Nokea
Which of the ff is the most severe complication among clients with allergies, regardless of type?
- A. Bronchitis
- B. Anaphylactic shock and angioneurotic
- C. Cardiac arrest edema
- D. Asthma and nasal polyps
Correct Answer: B
Rationale: Among clients with allergies, regardless of type, anaphylactic shock and angioneurotic edema are the most severe complications. Anaphylactic shock is a severe, potentially life-threatening allergic reaction that can occur rapidly and affect multiple organ systems, leading to a sudden drop in blood pressure and difficulty breathing. Angioneurotic edema, also known as angioedema, is another serious allergic reaction that involves swelling of the deep layers of the skin, often around the eyes and lips, but can also affect the throat and other areas, potentially leading to airway obstruction. These complications require immediate medical attention, including the administration of epinephrine and other interventions to stabilize the client.
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During chemotherapy for lymphocytic leukemia, a client develops abdominal pain, fever, and "horse barn" smelling diarrhea. It would be most important for the nurse to advise the physician to order:
- A. Enzyme-linked immunosuppressant assay
- B. Stool for Clostridium difficile test
- C. Flat palate X-ray of the abdomen
- D. Electrolyte panel and hemogram
Correct Answer: B
Rationale: The client's symptoms of abdominal pain, fever, and "horse barn" smelling diarrhea are concerning for Clostridium difficile infection, especially in the setting of receiving chemotherapy which can weaken the immune system. Clostridium difficile is a bacteria that can cause severe diarrhea and inflammation of the colon. Testing for Clostridium difficile in the stool is crucial for diagnosing the infection and guiding appropriate treatment. Therefore, advising the physician to order a stool test for Clostridium difficile would be the most important in this scenario to confirm the diagnosis and initiate appropriate management.
What instruction should the nurse give to then patient taking propan0lol (Inderal) for hypertension?
- A. Have potassium level checked
- B. Do not stop medication abruptly
- C. Report any changes in appetite
- D. Resume usual daily activities
Correct Answer: B
Rationale: The nurse should instruct the patient taking propranolol (Inderal) for hypertension to not stop the medication abruptly. Suddenly stopping propranolol can lead to rebound hypertension and potentially dangerous side effects. It is important for the patient to gradually taper off the medication under the guidance of a healthcare provider to avoid complications. Therefore, advising the patient not to stop the medication abruptly is a crucial instruction to ensure their safety and well-being.
A client was brought to the emergency room with complains of difficulty of breathing. What can lead the nurse to suspect that the client is experiencing acute respiratory distress syndrome (ARDS)?
- A. paO2 of 95, pCO2 of 43, x-ray showing enlarged heart, bradycardia
- B. Thick green sputum production, paO2 of 74, pH of 7.41
- C. restlessness, suprasternal retractions, paO2 of 62
- D. wheezes, slow, deep respirations, pCO2 of 52, pH of 7.35
Correct Answer: C
Rationale: Acute respiratory distress syndrome (ARDS) is a severe form of acute respiratory failure characterized by rapidly progressive dyspnea, hypoxemia, and noncardiogenic pulmonary edema. The key signs of ARDS include severe respiratory distress, low partial pressure of oxygen (paO2), and bilateral infiltrates on chest x-ray. In the given scenario, the client presenting with restlessness and suprasternal retractions along with a paO2 level of 62 indicates severe respiratory distress and hypoxemia, which are consistent with ARDS. Therefore, option C is the most indicative of ARDS among the choices provided.
The nurse should expect Mr. Gabatan to have some spasticity of the lower extremities. To prevent the development of contractures, careful consideration must be given to:
- A. Active exercise
- B. Use of tilt board
- C. Deep massage
- D. Proper positioning
Correct Answer: D
Rationale: Proper positioning is crucial in preventing the development of contractures in patients with spasticity of the lower extremities. Contractures can result from prolonged positioning in a way that shortens the muscle-tendon unit. By ensuring proper positioning, the nurse can help maintain the muscles and joints in a neutral and extended position, minimizing the risk of contractures. This may involve positioning supports such as pillows, splints, or footboards to keep the limbs in an optimal position.
Another girl was bitten by a poisonous snake. All of the following are true except
- A. The victim of a snake bite should be made to exercise the bitten extremity to hasten circulation
- B. The bite of a poisonous snake is distinguished by two fang marks
- C. Immediate severe pain and swelling distinguished the bite of a poisonous snake
- D. The tourniquet should be tight enough to prevent superficial circulation of blood thus stopping absorption of the poison
Correct Answer: A
Rationale: When it comes to snake bites, one should not exercise the bitten extremity as it can increase the spread of venom in the body. Moving the affected limb can potentially lead to the venom spreading more quickly through the lymphatic system and into the bloodstream. Therefore, it is essential to keep the victim as calm and still as possible to minimize the effects of the venom. Proper first aid for snake bites includes keeping the victim calm, immobilizing the bitten limb, and seeking immediate medical attention.