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Which of the following imaging modalities is most appropriate for evaluating suspected pulmonary embolism (PE) in a pregnant patient?
- A. Chest X-ray
- B. Ventilation-perfusion (V/Q) scan
- C. Contrast-enhanced computed tomography (CT) pulmonary angiography
- D. Transthoracic echocardiography
Correct Answer: C
Rationale: In a pregnant patient with suspected pulmonary embolism (PE), the most appropriate imaging modality for evaluation is contrast-enhanced computed tomography (CT) pulmonary angiography. This imaging technique has been shown to be safe for the fetus when necessary, especially if the benefits of making a diagnosis outweigh the minimal risks associated with radiation exposure. It provides quick and accurate detection of PE with high sensitivity and specificity.
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When there is respiratory depression resulting from drug overdose, the nurse have to watch for which of the following?
- A. Hyperventilation
- B. Biot's respiration
- C. Tachypnea
- D. Bradypnea Situation
Correct Answer: D
Rationale: Respiratory depression resulting from drug overdose typically leads to a decrease in the respiratory rate, known as bradypnea. This is characterized by abnormally slow breathing, which can be dangerous as it may lead to decreased oxygen levels in the blood. Bradypnea indicates a slowing down of the respiratory drive, in contrast to hyperventilation, biot's respiration, or tachypnea. It is crucial for the nurse to monitor a patient experiencing respiratory depression for signs of bradypnea and intervene promptly to prevent further complications.
Which of the following BEST describe a strong team?
- A. cohesive
- B. driven
- C. shared goa l
- D. Sense of mission
Correct Answer: A
Rationale: A strong team is cohesive, meaning its members work well together, communicate effectively, and support each other. Cohesion helps the team to function smoothly and achieve its goals efficiently. While being driven, having shared goals, and a sense of mission are important characteristics of a strong team, cohesion is the foundation that holds the team together and allows these other factors to thrive.
A cognitive assessment of Belle indicated that according to Piaget's theory she was functioning at the concrete operational stage. Which of these behaviors would the nurse observe in Belle?
- A. Thinks logically and sees possibilities.
- B. Understands only her own viewpoint.
- C. Feels her own reasoning should agree with the reasoning of others.
- D. Makes and tests hypothesis
Correct Answer: A
Rationale: At the concrete operational stage according to Piaget's theory, children typically demonstrate logical thinking abilities and are able to understand and work with concrete objects and events. They can also grasp concepts such as conservation and classification. These children are able to think logically about concrete events but may still struggle with abstract and hypothetical situations. Therefore, Belle, functioning at the concrete operational stage, would exhibit behaviors such as thinking logically and being able to see possibilities, as described in option A.
A patient receiving palliative care for end-stage liver disease develops hepatic encephalopathy, presenting with confusion and altered mental status. What intervention should the palliative nurse prioritize to manage the patient's symptoms?
- A. Administer lactulose or other ammonia-lowering agents to reduce ammonia levels.
- B. Initiate intravenous fluid therapy to correct electrolyte imbalances.
- C. Refer the patient to a neurologist for evaluation and treatment of encephalopathy.
- D. Prescribe sedative medications to promote sleep and reduce agitation.
Correct Answer: A
Rationale: The most appropriate intervention for managing hepatic encephalopathy in this patient receiving palliative care for end-stage liver disease is to administer lactulose or other ammonia-lowering agents to reduce ammonia levels. Hepatic encephalopathy is believed to be primarily caused by the accumulation of ammonia in the bloodstream due to compromised liver function. Lactulose works by acidifying the gut lumen, which facilitates the excretion of ammonia in the form of ammonium ions. By reducing ammonia levels, hepatic encephalopathy symptoms, such as confusion and altered mental status, can be improved. Initiating other supportive measures like managing precipitating factors, maintaining hydration, and addressing nutritional issues should also be part of the holistic approach in managing hepatic encephalopathy in palliative care. However, addressing the underlying cause by reducing ammonia levels with lactulose is the priority intervention in this scenario.
Cell-mediated immunity is NOT usually associated with what condition:
- A. Rejection of tissue graft
- B. Production of antibodies
- C. Skin hypersensitivity reaction
- D. Surveying for malignant cells
Correct Answer: B
Rationale: Cell-mediated immunity is a type of immune response that involves the activation of cytotoxic T cells and other immune cells to directly target and destroy infected or abnormal cells. It does not involve the production of antibodies, which are the primary component of humoral immunity. Antibodies are produced by B cells and are responsible for targeting extracellular pathogens such as bacteria and viruses. In contrast, cell-mediated immunity is more focused on targeting intracellular pathogens, cancerous cells, and other cells that have been compromised. So, production of antibodies is not usually associated with cell-mediated immunity.