Nokea
Which of the following signs is indicative of shock in a trauma patient?
- A. Increased heart rate
- B. Hypertension
- C. Rapid capillary refill
- D. Hyperthermia
Correct Answer: C
Rationale: Rapid capillary refill is a sign indicative of shock in a trauma patient. Shock is a life-threatening condition where the body's organs and tissues do not receive adequate blood flow and oxygen, leading to cellular damage and eventual organ failure. In a trauma patient, rapid capillary refill suggests poor perfusion, which is a common feature of shock. The capillary refill time is an important clinical assessment that measures the time it takes for color to return to the nail bed after pressure is applied. In cases of shock, the refill time is faster than normal, indicating a systemic circulatory disturbance. Other signs of shock may include tachycardia (increased heart rate), hypotension (not hypertension), and hypothermia (not hyperthermia).
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Which of the following structures is responsible for transporting food from the oral cavity to the esophagus during swallowing?
- A. Tongue
- B. Pharynx
- C. Esophagus
- D. Epiglottis
Correct Answer: B
Rationale: The pharynx is the structure responsible for transporting food from the oral cavity to the esophagus during swallowing. When food is chewed and mixed with saliva in the oral cavity, it forms a bolus that is propelled to the pharynx by the tongue. The pharynx serves as a common passageway for both air and food, allowing the bolus to pass into the esophagus while preventing it from entering the trachea. The epiglottis, although important in preventing food from entering the airway, is not directly involved in the transportation of food from the oral cavity to the esophagus.
Which of the following clinical features is most characteristic of acute respiratory distress syndrome (ARDS)?
- A. Hypoxemia refractory to supplemental oxygen
- B. Severe cough with purulent sputum production
- C. Chest pain exacerbated by deep breathing
- D. Productive cough with hemoptysis
Correct Answer: A
Rationale: Acute respiratory distress syndrome (ARDS) is a serious and life-threatening condition characterized by rapid onset of respiratory failure, severe hypoxemia (low oxygen levels in the blood), and non-cardiogenic pulmonary edema. The hallmark of ARDS is severe hypoxemia that is difficult to correct even with high levels of supplemental oxygen. Patients with ARDS often require mechanical ventilation to maintain adequate oxygen levels. Severe cough with purulent sputum production, chest pain exacerbated by deep breathing, and productive cough with hemoptysis are not typical features of ARDS.
Which of the following is NOT a step of record keeping?
- A. Structuring
- B. Securing
- C. Storing
- D. Easy Disposa l
Correct Answer: D
Rationale: Record keeping involves several key steps such as structuring, securing, and storing information. However, easy disposal is not a step in record keeping. In fact, it is important to carefully consider the disposal of records in a secure and responsible manner to protect sensitive information and comply with relevant regulations. Proper disposal methods should be followed to ensure that records are not accessible to unauthorized individuals and that any sensitive information is properly destroyed to prevent misuse or breaches of privacy. Therefore, easy disposal is not a recommended practice in effective record keeping.
A patient presents with swelling of the ankles, dyspnea on exertion, and orthopnea. An echocardiogram reveals decreased left ventricular ejection fraction and dilated left ventricle. Which cardiovascular disorder is most likely responsible for these symptoms?
- A. Stable angina
- B. Heart failure with preserved ejection fraction
- C. Heart failure with reduced ejection fraction
- D. Valvular heart disease
Correct Answer: C
Rationale: The patient's presentation of swelling of the ankles, dyspnea on exertion, and orthopnea is highly suggestive of heart failure. The echocardiogram findings of decreased left ventricular ejection fraction and dilated left ventricle are characteristic of heart failure with reduced ejection fraction (HFrEF), also known as systolic heart failure. In this condition, the heart's ability to pump blood effectively is compromised, leading to symptoms of congestion and decreased cardiac output. The decreased ejection fraction indicates that the heart is not able to efficiently pump out blood with each contraction. Dilatation of the left ventricle is a compensatory mechanism in response to increased volume overload.
A patient with chronic kidney disease is prescribed erythropoietin-stimulating agents (ESAs) to manage anemia. Which laboratory parameter should be monitored closely during ESA therapy?
- A. Serum potassium
- B. Serum creatinine
- C. Hemoglobin
- D. Platelet count
Correct Answer: C
Rationale: Erythropoietin-stimulating agents (ESAs) are prescribed to manage anemia in patients with chronic kidney disease. Monitoring the hemoglobin level closely during ESA therapy is crucial to ensure that the treatment is effective in increasing red blood cell production without causing excessive elevation. Hemoglobin levels should be checked regularly to adjust the ESA dosage accordingly and prevent risks associated with high hematocrit levels, such as increasing blood viscosity and cardiovascular events. Monitoring serum potassium, creatinine, and platelet count are important in the management of chronic kidney disease for different reasons, but for ESA therapy, monitoring hemoglobin is the most essential parameter.