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When the patient turned 69 years old, Orinase was discontinued and NPH insulin is prescribed for her. After several months, she is determined to be suffering from sumogyi effect. Which of the following conditons will most likely result when the patient is receiving too much insulin?
- A. Developing an elevation of the blood glucose level
- B. Producing even more insulin
- C. Becoming resistant to insulin
- D. Conserving excessive amount of fluid
Correct Answer: A
Rationale: When a patient is receiving too much insulin, the most likely result is hypoglycemia, not hyperglycemia. The excess insulin causes the blood glucose level to drop too low, leading to symptoms such as sweating, tremors, confusion, and in severe cases, seizures. The body responds to hypoglycemia by releasing counterregulatory hormones such as glucagon, epinephrine, and cortisol, which work to increase the blood glucose level. This rebound effect, known as the Somogyi effect, can result in the patient experiencing high blood glucose levels after a period of insufficient glucose supply due to excessive insulin administration.
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A patient is having elective surgery under general anesthesia. Who is responsible for obtaining the informed-consent?
- A. Surgeon
- B. Nurse anesthetist
- C. Nurse
- D. Anesthesiologist
Correct Answer: A
Rationale: The primary responsibility for obtaining informed consent lies with the surgeon who will be performing the procedure. Informed consent is a process where the healthcare provider explains the procedure, benefits, risks, and alternatives to the patient, allowing them to make an informed decision about their care. While other healthcare team members may also participate in this process, the ultimate responsibility typically rests with the surgeon as they are the one performing the surgery.
Nurse bea wants to pursue higher education in Nursing for her career advancement. Aside from enrolling in graduate school, which of the following she could enhance her career?
- A. Participates in professional organization
- B. Attends seminars.
- C. Conduct research
- D. Attends symposium Situation
Correct Answer: A
Rationale: Participating in professional organizations can provide Nurse Bea with numerous opportunities to network with other professionals in the field, stay updated with the latest trends and developments in nursing, access resources for professional growth, and even participate in leadership roles within the organization. Being active in a professional organization can help Nurse Bea build her professional profile, gain recognition, and open up possibilities for career advancement and opportunities for collaboration and learning from peers. It can also help her stay connected with the broader nursing community and enhance her visibility within the field. Engaging with a professional organization is a valuable way for Nurse Bea to enhance her career alongside pursuing further education.
A patient presents with chest pain, dyspnea, and a history of recent surgery or trauma. An echocardiogram reveals a large pericardial effusion with right ventricular collapse during diastole. Which cardiovascular disorder is most likely responsible for these symptoms?
- A. Stable angina
- B. Pericardial effusion
- C. Myocardial infarction
- D. Aortic dissection
Correct Answer: B
Rationale: The cardiovascular disorder most likely responsible for the symptoms described is a pericardial effusion. A pericardial effusion is an accumulation of fluid within the pericardial space surrounding the heart. When a large pericardial effusion is present, it can lead to compression of the heart chambers, resulting in symptoms such as chest pain and dyspnea.
A patient receiving palliative care for end-stage chronic obstructive pulmonary disease (COPD) experiences chronic cough and excessive sputum production. What intervention should the palliative nurse prioritize to address the patient's symptoms?
- A. Administer bronchodilator medications to improve airway clearance.
- B. Encourage the patient to practice controlled coughing techniques.
- C. Prescribe mucolytic medications to thin respiratory secretions.
- D. Refer the patient to a respiratory therapist for breathing exercises.
Correct Answer: B
Rationale: Encouraging the patient to practice controlled coughing techniques would be the most appropriate intervention to address the symptoms of chronic cough and excessive sputum production in a patient with end-stage COPD receiving palliative care. Controlled coughing techniques can help the patient effectively clear respiratory secretions and improve airway clearance without the need for additional medications or interventions. This approach focuses on optimizing the patient's ability to manage their symptoms and maintain comfort, which aligns with the goals of palliative care. Administering bronchodilator medications, prescribing mucolytic medications, or referring the patient to a respiratory therapist for breathing exercises may have limited effectiveness in this advanced stage of the disease, and controlled coughing techniques would be a more practical and patient-centered approach to symptom management.
A patient presents with fever, chills, headache, and myalgia after returning from a trip to sub-Saharan Africa. Laboratory tests reveal intraerythrocytic ring forms and trophozoites on blood smear examination. Which of the following is the most likely causative agent?
- A. Plasmodium falciparum
- B. Trypanosoma cruzi
- C. Borrelia burgdorferi
- D. Leishmania donovani
Correct Answer: A
Rationale: The patient's symptoms of fever, chills, headache, and myalgia after returning from sub-Saharan Africa are consistent with malaria. Intraerythrocytic ring forms and trophozoites observed on blood smear examination are characteristic of Plasmodium species, particularly Plasmodium falciparum, which is the most common and deadliest species causing malaria in sub-Saharan Africa. Plasmodium falciparum can lead to severe complications, such as cerebral malaria, if not promptly treated. Trypanosoma cruzi causes Chagas disease, not malaria. Borrelia burgdorferi is responsible for Lyme disease, which typically presents with a different set of symptoms like erythema migrans rash. Leishmania donovani causes visceral leishmaniasis, not malaria.