Nokea
Early Goal Directed Therapy in severe sepsis and septic shock (Rivers et al) does NOT recommend:
- A. hydrocortisone 100 mg QID
- B. maintaining mixed venous oxygen saturation measurement >70%
- C. maintaining CVP between 8-12 mmHg
- D. using inotropes to keep MAP >65 mmHg<90 mmHg
Correct Answer: A
Rationale: Rivers' sepsis hydrocortisone's out, SvO2, CVP, MAP, dobutamine hold. Nurses skip this chronic steroid sidestep.
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Which of the following countries has the highest percentage of diabetes patients?
- A. USA
- B. Britain
- C. India
- D. Saudi Arabia
Correct Answer: D
Rationale: Saudi Arabia's diabetes rate soars wealth, sedentary shifts, and diet spike it past USA's obesity-driven numbers, Britain's milder load, and India's vast but diluted count. Over 20% prevalence there trumps others' teens, a chronic epidemic nurses track in Gulf states, tied to rapid modernization.
A nurse is caring for a client who recently underwent a heart transplant. Which of the following postoperative nursing interventions is the priority?
- A. Maintain strict bedrest
- B. Advance diet as tolerated
- C. Educate the client on medication
- D. Ensure strict adherence to aseptic techniques
Correct Answer: D
Rationale: Heart transplant's success hinges on dodging infection immunosuppression skyrockets risk, making aseptic technique the priority to shield the graft. Bedrest aids early recovery but isn't top. Diet advances slowly, education's vital long-term, but infection's immediate threat trumps. Nurses enforce sterility dressings, lines safeguarding this fragile post-op phase, a life-or-death focus in transplant care.
The New York Heart Association functional class has four grades and is used to assess severity of CHF and impact on QOL. Class III is described as:
- A. Slight impairment of physical activity: comfortable at rest but ordinary activity results in fatigue and palpitations
- B. Unable to carry out any physical activity without discomfort: symptoms of CHF are present even at rest with increased discomfort with any physical activity
- C. No limitation: ordinary physical activity does not cause undue fatigue, dyspnoea or palpitations
- D. Marked limitation of physical activity: comfortable at rest but less than ordinary activity results in symptoms
Correct Answer: D
Rationale: NYHA Class III big limits; rest's fine, but small moves spark symptoms, a QOL hit. Slight's I; none's 0; all-out's IV. Nurses gauge this, a chronic heart's midway bind.
Clients with chronic illness want the health care system to provide them with which of the following?
- A. Less information
- B. Less travel time
- C. Ways to adjust to disease consequences
- D. Limited information on ways to cope with their symptoms
Correct Answer: C
Rationale: Chronic folks crave adaptation tools handling fear, sleep woes, or sex shifts not less info or travel ease. Nurses deliver this, a lifeline for illness' long tail, not just quick fixes.
You have just received the morning report from the night shift nurses. List the order of priority for assessing and caring for these patients.
- A. A patient who developed tumor lysis syndrome around 5:00 AM
- B. A patient with frequent reports of break-through pain over the past 24 hours
- C. A patient scheduled for exploratory laparotomy this morning
- D. A patient with anticipatory nausea and vomiting for the past 24 hours
Correct Answer: A
Rationale: Tumor lysis syndrome, an oncologic emergency from rapid cell breakdown, spikes electrolytes and risks renal failure its 5:00 AM onset demands immediate assessment for stability, trumping others. Surgery prep follows laparotomy needs readiness checks like NPO status, time-sensitive but stable. Breakthrough pain, chronic over 24 hours, requires analgesia adjustment, urgent but not life-threatening. Anticipatory nausea, psychogenic, needs comfort and antiemetics, least acute. Prioritizing tumor lysis aligns with ABCs circulation and organ function ensuring rapid intervention like fluids or dialysis, a nurse's critical triage call in this lineup.