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Which assessment by the nurse would cause a concern for Meperidine Overdosed?
- A. Respiration rate of 12 bpm.
- B. Dryness of the skin.
- C. Hypercapnia
- D. Pinpoint pupils.
Correct Answer: C
Rationale: Meperidine (Demerol) is an opioid analgesic. Overdose of Meperidine can lead to respiratory depression, characterized by slow and shallow breathing. As a result of respiratory depression, hypercapnia, which is an increased level of carbon dioxide in the blood, can occur. This is a serious concern and requires immediate medical intervention to support respiratory function. Therefore, hypercapnia would be the assessment by the nurse that causes a concern for Meperidine overdose.
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A patient presents with gradual, painless visual field loss in both eyes, particularly in the peripheral vision. Tonometry reveals elevated intraocular pressure (IOP). Which of the following conditions is most likely responsible for this presentation?
- A. Open-angle glaucoma
- B. Closed-angle glaucoma
- C. Age-related macular degeneration
- D. Diabetic retinopathy
Correct Answer: A
Rationale: The patient presents with gradual, painless visual field loss in both eyes, particularly in the peripheral vision, which is characteristic of glaucoma. The elevated intraocular pressure (IOP) on tonometry further supports a diagnosis of glaucoma. Open-angle glaucoma is the most common type of glaucoma and typically presents insidiously with a slow progression of vision loss. In open-angle glaucoma, the drainage angle of the eye remains open but becomes less efficient over time, leading to increased intraocular pressure and optic nerve damage. This results in peripheral visual field loss. Closed-angle glaucoma, on the other hand, presents more acutely with sudden eye pain, redness, and blurred vision due to a sudden increase in intraocular pressure from a blocked drainage angle. Age-related macular degeneration and diabetic retinopathy typically do not present with elevated IOP or peripheral visual field loss.
Nurse Adalynn explains to the mothers that early indication for hypovolemia caused by postpartum hemorrhage is _____.
- A. increasing pulse and decreasing blood pressure
- B. altered mental status and level of consciousness
- C. dizziness and increasing respiratory rate
- D. Cool, clammy skin, and pale mucous membranes
Correct Answer: A
Rationale: Nurse Adalynn explains to the mothers that early indication for hypovolemia caused by postpartum hemorrhage is an increasing pulse and decreasing blood pressure. Hypovolemia is a condition where there is a decreased volume of circulating blood in the body, often characterized by fluid loss such as through bleeding. As blood volume decreases, the heart rate increases in an attempt to maintain adequate perfusion to organs and tissues. This results in an elevated pulse rate. Additionally, as the blood volume decreases, the blood pressure may drop due to the reduced amount of blood being pumped around the body. Therefore, monitoring for an increasing pulse and decreasing blood pressure is crucial in detecting hypovolemia early, allowing for prompt intervention to prevent further complications.
A patient is admitted with a suspected myocardial infarction. Which cardiac biomarker is most specific for myocardial injury?
- A. Troponin
- B. Creatine kinase-MB (CK-MB)
- C. Myoglobin
- D. Brain natriuretic peptide (BNP)
Correct Answer: A
Rationale: Troponin is the most specific cardiac biomarker for myocardial injury. Troponin I and Troponin T are proteins released into the bloodstream when there is damage to the heart muscle, making them highly indicative of myocardial infarction. Troponin levels rise within a few hours of cardiac injury, peak within 24-48 hours, and can remain elevated for up to 2 weeks. Troponin is considered the gold standard biomarker for the diagnosis of acute myocardial infarction due to its high specificity and sensitivity for cardiac injury. In contrast, Creatine kinase-MB (CK-MB) and myoglobin are also used in diagnosing myocardial infarction but are less specific than troponin. Brain natriuretic peptide (BNP) is primarily used in heart failure diagnosis and management, and its levels are not specific to myocardial injury.
Nurses are taught as students that the ideal and PROPER time for recording vital signs and notes on the patient is __________.
- A. to wait for lunch break to do the recording
- B. after al11 the tasks are done, in order to conserve time
- C. as Soon as they obtain the signs or observations on the patient
- D. to wait for lunch break to do the recording
Correct Answer: C
Rationale: It is essential for nurses to record vital signs and notes on a patient as soon as they obtain them. This allows for accurate and timely documentation of crucial information related to the patient's health status. By recording the information promptly, nurses can ensure that they do not forget important details and can provide effective care based on accurate data. Waiting for lunch break or after completing other tasks can lead to delays in documentation, which may compromise patient care and safety. Therefore, the ideal and proper time for recording vital signs and notes is immediately after obtaining them.
A patient presents with fatigue, pallor, and dyspnea on exertion. Laboratory tests reveal a low hemoglobin level, decreased mean corpuscular volume (MCV), and decreased mean corpuscular hemoglobin concentration (MCHC). Which of the following conditions is most likely to cause these findings?
- A. Iron deficiency anemia
- B. Vitamin B12 deficiency anemia
- C. Thalassemia
- D. Sickle cell anemia
Correct Answer: A
Rationale: The patient's presentation with fatigue, pallor, dyspnea on exertion, low hemoglobin level, decreased MCV, and decreased MCHC are all consistent with iron deficiency anemia. Iron deficiency anemia is the most common type of anemia and occurs when there is insufficient iron available for hemoglobin production. The low hemoglobin level results in symptoms such as fatigue and pallor, while the decreased MCV and MCHC indicate microcytic and hypochromic red blood cells, respectively, which are characteristic of iron deficiency anemia. Vitamin B12 deficiency anemia and thalassemia typically present with a different pattern of laboratory findings and clinical manifestations. Sickle cell anemia is characterized by sickle-shaped red blood cells due to a genetic mutation, and the laboratory findings in sickle cell anemia are different from those seen in the patient described in this scenario.