion to the pancreas, prevent hypovolemic shock, and support overall organ function. This intervention also aids in flushing out inflammatory mediators and preventing complications such as acute kidney injury. Monitoring fluid status and adjusting the rate of intravenous fluid administration based on the patient's response is crucial in the management of acute pancreatitis. While other interventions such as imaging studies, nutritional support, and gastric acid suppression may be important in managing acute pancreatitis, ensuring adequate hydration is the most critical initial step.
A patient with a history of stroke is at risk for impaired skin integrity due to immobility. Which nursing intervention is most effective in preventing pressure ulcers in this patient?
- A. Turning and repositioning the patient every 2 hours
- B. Massaging bony prominences regularly
- C. Applying heating pads to areas of erythema
- D. Using a pressure-reducing mattress
Correct Answer: A
Rationale: Turning and repositioning the patient every 2 hours is the most effective nursing intervention in preventing pressure ulcers in a patient with a history of stroke and immobility. Pressure ulcers, also known as bedsores, are caused by prolonged pressure on the skin, leading to reduced blood flow and tissue damage. By regularly turning and repositioning the patient, pressure is relieved from specific areas of the body, helping to prevent the development of pressure ulcers. This intervention helps to redistribute pressure, improve blood flow, and reduce the risk of skin breakdown, thus promoting skin integrity in immobile patients.
In planning for Sonny's oxygen therapy, the nurse should consider which of the following, EXCEPT
- A. need for a humidifier.
- B. length of tubing .
- C. determine the age of Excel.
- D. manner of administering oxygen, continuous or intermittent.
Correct Answer: C
Rationale: The nurse does not need to determine the age of Excel when planning for Sonny's oxygen therapy. This information is irrelevant to the specific care requirements of Sonny's oxygen therapy. Sonny's age, medical history, respiratory status, and oxygen needs are the key considerations in planning for his oxygen therapy. The nurse should focus on factors such as the need for a humidifier, length of tubing, and the manner of administering oxygen (continuous or intermittent) to ensure effective and safe delivery of oxygen therapy to Sonny.
A nurse is preparing to perform a colposcopy procedure for a patient with abnormal cervical cytology results. What action should the nurse prioritize to enhance patient comfort during colposcopy?
- A. Administering intravenous sedation to the patient before the procedure
- B. Explaining the procedure steps and providing emotional support to the patient
- C. Applying a topical anesthetic cream to the cervix before colposcopy
- D. Allowing the patient to have a support person present during the procedure
Correct Answer: B
Rationale: The best action the nurse should prioritize to enhance patient comfort during a colposcopy procedure is to explain the procedure steps and provide emotional support to the patient. Colposcopy is a procedure that involves examining the cervix, vagina, and vulva closely. Patients may feel anxious or uncomfortable during the procedure due to the sensitive nature of the area being examined and the potential concerns related to abnormal cervical cytology results. By explaining the procedure steps in detail before starting and providing emotional support, the nurse can help alleviate the patient's fears and anxieties, thereby enhancing their comfort and promoting a more positive experience overall. Additionally, establishing good communication and trust with the patient can also improve their cooperation during the procedure. Administering sedation, applying a topical anesthetic cream, and allowing a support person to be present are all important factors in providing holistic care as well, but the initial priority should be on communication and emotional support.
The physician prescribes a treatment plan for patient Mila. Nurse Victor understands that the initial treatment goal is which of the following?
- A. Prevent infection
- B. Correct hypoxia
- C. Correct metabolic acidosis
- D. Increase myocardial oxygen supply
Correct Answer: A
Rationale: The initial treatment goal for a patient like Mila is often focused on preventing infection. Infection prevention is a basic and essential step in patient care, especially for someone who may be at risk due to their medical condition or treatment plan. By preventing infection, healthcare providers can help ensure the patient's safety and promote successful outcomes for the overall treatment plan. Correcting hypoxia, metabolic acidosis, and increasing myocardial oxygen supply may be important goals as well, but preventing infection is usually prioritized as it can have serious consequences if not addressed promptly.