Nokea
Signs and symptoms of a fecal impaction include the following:
- A. Urgency and black stools
- B. Urination and flatus
- C. Bleeding and itching
- D. Abdominal cramps and vomiting
Correct Answer: D
Rationale: The correct answer is D: Abdominal cramps and vomiting. Fecal impaction can cause abdominal cramps due to the blockage of the colon. Vomiting can occur as a result of the pressure and discomfort caused by the impaction. Urgency and black stools (A) are more indicative of lower gastrointestinal issues like bleeding or inflammation. Urination and flatus (B) are not typical signs of fecal impaction. Bleeding and itching (C) are more commonly associated with hemorrhoids or anal fissures, not fecal impaction.
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2 Under what conditions should a nursing assistant complete an incident report if he is injured on the job?
- A. Only if the injury is serious
- B. Only if the nursing assistant feels the facility is at fault
- C. Only if another employee was involved
- D. Any time he is injured on the job
Correct Answer: D
Rationale: The correct answer is D because completing an incident report after any on-the-job injury is crucial for documentation, regardless of the severity or fault. This process ensures proper record-keeping, aids in identifying safety hazards, and helps in providing necessary medical care and support to the injured individual. Choices A, B, and C are incorrect because they impose unnecessary restrictions on when to report an injury, which can hinder the overall safety and well-being of the nursing assistant and others in the facility.
A symptom of fluid overload is
- A. Skin that appears tight, smooth, and shiny
- B. Weight loss
- C. Increased urine output
- D. Decreased heart rate
Correct Answer: A
Rationale: The correct answer is A. Skin that appears tight, smooth, and shiny is a symptom of fluid overload due to increased fluid retention in the body. This occurs because excess fluid accumulates in the tissues, causing the skin to appear tight and shiny.
B: Weight loss is not a symptom of fluid overload, as excess fluid retention typically leads to weight gain.
C: Increased urine output is a symptom of fluid volume deficit, not fluid overload.
D: Decreased heart rate is not typically associated with fluid overload; instead, it may be a sign of dehydration.
A machine used to reduce fluid buildup and improve circulation is a(n)
- A. Antiembolic plastic sleeve
- B. Continuous bladder irrigation
- C. Catheter irrigation
- D. Sequential compression stocking
Correct Answer: D
Rationale: The correct answer is D: Sequential compression stocking. This machine helps reduce fluid buildup and improve circulation by applying sequential pressure to the legs, aiding in venous return. The other choices, A: Antiembolic plastic sleeve, B: Continuous bladder irrigation, and C: Catheter irrigation, do not specifically address reducing fluid buildup or improving circulation in the context of the question.
A four-year-old girl, weighing approximately 20kg is admitted in shock after an automobile crash. The initial fluid challenge or bolus should consist of Ringers lactate solution in the volume of
- A. "200ml"
- B. 400ml
- C. 440ml
- D. 600ml
Correct Answer: B
Rationale: The correct answer is B: 400ml. In pediatric resuscitation, the initial fluid bolus is usually calculated based on weight. The standard recommendation is to give 20ml/kg of Ringers lactate solution in shock. In this case, the girl weighs 20kg, so 20 x 20 = 400ml. This volume helps to restore intravascular volume and improve perfusion. Choice A (200ml) is insufficient for her weight, C (440ml) is slightly excessive, and D (600ml) is too much and could lead to fluid overload and potential complications.
You are on scene at a motor vehicle accident, and your 20-year-old patient is entrapped. He is unconscious, unresponsive, and has a palpable carotid pulse that is weak and thready. His breathing is slow and shallow at four times a minute with equal chest wall expansion. There are no obvious deformity injuries or hemorrhage noted. Fire department on-scene has stabilized the vehicle and provided you and your partner a relatively safe environment to manage the entrapped patient. However, access is limited to the seated patient, and extrication is expected to take another twenty minutes. After having your partner maintain cervical spine stabilization, which of the following would be the best choice for securing the patient's airway?
- A. Insert a nasal airway and administer high-flow oxygen therapy
- B. Use nasotracheal intubation techniques to gain complete control of the patient's airway and assist ventilation
- C. Intubate the patient using the blind orotracheal intubation technique to maintain in-line mobilization of the spine, then assist ventilation
- D. Insert a King LTD and begin assisting ventilations with a bag-valve mask
Correct Answer: C
Rationale: The correct answer is C: Intubate the patient using the blind orotracheal intubation technique to maintain in-line mobilization of the spine, then assist ventilation. In this scenario, the patient is entrapped with limited access and expected extrication time of 20 minutes. Given the patient's unconsciousness, unresponsiveness, weak carotid pulse, and slow, shallow breathing, securing the airway is crucial to ensure adequate oxygenation and ventilation. Intubating the patient using the blind orotracheal technique allows for maintaining in-line mobilization of the spine, reducing the risk of further spinal injury during the extrication process. This approach provides a more definitive airway management compared to nasal airway insertion or bag-valve mask ventilation. Nasotracheal intubation (choice B) may not be feasible due to limited access and potential for further injury. Using a King LTD (choice D) is not recommended in this situation as it does not provide the same