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Thirty people are injured in a train derailment. Ineffective and the transported to the hospital first?
- A. A 20-year-old who is unresponsive and has a high injury to his spinal cord.
- B. An 80-year-old who has a compound fracture of the arm.
- C. A 10-year-old with a laceration on his leg.
- D. A 25-year-old with a sucking chest wound.
Correct Answer: D
Rationale: A sucking chest wound is a life-threatening condition that can impair breathing and requires immediate intervention, prioritizing this patient for transport over others with less urgent injuries.
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A client with Raynaud's phenomenon is prescribed diltiazem (Cardizem). An expected outcome is:
- A. Decreased heart rate
- B. A return to normal sinus rhythm
- C. Reduced episodes of finger numbness
- D. Increased SpO2
Correct Answer: C
Rationale: Diltiazem, a calcium channel blocker, reduces vasospasm in Raynaud's by promoting vasodilation, decreasing episodes of finger numbness. It may lower heart rate or affect rhythm, but these are not primary goals, and SpO2 is not directly improved.
The incidence and risk of cancer increase when smoking is combined with:
- A. Asbestos exposure and alcohol consumption.
- B. Ultraviolet radiation exposure and alcohol consumption.
- C. Asbestos exposure and ultraviolet radiation exposure.
- D. Alcohol consumption and human papillomavirus (HPV) infection.
Correct Answer: A
Rationale: Smoking combined with asbestos exposure and alcohol consumption significantly increases cancer risk, particularly for lung and head/neck cancers, due to synergistic carcinogenic effects.
The client with acute leukemia and the health care team establish mutual client outcomes of improved tidal volume and activity tolerance. Which measure would be least likely to promote outcome achievement?
- A. Ambulating in the hallway.
- B. Sitting up in a chair.
- C. Lying in bed and taking deep breaths.
- D. Using a stationary bicycle in the room.
Correct Answer: C
Rationale: Improving tidal volume and activity tolerance requires active movement to enhance lung expansion and stamina. Ambulating, sitting up, and using a stationary bicycle promote these outcomes. Lying in bed, even with deep breaths, is passive and least effective.
A client has had multiple sclerosis (MS) for 15 years and has received various drug therapies. What is the primary reason why the nurse has found it difficult to evaluate the effectiveness of the drugs that the client has used?
- A. The client exhibits intolerance to many drugs.
- B. The client experiences spontaneous remissions from time to time.
- C. The client requires multiple drugs simultaneously.
- D. The client endures long periods of exacerbation before the illness responds to a particular drug.
Correct Answer: B
Rationale: Spontaneous remissions in MS make it challenging to attribute symptom improvement to drugs versus natural disease course. Intolerance, multiple drugs, or delayed responses are less primary factors.
Because a client's renal stone was found to be composed of uric acid, a low-purine, alkaline-ash diet was ordered. Incorporation of which of the following food items into the home diet would indicate that the client understands the necessary diet modifications?
- A. Milk, apples, tomatoes, and corn.
- B. Eggs, spinach, dried peas, and gravy.
- C. Salmon, chicken, and asparagus.
- D. Grapes, corn, cereals, and liver.
Correct Answer: A
Rationale: Milk, apples, tomatoes, and corn are low-purine and promote an alkaline-ash diet, suitable for uric acid stone prevention.