Nokea
A patient with acute exacerbation of chronic obstructive pulmonary disease (COPD) demonstrates hypercapnia and respiratory acidosis on arterial blood gas analysis. Which of the following ventilatory strategies is most appropriate for managing the patient's respiratory failure?
- A. Low tidal volume ventilation
- B. High-flow nasal cannula therapy
- C. Non-invasive positive pressure ventilation (NIPPV)
- D. Invasive mechanical ventilation with lung protective strategy
Correct Answer: D
Rationale: In a patient with acute exacerbation of COPD who presents with hypercapnia and respiratory acidosis, the most appropriate ventilatory strategy is invasive mechanical ventilation with a lung protective strategy. This involves using lower tidal volumes and limiting plateau pressures to prevent ventilator-induced lung injury.
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The CI is expected to set the atmosphere by welcoming everyone and by _________.
- A. showing every one the picture of the breast
- B. Discussing the objectives of the ward class
- C. giving an anecdote about an old man
- D. going ahead with the first part of the lecture
Correct Answer: B
Rationale: In a professional setting like a classroom or a meeting, it is important for the CI (chief instructor) to set the atmosphere by welcoming everyone and discussing the objectives of the ward class. By discussing the objectives, the CI can provide a clear direction for the session and ensure that everyone is on the same page in terms of what needs to be accomplished. This not only helps focus the participants but also creates a sense of purpose and organization, setting a positive tone for the rest of the interaction. Showing a picture of the breast or giving an anecdote about an old man may not be appropriate or relevant in this context. Going ahead with the first part of the lecture without any welcoming or setting the atmosphere may make the participants feel rushed or disconnected from the session's purpose.
Which of the following dental conditions is characterized by the involuntary grinding or clenching of teeth, often leading to tooth wear, muscle pain, and temporomandibular joint dysfunction?
- A. Dental caries
- B. Attrition
- C. Bruxism
- D. Periodontitis
Correct Answer: C
Rationale: Bruxism is the dental condition characterized by the involuntary grinding or clenching of teeth, often occurring during sleep. This habitual behavior can lead to tooth wear, muscle pain, headaches, and temporomandibular joint dysfunction. Dental caries (choice A) refers to tooth decay, while attrition (choice B) specifically refers to the wearing down of teeth due to forces like chewing. Periodontitis (choice D) is a condition involving inflammation and infection of the gums and supporting structures of the teeth. Among the choices provided, bruxism is the most fitting description for the condition characterized by tooth grinding and clenching.
What is the appropriate ratio of chest compressions to rescue breaths for adult CPR?
- A. 15 compressions: 2 breaths
- B. 30 compressions: 2 breaths
- C. 30 compressions: 1 breath
- D. 15 compressions: 1 breath
Correct Answer: C
Rationale: The appropriate ratio of chest compressions to rescue breaths for adult CPR is 30 compressions to 2 breaths. This means that after every 30 chest compressions, two rescue breaths should be given. This ratio helps in maintaining oxygen circulation in the body while also ensuring that the heart is being effectively pumped to circulate blood. The emphasis on chest compressions is critical in maintaining blood flow to vital organs during cardiac arrest, while the rescue breaths help in providing oxygen to the patient's lungs. This ratio is recommended by organizations like the American Heart Association for performing high-quality adult CPR.
Which of the following actions is appropriate when managing a patient with a suspected heat stroke?
- A. Administering warm intravenous fluids.
- B. Applying ice packs to the patient's skin.
- C. Encouraging the patient to drink cold water rapidly.
- D. Removing the patient from the hot environment and cooling the body.
Correct Answer: D
Rationale: When managing a patient with a suspected heat stroke, the appropriate action is to remove the patient from the hot environment and start cooling the body. Heat stroke is a medical emergency that can be life-threatening if not promptly treated. Cooling the body is essential to lower the core body temperature as quickly as possible. Ice packs should not be directly applied to the skin as they can cause vasoconstriction and may actually hinder heat dissipation. Administering warm intravenous fluids and encouraging the patient to drink cold water rapidly are also not recommended in the initial management of a heat stroke. The priority is to cool the patient down and seek medical attention immediately.
The nurse develops the following hypothesis: Elderly women receive less aggressive treatment for terminally-ill spine patients than younger women. Which variable would be considered to be the independent variable?
- A. Degree of treatment received
- B. Age of the patient
- C. Use of inpatient treatment
- D. Type of complications being treated
Correct Answer: B
Rationale: The independent variable in an experiment is the variable that is manipulated or determined by the researcher. In this hypothesis, the nurse is suggesting that the age of the patient (elderly vs. younger) influences the aggressiveness of treatment received. Therefore, the age of the patient is the independent variable in this scenario. The dependent variable would be the degree of treatment received, as it is expected to be influenced by the independent variable, which is the age of the patient.