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During surgery, the nurse notices that the patient's blood pressure is trending higher than the baseline. What action should the nurse take?
- A. Administer antihypertensive medication
- B. Document the blood pressure readings in the anesthesia record
- C. Notify the anesthesia provider for further assessment
- D. Continue monitoring the patient's blood pressure closely
Correct Answer: C
Rationale: The correct answer is C: Notify the anesthesia provider for further assessment. This is the most appropriate action because an anesthesia provider is trained to assess and manage changes in blood pressure during surgery. Administering antihypertensive medication (A) without proper assessment can be dangerous. Documenting the readings (B) is important but not the immediate action. Continuing to monitor closely (D) is necessary but notifying the anesthesia provider for further assessment should be the priority.
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Norse Sophie checks the gauge of the patient ' s intravenous catheter. Which is the smallest gauge catheter that the nurse can use to administer blood?
- A. 22-Gauge
- B. 20-Gauge
- C. 18-Gauge
- D. 12-Gauge
Correct Answer: B
Rationale: The correct answer is B: 20-Gauge. The smaller the gauge number, the larger the diameter of the catheter. Blood transfusions typically require a larger catheter size to prevent hemolysis and ensure proper flow. A 20-Gauge catheter is larger than 22-Gauge, 18-Gauge, and 12-Gauge, making it suitable for administering blood. 22-Gauge is too small and can cause hemolysis, 18-Gauge is smaller than the recommended size for blood transfusions, and 12-Gauge is too large and can cause damage to the vein.
A patient with suspected community-acquired pneumonia (CAP) is empirically started on antibiotic therapy pending culture results. Which of the following antibiotic regimens provides appropriate coverage for typical bacterial pathogens commonly implicated in CAP?
- A. Ceftriaxone and azithromycin
- B. Vancomycin and piperacillin/tazobactam
- C. Ampicillin-sulbactam and levofloxacin
- D. Clindamycin and cefepime
Correct Answer: A
Rationale: The correct answer is A: Ceftriaxone and azithromycin. Ceftriaxone covers Streptococcus pneumoniae, the most common pathogen in CAP, while azithromycin covers atypical pathogens like Mycoplasma pneumoniae. Vancomycin and piperacillin/tazobactam (choice B) are not first-line treatments for CAP. Ampicillin-sulbactam and levofloxacin (choice C) cover some pathogens but not as comprehensively as ceftriaxone and azithromycin. Clindamycin and cefepime (choice D) do not provide adequate coverage for typical CAP pathogens.
Which of the following structures is responsible for the initial mechanical breakdown of food during mastication?
- A. Tongue
- B. Pharynx
- C. Salivary glands
- D. Teeth
Correct Answer: D
Rationale: The correct answer is D: Teeth. Teeth are responsible for the initial mechanical breakdown of food during mastication. Step 1: Teeth use their hard surfaces to chew and grind food into smaller pieces. Step 2: This process increases the surface area of the food, making it easier for digestive enzymes to break down. Step 3: The tongue aids in moving the food around the mouth but does not break down the food mechanically. Pharynx is responsible for swallowing, not mastication. Salivary glands produce saliva that helps in the lubrication and digestion of food, but they do not directly participate in the mechanical breakdown of food.
The patient asks Nurse Vera, when could you hear the fetal heart of my baby? Which of the following should be the BEST answer of Nurse Vera?
- A. Nintth month
- B. Third month
- C. Fifth month
- D. First month
Correct Answer: C
Rationale: The correct answer is C: Fifth month. Nurse Vera should explain that the fetal heart can typically be heard using a Doppler ultrasound device around the fifth month of pregnancy. This is because the baby's heart is developed enough to produce audible sounds by this time. Choices A, B, and D are incorrect because in the ninth month, the baby is ready for delivery, in the third month the heart is still developing, and in the first month the heart is just beginning to form and is not yet audible.
A patient presents with recurrent episodes of throat pain, odynophagia, and fever. Physical examination reveals tonsillar enlargement with yellow-white exudates and tender cervical lymphadenopathy. Which of the following organisms is most likely responsible for this presentation?
- A. Streptococcus pneumoniae
- B. Haemophilus influenzae
- C. Group A beta-hemolytic Streptococcus (GAS)
- D. Epstein-Barr virus (EBV)
Correct Answer: C
Rationale: The correct answer is C: Group A beta-hemolytic Streptococcus (GAS). GAS is the most likely organism responsible for this presentation, known as acute bacterial tonsillitis. GAS commonly causes symptoms such as throat pain, odynophagia, fever, tonsillar enlargement with exudates, and cervical lymphadenopathy. Streptococcal pharyngitis is a common bacterial infection of the throat caused by GAS. The other options are less likely as Streptococcus pneumoniae typically causes pneumonia and Haemophilus influenzae is associated with respiratory tract infections. Epstein-Barr virus (EBV) commonly causes infectious mononucleosis, which presents with different symptoms than those described in the question.