Nokea
Mr. Santos a 59-year old businessman was diagnosed with angina pectoris. The nurse understands that the cause of angina pectoris is:
- A. decrease in the alveolar surface for gas exchange
- B. inadequate supply of oxygen to the myocardium
- C. inadequate blood pressure in the pulmonary circulation
- D. increase in the alveolar surface for gas exchange
Correct Answer: B
Rationale: Angina pectoris is chest pain or discomfort caused by a temporary lack of an adequate blood supply to the heart muscle (myocardium). This lack of blood supply results in a decreased supply of oxygen to the heart muscle, leading to chest pain. This condition is commonly associated with coronary artery disease, where the arteries that supply blood to the heart become narrowed or blocked, reducing the flow of oxygen-rich blood to the myocardium. This oxygen deficit can trigger chest pain, which is characteristic of angina pectoris. Therefore, the cause of angina pectoris is the inadequate supply of oxygen to the myocardium, making option B the correct answer.
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When taking the blood pressure of a client who has AIDS the nurse must;
- A. Wear a mask and gown
- B. Use barrier techniques
- C. Wash the hands thoroughly
Correct Answer: B
Rationale: When taking the blood pressure of a client with AIDS, it is important for the nurse to use barrier techniques to prevent the potential transmission of infection. This includes wearing gloves to protect against exposure to blood or other bodily fluids, using disposable blood pressure cuffs and stethoscopes, and ensuring proper hand hygiene before and after the procedure. Barrier techniques help minimize the risk of cross-contamination and protect both the healthcare provider and the client from potential infections.
Which clinical manifestation would be seen in a child with chronic renal failure?
- A. Hypotension
- B. Massive hematuria
- C. Hypokalemia
- D. Unpleasant "uremic" breath odor
Correct Answer: D
Rationale: Chronic renal failure is characterized by the buildup of waste products and toxins in the blood due to kidney dysfunction. One common clinical manifestation in children with chronic renal failure is the development of an unpleasant "uremic" breath odor. This odor is often described as a fishy or ammonia-like smell and is a result of the accumulation of urea in the blood, which is normally filtered out by the kidneys. Other common clinical manifestations of chronic renal failure in children may include hypertension, fluid retention, electrolyte abnormalities (such as hyperkalemia rather than hypokalemia), anemia, growth failure, and bone abnormalities.
Which of the following respiratory conditions is always considered a medical emergency?
- A. Asthma
- B. Cystic fibrosis (CF)
- C. Epiglottiditis
- D. Laryngotracheobronchitis (LTB)
Correct Answer: C
Rationale: Epiglottiditis is always considered a medical emergency due to the potential risk of airway obstruction. The epiglottis is a flap of tissue that prevents food and liquids from entering the airway during swallowing. If the epiglottis becomes inflamed or infected, it can swell and block the airway, making it difficult or impossible for the person to breathe. This obstruction can rapidly progress to a life-threatening situation if not treated promptly. Therefore, epiglottiditis requires immediate medical attention to ensure the airway remains open and the individual can breathe properly.
When administering a blood transfusion to a client with multiple traumatic injuries, the nurse monitors closely for evidence of a transfusion reaction. Shortly after the transfusion begins, the client complains of chest pain, nausea and itching. When urticarial, tachycardia, and hypotension develop, the nurse stops the transfusion and notifies the physician. The nurse suspects which type of hypersensitivity reaction?
- A. Type I (immediate, anaphylactic) hypersensitivity reaction
- B. Type II (cytolytic, cytotoxic) hypersensitivity reaction
- C. Type III (immune complex) hypersensitivity reaction
- D. Type IV (cell-mediated, delayed) hypersensitivity reaction
Correct Answer: A
Rationale: The symptoms described in the scenario, such as chest pain, nausea, itching, urticaria, tachycardia, and hypotension, are indicative of an immediate hypersensitivity reaction, also known as a Type I hypersensitivity reaction. This type of reaction is triggered by the release of histamine and other inflammatory mediators from mast cells and basophils. Symptoms can range from mild to severe and can manifest rapidly after exposure to the allergen, in this case, the blood transfusion. Common manifestations include skin reactions (e.g., itching, urticaria), respiratory symptoms (e.g., chest pain, wheezing), cardiovascular changes (e.g., tachycardia, hypotension), and gastrointestinal symptoms (e.g., nausea, vomiting).
Within 20 minutes of the start of transfusion, the client develops a sudden fever. What is the nurse's first action?
- A. Force fluids
- B. Increase the flow rate of IV fluids
- C. Continue to monitor the vitals signs
- D. Stop the transfusion
Correct Answer: D
Rationale: The sudden onset of fever early in a blood transfusion can indicate a transfusion reaction, such as a febrile non-hemolytic reaction or a hemolytic reaction. The nurse's first action in this situation should be to stop the transfusion immediately to prevent further complications. Continuing to administer the blood product could worsen the reaction and harm the client. Once the transfusion is stopped, the nurse can then assess the client's condition, provide appropriate interventions, and notify the healthcare provider as needed.