Nokea
How does shock typically progress?
- A. Compensated to hypotensive shock in hours and hypotensive shock to cardiac arrest in minutes
- B. Compensated to hypotensive shock in minutes and hypotensive shock to cardiac arrest in hours
- C. Hypotensive to compensated shock in hours and compensated shock to cardiac arrest in minutes
- D. Hypotensive to compensated shock in minutes and compensated shock to cardiac arrest in hours
Correct Answer: A
Rationale: Shock typically progresses from a compensated state to hypotensive shock over a period of hours. In the compensated phase, the body is trying to maintain perfusion. It is crucial to identify and intervene during this phase to prevent progression to hypotensive shock, where blood pressure drops significantly. If not promptly managed, hypotensive shock can rapidly deteriorate into cardiac arrest in minutes due to inadequate perfusion to vital organs. Choices B, C, and D are incorrect as they do not follow the typical progression of shock stages as seen in clinical practice. Understanding the stages of shock and their timeframes is crucial for early recognition and appropriate intervention to prevent further deterioration.
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The nurse is caring for a newborn infant after surgical intervention for imperforate anus. The nurse should place the infant in which position in the postoperative period?
- A. Supine with no head elevation
- B. Side-lying with the legs flexed
- C. Side-lying with the legs extended
- D. Supine with the head elevated 30 degrees
Correct Answer: B
Rationale: After surgical intervention for imperforate anus, the infant should be placed in a side-lying position with the legs flexed. This position helps reduce edema and pressure on the surgical site, preventing strain and promoting comfort. Placing the infant supine with no head elevation (Choice A) doesn't offer adequate support and may increase pressure on the area. Side-lying with the legs extended (Choice C) doesn't help reduce edema and pressure effectively. Placing the infant supine with the head elevated 30 degrees (Choice D) isn't recommended as it may not provide adequate support and comfort needed for recovery.
What drives respiration in a patient with advanced chronic respiratory failure?
- A. Hypoxemia
- B. Hypocapnia
- C. Hypercapnia
- D. None of the above
Correct Answer: A
Rationale: In patients with advanced chronic respiratory failure, such as those with chronic obstructive pulmonary disease (COPD), the respiratory drive shifts from being primarily stimulated by high levels of carbon dioxide (hypercapnia) to being driven by low oxygen levels (hypoxemia). This shift is due to the body's adaptation to chronic respiratory acidosis and hypoxemia. As a result, hypoxemia becomes the primary stimulus for respiration in these patients. Hypocapnia, a low level of carbon dioxide, is not a common driver of respiration in patients with advanced chronic respiratory failure. Therefore, the correct answer is hypoxemia.
A patient is being discharged from the med-surgical unit. The patient has a history of gastritis. The nurse questions the patient on their usual routine at home. Which of these statements would alert the nurse that additional teaching is required?
- A. I avoid NSAIDs. I only take a daily aspirin for my heart health.
- B. I always avoid eating hot and spicy foods.
- C. I will continue taking my antacids with or immediately after meals.
- D. I will only drink coffee once a week, if even that often.
Correct Answer: A
Rationale: The correct answer is, 'I avoid NSAIDs. I only take a daily aspirin for my heart health.' Aspirin is classified as an NSAID and can exacerbate existing stomach problems, such as gastritis. Therefore, patients with gastritis should avoid aspirin just like any other NSAID. Choice B, 'I always avoid eating hot and spicy foods,' is a good practice for a patient with gastritis. Choice C, 'I will continue taking my antacids with or immediately after meals,' indicates understanding of the correct timing for antacid use. Choice D, 'I will only drink coffee once a week, if even that often,' shows a suitable limitation of coffee intake, which is beneficial for patients with gastritis.
Which of the following diseases or disorders is acute?
- A. Pneumonia
- B. Paralysis
- C. Alzheimer's disease
- D. Diabetes
Correct Answer: A
Rationale: The correct answer is Pneumonia. Pneumonia is an acute illness characterized by inflammation of the air sacs in the lungs. It comes on suddenly and typically lasts for a short duration. Treatment can help cure pneumonia. Paralysis, Alzheimer's disease, and Diabetes are chronic conditions. Paralysis is the loss of muscle function in part of the body, usually permanent. Alzheimer's disease is a progressive brain disorder leading to memory loss and cognitive decline, and it is incurable. Diabetes is a chronic condition that affects how your body turns food into energy, and it requires lifelong management. Therefore, Pneumonia is the only acute condition among the options provided.
Which of the following statements best describes postural drainage as part of chest physiotherapy?
- A. Tapping on the chest wall to loosen secretions
- B. Squeezing the abdomen to increase expansion of the upper chest
- C. Using gravity to move secretions in the lung tissue
- D. Dilating the trachea to facilitate better release of secretions
Correct Answer: C
Rationale: Postural drainage is a technique used in chest physiotherapy for clients with accumulated lung secretions. It involves positioning the client to utilize gravity in moving secretions from the lungs. Choice A, tapping on the chest wall, describes percussion, not postural drainage. Choice B, squeezing the abdomen, is not a correct description of postural drainage. Choice D, dilating the trachea, is not related to postural drainage but may be associated with airway clearance techniques.