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When fluid is present in the alveoli what is the result?
- A. Alveoli collapse and atelectasis occurs.
- B. Diffusion of oxygen and carbon dioxide is impaired.
- C. Hypoventilation occurs.
- D. The patient is in heart failure.
Correct Answer: A
Rationale: The correct answer is A: Alveoli collapse and atelectasis occurs. When fluid is present in the alveoli, it impairs the surface tension necessary for the alveoli to remain open, leading to collapse and atelectasis. This prevents proper gas exchange, resulting in hypoxemia. Choice B is incorrect because impaired gas diffusion typically occurs with conditions affecting the alveolar-capillary membrane, not fluid in the alveoli. Choice C is incorrect as hypoventilation refers to decreased ventilation, not specifically related to fluid in the alveoli. Choice D is incorrect as fluid in the alveoli is not a direct indicator of heart failure.
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What is the primary mode of action of a neuromuscular bl ocking agent?
- A. Analgesia
- B. Anticonvulsant
- C. Paralysis
- D. Sedation
Correct Answer: C
Rationale: The correct answer is C: Paralysis. Neuromuscular blocking agents work by blocking the transmission of nerve impulses at the neuromuscular junction, leading to muscle paralysis. This paralysis helps facilitate intubation, surgical procedures, and mechanical ventilation.
A: Analgesia - Neuromuscular blocking agents do not provide pain relief; they primarily induce muscle paralysis without affecting pain sensation.
B: Anticonvulsant - Neuromuscular blocking agents do not prevent or treat seizures; their mechanism of action is not related to controlling convulsions.
D: Sedation - Neuromuscular blocking agents do not induce sedation; they specifically target the neuromuscular junction to cause muscle paralysis.
A 16-year-old male client is admitted to the hospital after falling off a bike and sustaining a fractured bone. The healthcare provider explains the surgery needed to immobilize the fracture. Which action should be implemented to obtain a valid informed consent?
- A. Obtain the permission of the custodial parent for the surgery.
- B. Notify the non-custodial parent to also sign a consent form.
- C. Instruct the client sign the consent before giving medications.
- D. Obtain the signature of the client’s stepfather for the surgery.
Correct Answer: A
Rationale: The correct answer is A: Obtain the permission of the custodial parent for the surgery. In this scenario, the client is a minor (16 years old), which means they are not legally able to provide informed consent for medical procedures. The custodial parent holds legal responsibility for the minor's healthcare decisions. Thus, obtaining the permission of the custodial parent is crucial to ensure valid informed consent.
Choice B is incorrect because the non-custodial parent's consent may not be legally required if the custodial parent is available to provide consent. Choice C is incorrect because obtaining consent should precede any administration of medications. Choice D is incorrect as the stepfather's consent may not hold legal weight unless designated as a legal guardian.
Which of the following patients is at the greatest risk of developing acute kidney injury? A patient who
- A. has been on aminoglycosides for the past 6 days
- B. has a history of controlled hypertension with a blood pressure of 138/88 mm Hg
- C. was discharged 2 weeks earlier after aminoglycoside therapy of 2 weeks
- D. has a history of fluid overload as a result of heart failure
Correct Answer: D
Rationale: The correct answer is D because a patient with a history of fluid overload due to heart failure is at the greatest risk of developing acute kidney injury. Heart failure can lead to decreased kidney perfusion causing acute kidney injury. In this scenario, the patient's fluid overload exacerbates the situation, further compromising kidney function.
Choice A is incorrect as aminoglycosides can cause kidney injury but the duration of 6 days is less concerning compared to chronic fluid overload from heart failure in choice D. Choice B is incorrect because controlled hypertension does not directly increase the risk of acute kidney injury. Choice C is incorrect as the patient being discharged 2 weeks earlier after aminoglycoside therapy does not necessarily indicate a higher risk compared to chronic fluid overload.
When caring for a patient with a pulmonary artery (PA) pressure catheter, the nurse observes that the PA waveform indicates that the catheter is in the wedged position. Which action should the nurse take next?
- A. Zero balance the transducer.
- B. Activate the fast flush system.
- C. Notify the health care provider.
- D. Deflate and reinflate the PA balloon.
Correct Answer: C
Rationale: The correct answer is C: Notify the health care provider. When the PA waveform indicates the catheter is in the wedged position, it means the catheter tip is in the pulmonary artery, potentially causing complications. The nurse should notify the healthcare provider immediately to assess and reposition the catheter to prevent further issues. Zero balancing the transducer (A) or activating the fast flush system (B) are not appropriate actions for this situation. Deflating and reinflating the PA balloon (D) could exacerbate the issue and should only be done under the guidance of the healthcare provider.
The most common cause of acute kidney injury in critically ill patients is
- A. sepsis.
- B. fluid overload.
- C. medications.
- D. hemodynamic instability.
Correct Answer: A
Rationale: The correct answer is A: sepsis. Sepsis is the most common cause of acute kidney injury in critically ill patients due to the systemic inflammatory response causing renal hypoperfusion. Sepsis leads to a decrease in renal blood flow, resulting in acute kidney injury. Fluid overload (B) can contribute to renal dysfunction but is not the primary cause in critically ill patients. Medications (C) can cause kidney injury, but sepsis is more prevalent. Hemodynamic instability (D) is a consequence of sepsis and can lead to acute kidney injury, making it an indirect cause.