Nokea
A patient with a history of chronic liver disease presents with bruising, petechiae, and mucosal bleeding. Laboratory tests reveal prolonged prothrombin time (PT) and activated partial thromboplastin time (aPTT) with decreased platelet count. Which of the following conditions is most likely to cause these findings?
- A. Immune thrombocytopenic purpura (ITP)
- B. Disseminated intravascular coagulation (DIC)
- C. Hemophilia A
- D. Von Willebrand disease
Correct Answer: B
Rationale: Disseminated intravascular coagulation (DIC) is a condition characterized by widespread activation of coagulation leading to both thrombosis and hemorrhage. In patients with chronic liver disease, especially in the setting of advanced cirrhosis, DIC can develop due to factors such as decreased synthesis of coagulation factors and impaired clearance of activated clotting factors. The patient in this scenario presents with signs of both abnormal bleeding (bruising, petechiae, mucosal bleeding) and laboratory findings consistent with DIC, including prolonged prothrombin time (PT) and activated partial thromboplastin time (aPTT) along with decreased platelet count.
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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.
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 postpartum client exhibits signs of depression, including tearfulness, feelings of guilt, and decreased interest in self-care. Which nursing intervention should be prioritized?
- A. Encouraging participation in support groups for new mothers
- B. Referring the client to a mental health professional for counseling
- C. Administering antidepressant medication as prescribed
- D. Assessing for risk of harm to self or infant
Correct Answer: D
Rationale: The prioritized nursing intervention in this situation should be assessing for the risk of harm to self or infant. It is crucial to ensure the safety of the postpartum client and her infant as depression can increase the risk of self-harm or harm to the newborn. By assessing for any potential risks, the nurse can take appropriate actions to prevent any harm and ensure the well-being of both the client and the infant. Once the assessment is completed, further interventions like encouraging participation in support groups, referring to a mental health professional, or administering medications can be considered based on the assessment findings.
A patient presents with a Colles' fracture. What is the characteristic deformity associated with this type of fracture?
- A. Dorsal displacement of the distal fragment
- B. Ventral displacement of the distal fragment
- C. Lateral displacement of the distal fragment
- D. Medial displacement of the distal fragment
Correct Answer: A
Rationale: Colles' fracture is a type of distal radius fracture characterized by a break of the radius bone in the forearm close to the wrist. In a Colles' fracture, the distal fragment of the fractured radius bone gets displaced dorsally, meaning it shifts upwards towards the back of the hand, creating a characteristic "dinner fork" deformity when viewed from the side. This dorsal displacement results in a visible bump on the back of the wrist and a noticeable deformity when compared to the uninjured side.
Which of the following structures is responsible for transporting food from the oral cavity to the esophagus during swallowing?
- A. Tongue
- B. Pharynx
- C. Esophagus
- D. Epiglottis
Correct Answer: B
Rationale: The pharynx is the structure responsible for transporting food from the oral cavity to the esophagus during swallowing. When food is chewed and mixed with saliva in the oral cavity, it forms a bolus that is propelled to the pharynx by the tongue. The pharynx serves as a common passageway for both air and food, allowing the bolus to pass into the esophagus while preventing it from entering the trachea. The epiglottis, although important in preventing food from entering the airway, is not directly involved in the transportation of food from the oral cavity to the esophagus.