Nokea
Which of the following is a priority nursing intervention for a client in atrial fibrillation with a rate of 180 beats per minute?
- A. Apply compression stockings
- B. Administer medications to slow the rate
- C. Administer anticoagulants
- D. Monitor urine output
Correct Answer: B
Rationale: AF at 180 bpm tanks output meds like beta-blockers or amiodarone slow it, restoring flow, a priority per ABCs over stockings' vein aid. Anticoagulants curb clots later; urine's secondary. Nurses push rate control, steadying this wild heart, a critical fix in this tachycardic storm.
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Cortical stimulation:
- A. Occurs before resection of a tumour.
- B. Localizes areas involved with hearing.
- C. Occurs by indirect application of electrodes.
- D. Allows identification of Wernicke's area, which is involved in the comprehension of language.
Correct Answer: D
Rationale: Cortical stimulation in awake craniotomy maps eloquent brain areas before tumor resection to avoid functional loss. It's performed pre-resection to define safe boundaries, localizing motor, sensory, and language areas, including hearing-related regions in the temporal lobe. Electrodes are applied directly to the cortex, not indirectly, for precision. Wernicke's area, in the dominant temporal lobe, is critical for language comprehension, and stimulation identifies it by eliciting speech errors (e.g., paraphasia). Seizures can occur, managed with cold saline irrigation, not warm. The ability to pinpoint Wernicke's area is pivotal, as its preservation ensures postoperative language function, balancing oncologic goals with quality of life in eloquent cortex surgeries.
Obesity is now determined to be a disease because: i. Obesity is common. ii. The development of obesity results from established pathophysiology. iii. Obesity results in negative health consequences. iv. Obesity increases mortality.
- A. i and ii
- B. ii and iii
- C. i and iv
- D. ii, iii, and iv
Correct Answer: D
Rationale: Obesity's disease tag leans on pathophysiology hormone and brain glitches plus harm like diabetes and higher death rates, not just its spread. Commonness alone doesn't clinch it; mechanisms, outcomes, and mortality do. Clinicians bank on this trio, framing interventions, a chronic shift from mere prevalence to impact.
Postoperative care at the completion of bimaxillary surgery:
- A. Is likely to be complicated by the presence of intermaxillary fixation (IMF).
- B. Involves awake rather than asleep extubation.
- C. Requires gentle removal of the tracheal tube to avoid damage of mandibular plates and screws.
- D. Involves reinsertion of a nasal tracheal tube when complicated by airway bleeding or obstruction requiring emergency reintubation.
Correct Answer: A
Rationale: Bimaxillary surgery's postoperative phase is complex. Intermaxillary fixation (IMF) aligns jaws but restricts mouth opening, complicating airway management, vomiting, and oral care raising aspiration or obstruction risks. Awake extubation is preferred, ensuring airway reflexes return, critical with IMF and swelling. Gentle tube removal prevents surgical site trauma (e.g., plates), though mandibular hardware is internal, less tube-accessible. Emergency reintubation may use nasal routes due to IMF, addressing bleeding/obstruction. HDU care is case-specific, not mandatory. IMF's presence drives tailored strategies, prioritizing airway security and patient stability in this high-risk recovery period.
A 66 year old man has recently been diagnosed with hypertension. He has no history of heart disease and diabetes mellitus. His average blood pressure is recorded as 154/82 mmHg. What is the MOST appropriate first line pharmacological therapy?
- A. Angiotensin converting enzyme-inhibitors
- B. Angiotensin receptor blockers
- C. Thiazide diuretics
- D. Calcium channel blockers
Correct Answer: C
Rationale: New hypertension at 66, 154/82 no heart or sugar issues thiazide diuretics kick off gentle, effective control, especially in older adults. ACE inhibitors or ARBs fit if kidneys or diabetes pop up; calcium blockers work but aren't first; beta blockers lag unless heart history. Nurses lean on thiazides cheap, proven for this chronic pressure nudge, keeping it simple and safe.
12 lead Electrocardiography (ECG) is a diagnostic tool used to assess the cardiovascular system. Which of the following are not diagnosed by ECG?
- A. Arrhythmias
- B. Conduction abnormalities
- C. Fluid overload
- D. Enlargement of heart chambers
Correct Answer: C
Rationale: ECG maps heart's electric arrhythmias, blocks, chamber bulges show up. Fluid overload? Physical, echo territory ECG hints, doesn't nail it. Nurses pair tools, a chronic heart's partial scope.