Nokea
Which of the following clients are more likely to suffer from a cerebral hematoma?
- A. A client with a family history of hemophilia; no symptoms
- B. A client receiving platelets for a low platelet count
- C. A client with anemia taking iron
- D. A client with atrial fibrillation on Coumadin
Correct Answer: D
Rationale: Clients on anticoagulants are at higher risk for bleeding complications.
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Referred pain from pancreatitis is at what level?
- A. T7/8
- B. L1/2
- C. T3/4
- D. T12/L1
Correct Answer: A
Rationale: Referred pain from pancreatitis is typically felt at the T7-T8 dermatome, which corresponds to the epigastric region. This is due to shared spinal cord segments between the pancreas and the abdominal wall.
The nurse practitioner is reviewing the chart of a patient who is scheduled to receive their first dose of sumatriptan (Imitrex) in the clinic today. Past medical history is positive for only migraines. Which of the following requires further evaluation before the medication is administered?
- A. Recent naproxen (Naprosyn) use
- B. Current blood pressure 142/90 mmHg
- C. Resting pulse rate of 61 bpm
- D. Adverse reaction to ubrogepant (Ubrelvy)
Correct Answer: B
Rationale: The correct answer is B: Current blood pressure 142/90 mmHg. Before administering sumatriptan, the nurse practitioner should further evaluate the patient's elevated blood pressure to ensure it is not contraindicated for the medication. Sumatriptan can potentially increase blood pressure, so it is crucial to monitor and address any hypertension before giving the medication.
Choice A: Recent naproxen use is not a direct contraindication for sumatriptan. Both medications are commonly used together for migraine treatment.
Choice C: A resting pulse rate of 61 bpm is within the normal range and does not require further evaluation before administering sumatriptan.
Choice D: Adverse reaction to ubrogepant is not relevant for evaluating the safety of sumatriptan. Each medication has its own set of potential side effects and interactions.
KL is a 34-year-old male admitted to the hospital (large trauma center) after suffering a traumatic brain injury (TBI) secondary to a serious motor vehicle accident. He was in excellent health prior to the accident. HT: 6'2" WT: 190 pounds (86 kg) What is likely the best way to feed KL while he is in the hospital?
- A. nasogastric tube
- B. nasoenteric tube
- C. parenteral nutrients
- D. baby food orally
Correct Answer: B
Rationale: A nasoenteric tube is often the preferred method for feeding patients with traumatic brain injury (TBI) who cannot safely swallow. It allows for enteral nutrition delivery directly into the small intestine, reducing the risk of aspiration compared to a nasogastric tube.
Which type of drug would be an antidote to atropine poisoning?
- A. nicotinic agonist
- B. anticholinergic
- C. muscarinic agonist
- D. α-blocker
Correct Answer: C
Rationale: The correct answer is C: muscarinic agonist. Atropine is an anticholinergic drug that blocks muscarinic receptors. Therefore, the antidote for atropine poisoning would be a muscarinic agonist, which competes with atropine for binding to muscarinic receptors and reverses its effects. Nicotinic agonist (A) would not be effective as atropine acts on muscarinic receptors, not nicotinic receptors. Anticholinergic (B) is the same class as atropine, so it would not counteract its effects. α-blocker (D) works on a different receptor system and would not be effective in treating atropine poisoning.
Which other extraarticular manifestation of RA is most likely to be seen in the patient with rheumatoid nodules?
- A. Lyme disease
- B. Felty syndrome
- C. Sjögren's
- D. Spondyloarthropathies
Correct Answer: B
Rationale: Felty syndrome involves splenomegaly and neutropenia.