Nokea
A young man sustains a gunshot wound to the abdomen. The definitive treatment in managing this patient is to:
- A. Administer O-negative blood
- B. Apply external warming devices
- C. Control internal hemorrhage operatively
- D. Apply a pneumatic antishock garment (PASG)
Correct Answer: C
Rationale: The correct answer is C: Control internal hemorrhage operatively. In managing a gunshot wound to the abdomen, the priority is to control internal bleeding, usually through surgical intervention. Administering O-negative blood (A) is important for resuscitation but does not address the primary issue. External warming devices (B) are not the priority in this scenario. Applying a pneumatic antishock garment (PASG) (D) is not recommended as it could delay necessary surgical intervention to control hemorrhage. Operating to control internal hemorrhage is crucial to prevent further blood loss and stabilize the patient's condition.
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A patient tells the nurse that he takes laxatives every day but is still constipated. The nurses response is based on which of the following?
- A. Habitual laxative use is the most common cause of chronic constipation.
- B. If laxatives are not effective, the patient should begin to use enemas.
- C. A laxative that works by a different method should be used.
- D. Chronic constipation is nothing to be concerned about.
Correct Answer: A
Rationale: Overuse of laxatives weakens bowel response, causing constipation.
Which of the following components is MISPLACED in the circle system shown in the above illustration?
- A. Fresh gas inlet
- B. CO2 absorber
- C. Expiratory valve
- D. Inspiratory valve
Correct Answer: A
Rationale: In a circle system, the fresh gas inlet should be downstream of the CO2 absorber but upstream of the inspiratory valve; misplacement alters gas flow dynamics.
You are transporting a 20-year-old pregnant female from a local hospital to a medical facility that specializes in high-risk pregnancies when you note the patient is experiencing unexplained hypotension and bradycardia. The patient has a patent IV and is being administered magnesium that was initiated by hospital staff. On the cardiac monitor, the patient presents with a lengthening PR interval and signs of an impending high-degree nodal block. Which of the following interventions would be most appropriate in this case?
- A. Increase the magnesium sulfate infusion rate, and administer a 1,000 mL normal saline bolus to support the patient's blood pressure
- B. Stop the magnesium sulfate infusion immediately, and administer the appropriate dose of calcium chloride to correct the adverse effects of magnesium toxicity
- C. Continue the infusion, but administer potassium chloride to counteract the adverse effects of the magnesium chloride administration
- D. Reduce the infusion by half, and administer dextrose 50% to counteract the adverse cardiac effects caused by the magnesium chloride infusion
Correct Answer: B
Rationale: The correct answer is B: Stop the magnesium sulfate infusion immediately, and administer the appropriate dose of calcium chloride to correct the adverse effects of magnesium toxicity.
Rationale:
1. **Stop magnesium infusion**: Magnesium toxicity can cause hypotension, bradycardia, and high-degree nodal block, hence stopping the infusion is crucial.
2. **Administer calcium chloride**: Calcium is the antidote for magnesium toxicity as it competes with magnesium for binding sites, reversing its effects.
3. **Corrects adverse effects**: Calcium chloride helps in counteracting the negative effects of magnesium on the cardiovascular system.
Summary:
- **Option A**: Increasing magnesium and giving saline won't address magnesium toxicity.
- **Option C**: Potassium won't counteract magnesium toxicity.
- **Option D**: Reducing infusion and giving dextrose won't correct magnesium toxicity.
What is the name of the legal document in which an individual specifies what medical treatments should and should not be done for him in the event he is unable to make his own medical care decisions?
- A. A do not resuscitate order (DNR)
- B. A will
- C. An advanced directive
- D. A personal directive
Correct Answer: C
Rationale: The correct answer is C: An advanced directive. An advanced directive is a legal document that allows an individual to specify their medical treatment preferences in case they are unable to make decisions. It includes instructions on the use of life-sustaining treatments.
A: A do not resuscitate order (DNR) specifically addresses whether or not to perform cardiopulmonary resuscitation in case of cardiac arrest, but it does not cover overall medical treatment preferences.
B: A will is a legal document that specifies how a person's assets and properties should be distributed after their death, not their medical treatment preferences.
D: A personal directive is a general term that may refer to various legal documents but does not specifically address medical treatment preferences.
Standard Precautions means
- A. Not performing care on residents who have infectious diseases
- B. Treating all blood
- C. body fluids
- D. and mucous membranes as if they were infected
Correct Answer: B
Rationale: Standard Precautions means treating all blood, body fluids, and mucous membranes as if they were infected. This approach is crucial in preventing the spread of infections in healthcare settings. By assuming that all bodily fluids are potentially infectious, healthcare workers can protect themselves and others from exposure to pathogens. This includes using personal protective equipment and following proper hygiene practices consistently. Options A, C, and D are incorrect because Standard Precautions do not involve avoiding care for residents with infectious diseases, but rather implementing necessary precautions to prevent transmission of infections.