Nokea
Sympathetic stimulation of the respiratory system leads to what?
- A. Decreased depth of respirations.
- B. Increased perfusion of lungs.
- C. Increase respiratory rate.
- D. Decreased respiratory rate.
Correct Answer: C
Rationale: Sympathetic stimulation of the respiratory system causes an increase in respiratory rate to enhance oxygen intake during fight or flight response. This is due to activation of sympathetic nerves that stimulate the respiratory muscles and increase the rate of breathing. Choice A is incorrect as sympathetic stimulation typically increases, not decreases, the depth of respirations. Choice B is incorrect because sympathetic stimulation does not directly affect lung perfusion. Choice D is incorrect because sympathetic stimulation generally increases, rather than decreases, the respiratory rate.
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Order: 1000ml D5W at 120ml/hr. Available: Macro drop 15ml/hr. What is the drip factor in drops per minute?
- A. 30 gtt/min.
- B. 33 gtt/min.
- C. 31 gtt/min.
- D. 32 gtt/min.
Correct Answer: A
Rationale: To calculate the drip factor in drops per minute, we use the formula: Drip factor = (Volume to be infused in ml) x (drop factor) / (Time in minutes). In this case, Volume = 1000ml, drop factor = 15 gtt/hr, and Time = 60 minutes (to convert 1 hour to minutes). Therefore, Drip factor = (1000ml) x (15 gtt/hr) / (60 min) = 250 gtt/min. However, since the available drop factor is 15 ml/hr and not 1 ml/hr, we need to adjust by dividing by 5 (15 ml/hr ÷ 3 ml/hr = 5). Therefore, the correct drip factor is 250 gtt/min ÷ 5 = 30 gtt/min (rounded to the nearest whole number).
Summary:
A: 30 gtt/min - Correct calculation.
B: 33 gtt/min - Incorrect calculation
The nurse is preparing to assist with blood collection on a newly admitted patient who has been taking phenytoin for several years. The provider has ordered a complete blood count and liver function tests. Which other blood test will the nurse discuss with the provider?
- A. Coagulation studies.
- B. Serum electrolytes.
- C. Renal function tests.
- D. Blood glucose.
Correct Answer: D
Rationale: The correct answer is D: Blood glucose. Phenytoin can potentially affect blood glucose levels by causing hyperglycemia. Monitoring blood glucose levels is important to ensure the patient's safety and adjust medication dosages if needed.
Other choices are incorrect:
A: Coagulation studies are not typically affected by phenytoin therapy.
B: Serum electrolytes may need monitoring for other reasons, but not specifically related to phenytoin use.
C: Renal function tests are important for monitoring kidney function but are not directly influenced by phenytoin.
A patient exhibits ptosis of both eyes and the provider orders edrophonium (Tensilon). The nurse notes immediate improvement of the ptosis. The nurse understands that this patient most likely has which disorder?
- A. Myasthenia gravis.
- B. Cerebral palsy.
- C. Multiple sclerosis.
- D. Muscle spasm.
Correct Answer: A
Rationale: The correct answer is A: Myasthenia gravis. Edrophonium is a reversible acetylcholinesterase inhibitor that improves muscle strength in patients with myasthenia gravis due to its ability to increase acetylcholine levels at the neuromuscular junction. The immediate improvement of ptosis after administration of edrophonium suggests a diagnosis of myasthenia gravis, a disorder characterized by muscle weakness and fatigability. Cerebral palsy (B) is a non-progressive neurological disorder not typically associated with ptosis and not responsive to edrophonium. Multiple sclerosis (C) is an autoimmune demyelinating disorder that does not typically present with ptosis. Muscle spasm (D) does not explain the ptosis and would not improve with edrophonium.
The nurse is helping develop a plan of care for a patient that has advanced Alzheimer's disease. The patient will be taking a new medication. Which is a realistic goal for this patient?
- A. Exhibit ability to provide self-care.
- B. Show improved memory for recent events.
- C. Receive appropriate assistance for care needs.
- D. Demonstrate improved cognitive function.
Correct Answer: C
Rationale: The correct answer is C: Receive appropriate assistance for care needs. For a patient with advanced Alzheimer's disease, improving memory or cognitive function is unrealistic due to the progressive nature of the disease. Providing self-care may also be beyond their ability. Setting a goal for the patient to receive appropriate assistance for care needs is realistic and important for maintaining their quality of life and safety. This goal focuses on ensuring the patient's basic needs are met and promoting their overall well-being despite their cognitive decline. It prioritizes practical support and enhances the patient's quality of life.
A 54-year-old man has a myocardial infarction, resulting in left-sided heart failure. The nurse caring for the man is most concerned that he will develop edema in what area of the body.
- A. Peripheral.
- B. Pulmonary.
- C. Liver.
- D. Abdominal.
Correct Answer: B
Rationale: The correct answer is B: Pulmonary. Left-sided heart failure leads to the accumulation of fluid in the lungs, causing pulmonary edema. As the heart fails to pump effectively, blood backs up into the pulmonary circulation, leading to increased pressure in the blood vessels of the lungs. This results in fluid leakage into the alveoli, impairing gas exchange and causing symptoms like shortness of breath and coughing. Peripheral edema (choice A) occurs in right-sided heart failure due to fluid accumulation in the extremities. Liver congestion (choice C) can lead to hepatomegaly but is not the primary concern in this case. Abdominal edema (choice D) may occur in severe cases but is not as immediate a concern as pulmonary edema in left-sided heart failure.