Nokea
The most common complication of respiratory distress syndrome is
- A. Cerebral palsy
- B. Pneumothorax
- C. Epilepsy
- D. Fractured ribs
Correct Answer: B
Rationale: The correct answer is B: Pneumothorax. Respiratory distress syndrome is characterized by difficulty breathing due to immature lungs in premature infants. Pneumothorax, a condition where air leaks into the chest cavity, is a common complication as the fragile lungs are prone to air leaks. Cerebral palsy (A), epilepsy (C), and fractured ribs (D) are not direct complications of respiratory distress syndrome. Pneumothorax is the most likely and common complication due to the fragility of the premature infant's lungs.
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A fetal associated risk of prolonged pregnancy includes
- A. Fetal macrosomia
- B. Placental dysfunction
- C. Cesarean section
- D. Shoulder dystocia
Correct Answer: A
Rationale: The correct answer is A: Fetal macrosomia. Prolonged pregnancy increases the risk of fetal macrosomia due to continued fetal growth beyond the normal term. This can lead to complications during delivery, such as shoulder dystocia and birth injuries. Placental dysfunction and cesarean section are possible outcomes of prolonged pregnancy but are not directly associated with fetal risks in this context. Shoulder dystocia is a potential complication of fetal macrosomia but is not a direct fetal risk of prolonged pregnancy.
The MAIN aim of encouraging plenty of fluids to a postnatal client with urinary tract trauma is to
- A. Control growth of organisms
- B. Keep client well hydrated
- C. Maintain proper fluid balance
- D. Facilitate proper healing
Correct Answer: B
Rationale: Step 1: Postnatal clients with urinary tract trauma are at risk of dehydration due to increased fluid loss.
Step 2: Encouraging plenty of fluids helps maintain hydration levels.
Step 3: Proper hydration supports kidney function and aids in flushing out bacteria, reducing infection risk.
Step 4: Adequate hydration also promotes tissue healing and prevents complications.
Step 5: Therefore, the main aim of encouraging plenty of fluids is to keep the client well hydrated.
A patient admitted for management of sepsis is critically ill and wants to talk with a hospital representative about donating her organs if she dies. She has a fairly complex medical history that includes traumatic brain injury, breast cancer, and dialysis-dependent renal failure. The patient is advised that she is ineligible to donate due to her
- A. Renal failure
- B. Traumatic brain injury
- C. Gram negative infection
- D. Breast cancer
Correct Answer: D
Rationale: The correct answer is D: Breast cancer. The patient's breast cancer is the reason she is ineligible to donate organs. Breast cancer is a contraindication for organ donation due to the risk of cancer transmission to the recipient. Traumatic brain injury (choice B) and renal failure (choice A) are not absolute contraindications to organ donation. Gram-negative infection (choice C) may temporarily disqualify the patient but can be treated, unlike breast cancer. In summary, breast cancer poses the highest risk of organ recipient harm compared to the other medical conditions listed.
A patient with chronic hepatic encephalopathy is being discharged home. Discharge teaching centers upon long-term management strategies to prevent ammonia accumulation. Teaching for this patient includes instruction about
- A. Lactulose taken 20 g PO daily
- B. Spironolactone taken 100 mg PO daily
- C. Protein intake of 50 g daily
- D. Zolpidem taken 10 mg PO qhs.
Correct Answer: C
Rationale: The correct answer is C: Protein intake of 50 g daily. In hepatic encephalopathy, reducing protein intake is crucial to prevent ammonia accumulation. Protein breakdown in the body leads to ammonia production, which worsens encephalopathy symptoms. Limiting protein intake to 50g daily helps decrease ammonia formation. Lactulose (choice A) is used to reduce ammonia absorption in the gut. Spironolactone (choice B) is a diuretic used to treat fluid retention in liver disease. Zolpidem (choice D) is a sedative and not related to managing ammonia accumulation in hepatic encephalopathy. Therefore, choices A, B, and D are incorrect for long-term management of ammonia accumulation in hepatic encephalopathy.
The AGACNP is covering an internal medicine service and is paged by staff to see a patient who has just pulled out his ET tube. After the situation has been assessed, it is clear that the patient will go into respiratory failure and likely die if he is not reintubated. The patient is awake and alert and is adamant that he does not want to be reintubated. The AGACNP is concerned that there is not enough time to establish a DNRthe patient needs to be reintubated immediately and already is becoming obtunded. Which ethical principles are in conflict here?
- A. Veracity and beneficence
- B. Beneficence and nonmalfeasance
- C. Autonomy and beneficence
- D. Justice and autonomy
Correct Answer: A
Rationale: The correct answer is A: Veracity and beneficence. Veracity refers to truthfulness, and the AGACNP is facing a conflict between being honest with the patient about the need for reintubation (veracity) and providing beneficence by ensuring the patient receives necessary medical care to prevent harm. The patient's autonomy and right to make decisions are not directly in conflict since the patient is conscious, and autonomy is respected by honoring the patient's wishes. Justice is also not in conflict here as it does not pertain to the immediate ethical dilemma of reintubation. Autonomy and beneficence are not in direct conflict as the patient's autonomy is being respected by allowing them to make an informed decision. Nonmalfeasance is not directly applicable in this scenario.