Nokea
What diagnostic procedure is required to make a definitive diagnosis of pulmonary embolism?
- A. Arterial blood gas (ABG) analysis.
- B. Chest x-ray examination.
- C. High resolution multidetector CT angiogram.
- D. Ventilation-perfusion scanning.
Correct Answer: C
Rationale: The correct answer is C: High resolution multidetector CT angiogram. This diagnostic procedure is required for a definitive diagnosis of pulmonary embolism because it provides detailed imaging of the pulmonary vasculature, allowing visualization of blood clots in the pulmonary arteries.
A: Arterial blood gas (ABG) analysis does not directly diagnose pulmonary embolism but may show signs of hypoxemia or respiratory alkalosis, which can be seen in some cases of pulmonary embolism.
B: Chest x-ray examination may show nonspecific findings such as atelectasis or pleural effusion but cannot definitively diagnose pulmonary embolism.
D: Ventilation-perfusion scanning is another imaging modality used in the diagnosis of pulmonary embolism, but it is less commonly used compared to CT angiogram due to lower sensitivity and specificity.
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The nurse caring for a patient diagnosed with acute respiratory failure identifies “Risk for Ineffective Airway Clearance” as a nursing diagnosis. Wh at nursing intervention is relevant to this diagnosis?
- A. Elevate head of bed to 30 degrees.
- B. Obtain order for venous thromboembolism prophylaxi s.
- C. Provide adequate sedation.
- D. Reposition patient every 2 hours.
Correct Answer: A
Rationale: The correct answer is A: Elevate head of bed to 30 degrees. Elevating the head of the bed helps promote optimal airway clearance by facilitating drainage of secretions and reducing the risk of aspiration. This position also improves lung expansion and oxygenation. Choice B is important for preventing venous thromboembolism but not directly related to airway clearance. Choice C may not be appropriate as excessive sedation can impair airway clearance. Choice D is important for preventing pressure ulcers but does not directly address airway clearance.
The patient’s serum creatinine level is 0.7 mg/dL. The expected BUN level should be
- A. 1 to 2 mg/dL.
- B. 7 to 14 mg/dL.
- C. 10 to 20 mg/dL.
- D. 20 to 30 mg/dL.
Correct Answer: C
Rationale: The correct answer is C (10 to 20 mg/dL). The normal BUN-to-creatinine ratio is approximately 10:1. With a serum creatinine level of 0.7 mg/dL, the expected BUN level should be around 7 to 14 mg/dL. Therefore, choice C (10 to 20 mg/dL) falls within this expected range. Choices A, B, and D are incorrect as they do not align with the typical BUN-to-creatinine ratio and would indicate abnormal kidney function.
An ICU nurse has provided excellent care for a 6-year-old girl who had been admitted to the ICU for a head injury. The nurse was attentive not only to the needs of the patient but also went out of her way to care for the needs of the girls family. According to research, which of the following forms of recognition would the nurse value the most?
- A. A card from the girls family
- B. A plaque from the ICU physicians naming her as Nurse of the Year
- C. A letter of commendation from the hospitals administration
- D. A bouquet of flowers from her supervisor
Correct Answer: A
Rationale: Rationale: The correct answer is A: A card from the girl's family. The nurse would value this form of recognition the most because it directly reflects the impact of her care on the patient and her family. It is a personal, heartfelt gesture that acknowledges the nurse's compassion and dedication. A card from the family shows genuine appreciation and gratitude for the nurse's efforts, making it the most meaningful form of recognition.
Summary:
- Choice B: A plaque from the ICU physicians could be seen as a formal recognition but lacks the personal touch and direct impact of the nurse's care on the patient and family.
- Choice C: A letter of commendation from the hospital's administration is a professional acknowledgment but may not capture the emotional connection and impact that the nurse had on the family.
- Choice D: A bouquet of flowers from her supervisor is a nice gesture but does not necessarily reflect the specific impact of the nurse's care on the patient and family.
assessment, the patient is restless, heart rate has increased to 110 beats/min, respirations are 36 breaths/min, and blood pressure is 156/98 mm Hg. The cardiac monitor shows sinaubsir bt.acocmh/ytecsat rdia with 10 premature ventricular contractions (PVCs) per minute. Pulmonary artery pressures are elevated. The nurse suctions the patient and obtains pink, frothy secretio ns. Loud crackles are audible throughout lung fields. The nurse notifies the physician, w ho orders an ABG analysis, electrolyte levels, and a portable chest x-ray study. How d oes the nurse interpret the following blood gas levels? pH 7.28 PaCO 46 mm Hg Bicarbonate 22 mEq/L PaO 58 mm Hg O saturation 88% 2
- A. Hypoxemia and compensated respiratory alkalosis
- B. Hypoxemia and uncompensated respiratory acidosis
- C. Normal arterial blood gas levels
- D. Normal oxygen level and partially compensated metabaobliribc.c aomci/dteosts is
Correct Answer: B
Rationale: The correct answer is B: Hypoxemia and uncompensated respiratory acidosis.
Step-by-step rationale:
1. pH is low (7.28), indicating acidosis.
2. PaCO2 is elevated (46 mm Hg), indicating respiratory acidosis.
3. PaO2 is low (58 mm Hg), indicating hypoxemia.
4. Bicarbonate is within normal range (22 mEq/L), suggesting no compensation for the acidosis.
5. Oxygen saturation is low (88%), supporting the presence of hypoxemia.
Summary:
A: Incorrect - pH is low, not indicating compensated alkalosis.
C: Incorrect - Various abnormalities in the blood gas levels are present.
D: Incorrect - There is hypoxemia and uncompensated acidosis, not metabolic alkalosis.
The nurse identifies a client's needs and formulates the nursing problem of, 'Imbalanced nutrition: less than body requirements, related to mental impairment and decreased intake, as evidenced by increasing confusion and weight loss of more than 30 pounds over the last 6 months.' Which short-term goal is best for this client?
- A. Verbalize understanding of plan and of intention to eat meals.
- B. Eat 50% of six small meals each day by the end of one week.
- C. Meals prepared during hospitalization will be fed by the nurse.
- D. Demonstrate progressive weight gain toward the ideal weight.
Correct Answer: B
Rationale: The correct short-term goal for the client with imbalanced nutrition is choice B: Eat 50% of six small meals each day by the end of one week. This goal is specific, measurable, achievable, relevant, and time-bound (SMART). By setting a goal for the client to eat a specific amount of meals within a defined timeframe, it allows for objective monitoring of progress. This goal also addresses the client's decreased intake and aims to improve their nutritional status gradually.
Choice A is incorrect as verbalizing understanding does not directly address the client's nutritional needs. Choice C is not appropriate as it does not promote independence in meal consumption. Choice D is not the best short-term goal as it focuses on the outcome of weight gain rather than the process of increasing food intake. Overall, choice B is the most appropriate short-term goal as it targets the client's specific nutritional needs and provides a clear direction for intervention.