Nokea
You are caring for a patient with Raynaud's disease who has intractable pain. The patient is scheduled to undergo surgical interruption of pain conduction pathways to improve vascular blood supply as well as eliminate vasospasm and pain. Which type of surgery is the patient most likely to undergo?
- A. Cordotomy
- B. Rhizotomy
- C. Neurectomy
- D. Sympathectomy
Correct Answer: D
Rationale: Sympathectomy (D) interrupts sympathetic nerve pathways to reduce vasospasm and improve blood flow in Raynaud's disease. Cordotomy (A) and rhizotomy (B) target pain pathways for other conditions, and neurectomy (C) involves peripheral nerve removal, less specific for Raynaud's.
You may also like to solve these questions
The nurse suspects the client is experiencing ………………… which is classified as a(n) ……………………………
- A. rheumatoid arthritis
- B. multiple sclerosis
- C. erythematosus (SLE)
- D. anaphylaxis
- E. myasthenia gravis
- F. Hypersensitivity disorder
- G. Autoimmune disorder
Correct Answer: C,G
Rationale: The symptoms of fatigue, joint pain, facial rash worsened by sun exposure, fever, and swelling are classic for systemic lupus erythematosus (SLE) (C), an autoimmune disorder (I). Rheumatoid arthritis (A) lacks the photosensitive rash, multiple sclerosis (B) involves neurological symptoms, anaphylaxis (D) is acute, and myasthenia gravis (E) causes muscle weakness.
The following scenario applies to the next 6 items
The nurse in the intensive care unit (ICU) is caring for a 59-year-old female client
Item 1 of 6
Admission Note
Nurses' Notes
Physician Orders
1450 - Client was admitted directly from the primary health care physician's office for a severe exacerbation of systemic lupus erythematosus (SLE). The client was being treated outpatient with corticosteroids but was not responding. Reported intermittent chest pain at the physician's office and became pale and
Diaphoretic. The 12-lead electrocardiogram (ECG) showed normal sinus rhythm with no ST-elevations. Point of care (POC) troponin showed no elevations.
• The client was directly admitted to the intensive care unit for observation and medical management. • Cardiac consultation has been placed, and laboratory work is pending. The client has a medical history of systemic lupus erythematosus (SLE), dyslipidemia, and pulmonary hypertension
Which of the following assessment findings require immediate follow-up? Select all that apply.
- A. lung sounds
- B. cardiac sounds
- C. temperature
- D. blood pressure
- E. butterfly-shaped rash on face
- F. pulse oximetry
- G. pulse
Correct Answer: A,B,D,F,G
Rationale: Given the client's severe SLE exacerbation, chest pain, pallor, and diaphoresis, immediate follow-up is needed for lung sounds (A) to assess for pulmonary issues like pleural effusion, cardiac sounds (B) for pericarditis or tamponade, blood pressure (D) for hemodynamic stability, pulse oximetry (F) for oxygenation, and pulse (G) for cardiovascular status. Temperature (C) and butterfly rash (E) are less urgent in this acute context.
The following scenario applies to the next 6 items
The nurse in the intensive care unit (ICU) is caring for a 59-year-old female client
Item 5 of 6
Admission Note
Nurses' Notes
Physician Orders
1450 - Client was admitted directly from the primary health care physician's office for a severe exacerbation of systemic lupus erythematosus (SLE). The client was being treated outpatient with corticosteroids but was not responding. Reported intermittent chest pain at the physician's office and became pale and
Diaphoretic. The 12-lead electrocardiogram (ECG) showed normal sinus rhythm with no ST-elevations. Point of care (POC) troponin showed no elevations.
• The client was directly admitted to the intensive care unit for observation and medical management. • Cardiac consultation has been placed, and laboratory work is pending. The client has a medical history of systemic lupus erythematosus (SLE), dyslipidemia, and pulmonary hypertension
The nurse prepares the client for an emergent pericardiocentesis and it is essential to have …………….. at the bedside. During the procedure, it is a priority for the nurse to monitor the client's ………….
- A. a bottle of sterile water
- B. a defibrillator
- C. positive pressure ventilation
- D. urinary output
- E. cardiac rhythm
- F. Gasaow coma scale
Correct Answer: B,E
Rationale: A defibrillator (B) is essential at the bedside during pericardiocentesis due to the risk of arrhythmias from needle insertion. Monitoring cardiac rhythm (E) is a priority to detect complications like ventricular arrhythmias. Sterile water (A), positive pressure ventilation (C), urinary output (D), and Glasgow Coma Scale (F) are not directly relevant.
The intensive care unit (ICU) nurse is preparing to admit a client with Guillain-Barre syndrome. Which of the following items is essential for the nurse to have at the client's bedside?
- A. blood pressure cuff
- B. pulse oximeter
- C. oral intubation equipment
- D. arterial blood gas (ABG) supplies
Correct Answer: C
Rationale: Guillain-Barré syndrome can cause respiratory muscle weakness, making oral intubation equipment (C) essential for potential respiratory failure. Blood pressure cuff (A), pulse oximeter (B), and ABG supplies (D) are important but less critical than intubation readiness.
The following scenario applies to the next 6 items
The nurse in the intensive care unit (ICU) is caring for a 59-year-old female client
Item 2 of 6
Admission Note
Nurses' Notes
Physician Orders
1450 - Client was admitted directly from the primary health care physician's office for a severe exacerbation of systemic lupus erythematosus (SLE). The client was being treated outpatient with corticosteroids but was not responding. Reported intermittent chest pain at the physician's office and became pale and
Diaphoretic. The 12-lead electrocardiogram (ECG) showed normal sinus rhythm with no ST-elevations. Point of care (POC) troponin showed no elevations.
• The client was directly admitted to the intensive care unit for observation and medical management. • Cardiac consultation has been placed, and laboratory work is pending. The client has a medical history of systemic lupus erythematosus (SLE), dyslipidemia, and pulmonary hypertension
Which of the following issues is the client at risk of developing? Select all that apply.
- A. cardiac tamponade
- B. cardiogenic shock
- C. stroke
- D. pneumothorax
- E. acute coronary syndrome
Correct Answer: A,B,C,E
Rationale: SLE increases the risk of cardiac tamponade (A) due to pericarditis, cardiogenic shock (B) from cardiac involvement, stroke (C) from antiphospholipid syndrome, and acute coronary syndrome (E) from accelerated atherosclerosis. Pneumothorax (D) is not a typical SLE complication.