Nokea
What should be the first medication given for wheezing due to an allergic reaction?
- A. Albuterol via nebulizer
- B. Cromolyn via nebulizer
- C. Methylprednisolone IV
- D. Aminophylline 500 mg IV
Correct Answer: A
Rationale: The correct answer is A, Albuterol via nebulizer. Albuterol is the first-line medication for treating wheezing caused by an allergic reaction as it works as a bronchodilator, helping to relieve the symptoms of wheezing and shortness of breath quickly. Cromolyn (choice B) is used more for preventing asthma symptoms rather than for immediate relief. Methylprednisolone IV (choice C) and Aminophylline 500 mg IV (choice D) are not the first-line treatments for wheezing due to an allergic reaction.
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A nurse is administering insulin to a patient after misreading their glucose as 210 mg/dL instead of 120 mg/dL. What should the nurse monitor for?
- A. Monitor for hypoglycemia
- B. Monitor for hyperkalemia
- C. Administer glucose IV
- D. Document the incident
Correct Answer: A
Rationale: The correct answer is to monitor for hypoglycemia. Insulin administration based on a misread glucose level can lead to hypoglycemia due to the unnecessary lowering of blood sugar levels. Monitoring for hypoglycemia involves assessing the patient's blood glucose levels frequently, observing for signs and symptoms such as shakiness, confusion, sweating, and administering glucose if hypoglycemia occurs. Choice B, monitoring for hyperkalemia, is incorrect as insulin administration typically lowers potassium levels. Choice C, administering glucose IV, is not the immediate action needed as the patient could potentially develop hypoglycemia from the excess insulin. Choice D, documenting the incident, is important but not the immediate priority when dealing with a potential hypoglycemic event.
What dietary recommendation should be given to a patient with pre-dialysis end-stage kidney disease?
- A. Limit phosphorus intake to 700 mg/day
- B. Increase sodium intake
- C. Restrict protein intake to 0.55-0.60 g/kg/day
- D. Eat three large meals per day
Correct Answer: A
Rationale: The correct dietary recommendation for a patient with pre-dialysis end-stage kidney disease is to limit phosphorus intake to 700 mg/day. Excess phosphorus can be harmful to individuals with kidney disease as their kidneys are not able to remove it effectively. Choice B is incorrect as increasing sodium intake is generally not recommended for individuals with kidney disease due to its association with high blood pressure. Choice C is also incorrect as protein restriction is a common recommendation for patients with advanced kidney disease, but the range provided is not accurate. Choice D is incorrect as eating three large meals per day may not be suitable for managing the condition.
What ECG changes are associated with hyperkalemia?
- A. Flattened T waves
- B. ST depression
- C. Prominent U waves
- D. Elevated ST segments
Correct Answer: B
Rationale: Hyperkalemia is known to cause ST depression on an ECG. Flattened T waves are more commonly seen in hypokalemia. Prominent U waves are associated with hypokalemia rather than hyperkalemia. Elevated ST segments are not typical findings in hyperkalemia.
What is the initial action for treating chest pain in acute coronary syndrome?
- A. Administer sublingual nitroglycerin
- B. Administer aspirin
- C. Check cardiac enzymes
- D. Obtain IV access
Correct Answer: A
Rationale: The correct initial action for treating chest pain in acute coronary syndrome is to administer sublingual nitroglycerin. Nitroglycerin helps dilate blood vessels, reducing the workload on the heart and improving blood flow to the heart muscle. Administering aspirin can also be beneficial, but the priority is to address chest pain promptly. Checking cardiac enzymes and obtaining IV access are important steps but are not the initial actions needed to alleviate chest pain in acute coronary syndrome.
What does continuous bubbling in the water seal chamber of a chest tube indicate?
- A. An air leak
- B. A blocked chest tube
- C. Normal chest tube function
- D. Continuous drainage from the chest tube
Correct Answer: A
Rationale: Continuous bubbling in the water seal chamber of a chest tube indicates an air leak in the system. This occurs when air is entering the system through a leak, preventing the lung from fully re-expanding. Choice B, a blocked chest tube, is incorrect as a blocked tube would result in a lack of drainage rather than continuous bubbling. Choice C, normal chest tube function, is incorrect as continuous bubbling signifies an issue. Choice D, continuous drainage from the chest tube, is incorrect as bubbling in the water seal chamber specifically indicates an air leak, not just the presence of drainage.