Nokea
Which of the following statements is NOT true of Pneumothorax?
- A. Atmospheric air within the pleural space can result to a rise in intra thoracic pressure and reduces vital capacity in the lungs
- B. The loss of positive intra-pleural pressure can produce pneumothorax
- C. The loss of negative intra pleural pressure can result to collapse of the lungs.
- D. A spontaneous pneumothorax can occur with the rupture of pulmonary bleb.
Correct Answer: C
Rationale: In pneumothorax, air enters the normally negative pressure space between the lung and chest wall, leading to loss of negative intra-pleural pressure. However, this loss of negative pressure typically does not directly result in lung collapse. Instead, the accumulation of air in the pleural space can lead to a pressure imbalance, causing the lung to collapse partially or completely, which is known as atelectasis. Therefore, it is more accurate to state that the loss of negative intra-pleural pressure can result in lung collapse due to the presence of air in the pleural space, rather than the loss of negative pressure itself causing the collapse.
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A patient with a history of coronary artery disease is prescribed aspirin for antiplatelet therapy. Which information is important for the nurse to include in patient education about aspirin therapy?
- A. "Take aspirin with a full glass of milk to minimize gastrointestinal upset."
- B. "Avoid using nonsteroidal anti-inflammatory drugs (NSAIDs) while taking aspirin."
- C. "Discontinue aspirin therapy if you develop a fever."
- D. "Take aspirin on an empty stomach for better absorption."
Correct Answer: B
Rationale: The correct information for the nurse to include in patient education about aspirin therapy is to advise the patient to avoid using nonsteroidal anti-inflammatory drugs (NSAIDs) while taking aspirin. NSAIDs can increase the risk of gastrointestinal bleeding when taken along with aspirin, which is already a blood-thinning medication due to its antiplatelet effects. Patients with coronary artery disease are typically prescribed aspirin for its antiplatelet properties to prevent blood clot formation in the arteries. Avoiding NSAIDs will help reduce the risk of gastrointestinal complications and ensure the effectiveness of aspirin therapy in preventing cardiovascular events. Taking aspirin with a full glass of milk (Option A) is not a necessary instruction for aspirin therapy. Discontinuing aspirin therapy if a patient develops a fever (Option C) is not a standard practice unless advised by a healthcare provider. Taking aspir
Upon further assessment, you notices that she had any scratches on her right ankle, a resulting infection, and cellulitis. When you asked her about the scratches, the patient states, "Oh, my cat might have been using my leg as a scratiching post again and I did not even feel it." Which diabetic complicatons suspect the patient to have?
- A. Neuropathy
- B. Retinopathy
- C. Macroangiopathy
- D. Nephropathy
Correct Answer: A
Rationale: The patient's lack of sensation in her right leg, allowing her cat to scratch her without her noticing, is indicative of neuropathy. Neuropathy is a common diabetic complication characterized by nerve damage that can result in loss of sensation or altered sensation in different parts of the body, including the extremities. In this case, neuropathy has likely affected the patient's right lower extremity, leading to her inability to feel the cat scratching her leg and resulting in the unnoticed scratches, infection, and subsequent cellulitis.
A patient presents with abdominal pain, fever, and peripheral blood smear showing fragmented red blood cells (schistocytes). Laboratory tests reveal elevated lactate dehydrogenase (LDH), decreased haptoglobin, and increased indirect bilirubin. Which of the following conditions is most likely to cause these findings?
- A. Hemolytic uremic syndrome (HUS)
- B. Thrombotic thrombocytopenic purpura (TTP)
- C. Disseminated intravascular coagulation (DIC)
- D. Immune thrombocytopenic purpura (ITP)
Correct Answer: B
Rationale: Thrombotic thrombocytopenic purpura (TTP) is a rare blood disorder characterized by microangiopathic hemolytic anemia, thrombocytopenia, fever, neurological abnormalities, and renal dysfunction. The peripheral blood smear in TTP typically shows fragmented red blood cells (schistocytes) due to mechanical destruction within small blood vessels. Laboratory findings in TTP commonly include elevated lactate dehydrogenase (LDH), decreased haptoglobin (as it is consumed in the clearance of free hemoglobin), and increased indirect bilirubin due to increased red blood cell breakdown. This combination of clinical presentation and laboratory abnormalities is classic for TTP. Hemolytic uremic syndrome (HUS) may present similarly but is more commonly associated with renal dysfunction and is often triggered by infection with Shiga toxin-producing E. coli.
A woman in active labor demonstrates persistent posterior fetal position, contributing to prolonged labor and severe back pain. What nursing intervention should be implemented to facilitate fetal rotation and optimize labor progress?
- A. Encourage frequent position changes, including hands-and-knees position.
- B. Administer intravenous analgesics to manage maternal discomfort.
- C. Prepare for immediate instrumental delivery.
- D. Initiate continuous fetal monitoring to assess fetal well-being.
Correct Answer: A
Rationale: Encouraging frequent position changes, including the hands-and-knees position, is the most appropriate nursing intervention in this scenario. This position is known to help rotate the baby from a persistent posterior position to an optimal anterior position for delivery. The hands-and-knees position can help take pressure off the mother's back, alleviate back pain, and facilitate the rotation of the baby's head to engage in the mother's pelvis, thus promoting labor progress. It is a non-invasive and effective way to promote fetal rotation without the need for immediate instrumental delivery or intravenous analgesics. Continuous fetal monitoring is important for assessing fetal well-being but would not directly address the issue of posterior fetal position and the associated prolonged labor.
The nurse specialist cites a situation. If a patient experiences episodes of severe nausea and vomiting with more than 1,000 ml. of vomitus with in a period of four hours, which of the following is the nurses MOST appropriate action?
- A. Withhold fluids for four hours
- B. Observe the patient for another four hours
- C. Notify the physician
- D. Place the patient on a liquid diet
Correct Answer: C
Rationale: Severe nausea and vomiting with a large volume of vomitus can indicate a serious underlying issue such as gastrointestinal obstruction or other medical emergencies. In this situation, it is crucial for the nurse to notify the physician immediately so that further assessment and appropriate management can be initiated promptly. Delay in seeking medical help can lead to complications and worsen the patient's condition. It is important to act quickly and involve the physician in situations where the patient's health may be at risk.