Nokea
Which of the following are normal arterial blood gas values?
- A. PH 7.25, PaCO2 52 mm Hg, PaO2 75 mm Hg, HCO3 18 mEq/L
- B. PH 7.50, PaCO2 30 mm Hg, PaO2 80 mm Hg, HCO3 28 mEq/L
- C. PH 7.40, PaCO2 40 mm Hg, PaO2 90 mm Hg, HCO3 24 mEq/L
- D. PH 7.15, PaCO2 30 mm Hg, PaO2 50 mm Hg, HCO3 24 mEq/L
Correct Answer: C
Rationale: The correct answer is C: PH 7.40, PaCO2 40 mm Hg, PaO2 90 mm Hg, HCO3 24 mEq/L. These values represent a balanced state for arterial blood gas. Choice A has lower than normal PH and HCO3 levels and higher PaCO2 and lower PaO2 levels. Choice B has higher than normal PH and HCO3 levels, lower PaCO2, and a normal PaO2 level. Choice D has a significantly lower PH and PaO2 level, normal HCO3 level, and low PaCO2 level, indicating an acidic state with impaired oxygenation.
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What are the major mechanisms of spinal cord injuries?
- A. Hypoextension, expansion, hyperflexion
- B. Hyperflexion, expansion, hypometabolism
- C. Hypermetabolism, compression, hyperextension
- D. Hyperextension, hyperflexion, compression
Correct Answer: D
Rationale: The correct answer is D. Spinal cord injuries commonly occur due to hyperextension, hyperflexion, and compression. Hyperextension and hyperflexion refer to the excessive bending or stretching of the spinal cord, while compression is the exertion of pressure on the spinal cord. These mechanisms can lead to damage such as contusions, lacerations, and compression of the spinal cord. Choices A, B, and C are incorrect as they do not accurately represent the major mechanisms of spinal cord injuries.
When discussing the risks associated with hormone replacement therapy (HRT) with a patient who has a history of coronary artery disease, what should the nurse emphasize?
- A. HRT may increase the risk of cardiovascular events such as heart attack and stroke.
- B. HRT may increase the risk of osteoporosis.
- C. HRT may decrease the risk of venous thromboembolism.
- D. HRT may increase the risk of breast cancer.
Correct Answer: A
Rationale: The correct answer is A. Hormone replacement therapy (HRT) is associated with an increased risk of cardiovascular events, such as heart attack and stroke, especially in patients with a history of coronary artery disease. Choice B is incorrect because HRT is actually known to decrease the risk of osteoporosis. Choice C is incorrect as HRT is associated with an increased risk of venous thromboembolism. Choice D is also incorrect as HRT may slightly increase the risk of breast cancer.
A client on an acute medicine unit of a hospital with a diagnosis of small bowel obstruction is reporting intense, diffuse pain in her abdomen. Which physiologic phenomenon is most likely contributing to her complaint?
- A. Somatic pain resulting from pressure on the parietal peritoneum
- B. Referred pain from her small bowel
- C. Visceral pain resulting from distension and ischemia
- D. Neuropathic pain resulting from autonomic dysfunction
Correct Answer: C
Rationale: Visceral pain is associated with distension, ischemia, and inflammation of internal organs. In the case of a small bowel obstruction, the intense, diffuse pain reported by the client is likely due to the distension and ischemia of the small bowel. Somatic pain (Choice A) would be more localized and sharp, typically arising from the parietal peritoneum. Referred pain (Choice B) is pain perceived at a site distant from the actual pathology. Neuropathic pain (Choice D) involves dysfunction or damage to the nervous system and is not typically associated with the described physiologic phenomenon of distension and ischemia in the context of a small bowel obstruction.
A patient who is taking metronidazole for the past 4 days for the treatment of a parasitic infection reports to the nurse that his most recent dose made him 'flushed, sweaty, and sick in the stomach.' What assessment is most likely to address the cause of this phenomenon?
- A. "Have you experienced any allergic reactions to metronidazole before?"
- B. "Did you drink any alcoholic beverages around the time of taking the drug?"
- C. "Did you take this dose on an empty stomach?"
- D. "Are you currently using any over-the-counter antihistamines?"
Correct Answer: B
Rationale: The correct answer is B. Metronidazole can cause a disulfiram-like reaction when taken with alcohol, leading to symptoms such as flushing, sweating, and gastrointestinal upset. Asking the patient about alcohol consumption can help identify if this reaction is due to alcohol interaction. Choice A is incorrect as it focuses on penicillin allergy, which is not relevant to metronidazole. Choice C is less likely to cause the reported symptoms and is not a common concern with metronidazole. Choice D is not directly related to the symptoms described by the patient.
Which of the following disturbances would cause a client to experience gout?
- A. Serotonin receptors
- B. Uric acid metabolism
- C. Liver function
- D. Cardiac function
Correct Answer: B
Rationale: Gout is caused by a disturbance in uric acid metabolism, leading to the accumulation of uric acid crystals in joints. Serotonin receptors (Choice A) are not related to gout. Liver function (Choice C) is important for metabolism but is not directly linked to gout development. Cardiac function (Choice D) is primarily related to the heart's functioning and not associated with gout.