Nokea
Physiologically, what happens to the brain as Alzheimer progresses?
- A. Brain stem atrophies
- B. Fluids collect
- C. Cells die
- D. tissues swells
Correct Answer: C
Rationale: The correct answer is C: Cells die. In Alzheimer's disease, there is a progressive degeneration of brain cells, leading to cell death. This results in a loss of important brain functions such as memory, cognition, and eventually, bodily functions. The atrophy of the brain stem (choice A) is not a characteristic feature of Alzheimer's. Fluid buildup (choice B) is not a primary mechanism of the disease. Tissue swelling (choice D) is not typically associated with the progression of Alzheimer's; rather, there is a gradual loss of brain tissue due to cell death.
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During surgery, the nurse observes a sudden change in the patient's level of consciousness. What is the nurse's immediate action?
- A. Administer a reversal agent for anesthesia
- B. Document the change in the patient's chart
- C. Check the patient's vital signs
- D. Notify the anesthesia provider immediately
Correct Answer: D
Rationale: The correct immediate action for the nurse is to notify the anesthesia provider immediately (Option D). This is crucial because a sudden change in the patient's level of consciousness during surgery could indicate a serious issue related to anesthesia administration. Notifying the anesthesia provider promptly allows for quick assessment and intervention to address the underlying cause, potentially preventing complications or even saving the patient's life. Administering a reversal agent (Option A) without proper evaluation by the anesthesia provider could be dangerous. Documenting the change in the patient's chart (Option B) is important but not the most immediate action. Checking the patient's vital signs (Option C) is also important but may not provide immediate insight into the cause of the change in consciousness.
A postpartum client presents with severe abdominal pain, nausea, and vomiting. Which nursing action is most appropriate?
- A. Administering antiemetic medication as ordered
- B. Encouraging the client to drink clear fluids
- C. Assessing for signs of peritonitis or surgical abdomen
- D. Providing a heating pad to alleviate abdominal discomfort
Correct Answer: C
Rationale: In a postpartum client who presents with severe abdominal pain, nausea, and vomiting, it is crucial to assess for signs of peritonitis or surgical abdomen. These signs may include rebound tenderness, guarding, rigidity, and fever. Peritonitis is a serious condition that may require immediate surgical intervention. Administering antiemetic medication, encouraging clear fluids, or providing a heating pad may not address the underlying cause of the symptoms and delay appropriate treatment. Assessing for signs of peritonitis or surgical abdomen is crucial for prompt identification and management of the client's condition.
A pregnant woman presents with fever, chills, and abdominal pain localized to the right upper quadrant. On examination, she has tenderness in the right upper abdomen and a positive Murphy's sign. Which of the following conditions is the most likely cause of these symptoms?
- A. Ectopic pregnancy
- B. Pelvic inflammatory disease
- C. Acute cholecystitis
- D. Ovarian torsion
Correct Answer: C
Rationale: The scenario described in the question is consistent with acute cholecystitis, which is inflammation of the gallbladder usually caused by an impacted gallstone in the cystic duct. The key clinical features of acute cholecystitis include fever, chills, right upper quadrant abdominal pain (which can be localized to the right upper quadrant), tenderness in the right upper abdomen, and a positive Murphy's sign (pain and inspiratory arrest upon palpation of the right upper quadrant). This condition is more common in pregnant women due to hormonal changes that can lead to gallstone formation and subsequent inflammation of the gallbladder. Ectopic pregnancy, pelvic inflammatory disease, and ovarian torsion typically present with different clinical features compared to those described in acute cholecystitis.
A patient undergoing mechanical ventilation in the ICU develops acute exacerbation of chronic obstructive pulmonary disease (COPD). What intervention should the healthcare team prioritize to manage the patient's exacerbation?
- A. Initiate non-invasive positive pressure ventilation (NIPPV).
- B. Administer bronchodilator medications for bronchodilation.
- C. Perform endotracheal intubation for invasive mechanical ventilation.
- D. Recommend chest physiotherapy to promote airway clearance.
Correct Answer: A
Rationale: The correct answer is A: Initiate non-invasive positive pressure ventilation (NIPPV). This intervention is prioritized as it helps improve oxygenation and ventilation in COPD exacerbation without the need for invasive mechanical ventilation, reducing the risk of ventilator-associated complications. NIPPV also decreases the work of breathing and can prevent the need for intubation. Administering bronchodilator medications (B) is important in COPD exacerbation but may not address the immediate need for ventilatory support. Endotracheal intubation (C) should be reserved for cases of respiratory failure not responding to NIPPV. Chest physiotherapy (D) may be beneficial in some cases but is not the first-line intervention for managing acute COPD exacerbation.
Nurse Merry 's application to Canada has finally been approved and she was advised to depart in three months But, she is also enrolled in the graduate school and ambivalent to go because of this engagement plus the fact that her mother has just been discharged from the hospital. Which of the following actions is BEST?
- A. Tell family that the. money spent in graduate school can be easily earned in Canada
- B. Inform the agency that she could go anytime as they wish.
- C. Tell the recruiter to give her more time to settle her personal affairs.
- D. Share to friends this is her escape from her sad life with her family.
Correct Answer: C
Rationale: The correct answer is C. Nurse Merry should tell the recruiter to give her more time to settle her personal affairs before departing to Canada. This is the best action because it shows responsibility and consideration for her current commitments and family situation. By requesting more time, she can prioritize her mother's recovery and complete her graduate studies, demonstrating good decision-making skills and care for her loved ones.
Option A is incorrect because it dismisses the importance of family and personal obligations. Option B is incorrect as it shows a lack of planning and responsibility. Option D is incorrect as it suggests running away from problems instead of addressing them responsibly.