Nokea
In the ED, a homeless client is brought in with severe hypothermia. The police officers also state that they found a 'bottle of booze' on the sidewalk next to him. This puts the nurse on high alert since alcohol contributes to hypothermia by:
- A. interfering with the appetite center in the brain, causing the person to not respond to hunger cues.
- B. causing the person to have less insulation from body fat.
- C. dulling mental awareness, impairing judgment to seek shelter.
- D. increasing the basal metabolic rate, leading to faster depletion of ATP.
Correct Answer: C
Rationale: Alcohol impairs judgment and dulls mental awareness, making a person less likely to seek shelter when experiencing hypothermia. This impaired judgment can lead to risky behaviors that exacerbate the effects of cold exposure. Choice A is incorrect because alcohol does not directly interfere with the appetite center in the brain to the extent described. Choice B is incorrect as alcohol consumption does not directly impact the amount of body fat present. Choice D is incorrect because alcohol does not increase the basal metabolic rate but rather slows it down.
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A patient is prescribed sildenafil (Viagra) for erectile dysfunction. What condition would contraindicate the use of this medication?
- A. History of peptic ulcer disease
- B. Use of nitrates
- C. Use of antihypertensive medications
- D. History of hypertension
Correct Answer: B
Rationale: The correct answer is B: Use of nitrates. Sildenafil (Viagra) is contraindicated in patients taking nitrates due to the risk of severe hypotension. Nitrates combined with sildenafil can lead to a dangerous drop in blood pressure. Choices A, C, and D are incorrect because a history of peptic ulcer disease, use of antihypertensive medications, or a history of hypertension are not direct contraindications for sildenafil use.
An older adult patient has just sheared the skin on her elbow while attempting to boost herself up in bed, an event that has precipitated acute inflammation in the region surrounding the wound. Which of the following events will occur during the vascular stage of the patient's inflammation?
- A. Outpouring of exudate into interstitial spaces
- B. Chemotaxis
- C. Accumulation of leukocytes along epithelium
- D. Phagocytosis of cellular debris
Correct Answer: A
Rationale: During the vascular stage of inflammation, there is an outpouring of exudate into the interstitial spaces, leading to swelling and edema. Choice B, chemotaxis, occurs during the cellular stage of inflammation, where leukocytes move to the site of injury in response to chemical signals. Choice C, accumulation of leukocytes along the epithelium, is not a typical event during the vascular stage. Phagocytosis of cellular debris, as in choice D, mainly occurs during the resolution stage of inflammation.
The college health nurse is providing health education for freshmen. Which of the following pieces of information about immunizations is applicable to individuals of this age group?
- A. The oral polio vaccine should be updated.
- B. The yearly administration of flu vaccine is recommended.
- C. The tetanus toxoid should be within 2 years.
- D. The administration of hepatitis A vaccine is mandatory.
Correct Answer: B
Rationale: For freshmen in college, the yearly administration of the flu vaccine is recommended. This is important to protect against seasonal influenza outbreaks that can spread rapidly in close living quarters such as dormitories. Choice A is incorrect as oral polio vaccine is not typically given to individuals of this age group. Choice C is incorrect as tetanus toxoid boosters are usually recommended every 10 years, not within 2 years. Choice D is incorrect as the administration of the hepatitis A vaccine is not mandatory for all individuals in this age group.
When starting on oral contraceptives, what key point should the nurse emphasize about taking the medication consistently?
- A. Oral contraceptives should be taken at the same time each day to maintain stable hormone levels and prevent pregnancy.
- B. Oral contraceptives can be taken at any time of day, as long as the schedule is consistent.
- C. Oral contraceptives should be taken in the morning to avoid nighttime side effects.
- D. Oral contraceptives are effective immediately upon starting, regardless of timing.
Correct Answer: A
Rationale: When starting on oral contraceptives, it is crucial to take them at the same time each day to maintain stable hormone levels and ensure their effectiveness in preventing pregnancy. Choice B is incorrect because consistency in timing is essential to maximize contraceptive efficacy. Choice C is incorrect as there is no evidence that taking oral contraceptives in the morning helps avoid nighttime side effects. Choice D is incorrect because oral contraceptives do not provide immediate effectiveness and require consistent use to prevent pregnancy.
A 57-year-old male presents to his primary care provider with a red face, hands, feet, ears, headache, and drowsiness. A blood smear reveals an increased number of erythrocytes, indicating:
- A. Leukemia
- B. Sideroblastic anemia
- C. Hemosiderosis
- D. Polycythemia vera
Correct Answer: D
Rationale: In this case, the symptoms of a red face, hands, feet, ears, headache, and drowsiness along with an increased number of erythrocytes in the blood smear are indicative of polycythemia vera. This condition is characterized by the overproduction of red blood cells, leading to symptoms related to increased blood volume and viscosity. Leukemia (Choice A) is a cancer of the blood and bone marrow, but the presentation described here is more suggestive of polycythemia vera. Sideroblastic anemia (Choice B) is characterized by abnormal iron deposits in erythroblasts, not an increased number of erythrocytes. Hemosiderosis (Choice C) refers to abnormal accumulation of iron in the body, not an increase in red blood cells as seen in polycythemia vera.