A 45-year-old patient presents with symptoms of severe headache, neck stiffness, and photophobia. The nurse suspects a potential central nervous system infection and recommends a lumbar puncture. What is the primary purpose of performing a lumbar puncture in this case?

A) To assess blood glucose levels
B) To measure intracranial pressure
C) To collect cerebrospinal fluid (CSF) for analysis
D) To administer pain medication

Explanation: The primary purpose of a lumbar puncture in this case is to collect cerebrospinal fluid (CSF) for analysis, which can help diagnose or rule out central nervous system infections.

Correct Answer:

Select an answer C) To collect cerebrospinal fluid (CSF) for analysis

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A 28-year-old patient is scheduled for a lumbar puncture. To ensure a successful procedure, what is the most important pre-procedure nursing intervention?

A) Administering pain medication
B) Explaining the procedure to the patient
C) Obtaining informed consent
D) Checking the patient’s blood pressure

Explanation: The most important pre-procedure nursing intervention is obtaining informed consent, ensuring that the patient understands the procedure and its risks.

Correct Answer:

Select an answer C) Obtaining informed consent

Medical-Surgical Nursing Questions: Stroke Treatments

A 60-year-old patient with a history of multiple sclerosis (MS) is scheduled for a lumbar puncture to assess disease progression. The nurse should educate the patient that the most common side effect of this procedure is:

A) Infection
B) Bleeding
C) Headache
D) Nausea and vomiting

Explanation: The most common side effect of a lumbar puncture is a post-procedure headache, which can occur due to cerebrospinal fluid (CSF) leakage and can usually be managed with rest and fluids.

Correct Answer:

Select an answer C) Headache

A 55-year-old patient with suspected subarachnoid hemorrhage is undergoing a lumbar puncture to assess for the presence of blood in the cerebrospinal fluid (CSF). Which finding during the procedure would indicate a positive result for blood in the CSF?

A) Clear and colorless CSF
B) Yellowish CSF
C) Red or pink-tinged CSF
D) Thick and cloudy CSF

Explanation: A finding of red or pink-tinged cerebrospinal fluid (CSF) during a lumbar puncture indicates the presence of blood, which is a positive result for subarachnoid hemorrhage.

Correct Answer:

Select an answer C) Red or pink-tinged CSF

Medical-Surgical Nursing Questions Focus on Stroke: Causes and Diagnosis

A 30-year-old patient with a suspected central nervous system infection has undergone a lumbar puncture, and cerebrospinal fluid (CSF) analysis reveals an elevated white blood cell count and an increased protein level. The nurse recognizes these findings as indicative of:

A) Normal CSF findings
B) Viral infection
C) Bacterial infection
D) Fungal infection

Explanation: Elevated white blood cell count and increased protein level in CSF are indicative of a bacterial infection of the central nervous system.

Correct Answer:

Select an answer C) Bacterial infection

Medical-Surgical Nursing Questions Focus on Stroke: Delegation Questions

A 40-year-old patient is undergoing a lumbar puncture to evaluate for the presence of neurologic diseases such as multiple sclerosis (MS) or Guillain-Barré syndrome. During the procedure, what is the appropriate position for the patient?

A) Supine with legs extended
B) Sitting upright and leaning forward
C) Lying on the left side
D) Prone with legs flexed

Explanation: During a lumbar puncture, the patient should be in a sitting position, leaning forward to maximize the space between the spinal vertebrae and facilitate the procedure.

Correct Answer:

Select an answer B) Sitting upright and leaning forward

Medical-Surgical Nursing Questions: Understanding Stroke Causes and Symptoms

A 50-year-old patient has just undergone a lumbar puncture. The nurse should provide post-procedure instructions to the patient to prevent the common complication of a post-lumbar puncture headache. What should the nurse recommend?

A) Increase caffeine intake
B) Lie flat and avoid sitting up
C) Resume normal activities immediately
D) Maintain strict bed rest for 24 hours

Explanation: To prevent post-lumbar puncture headaches, patients are often advised to lie flat for several hours after the procedure and increase fluid intake to maintain cerebrospinal fluid (CSF) volume.

Correct Answer:

Select an answer B) Lie flat and avoid sitting up

Understanding Stroke: Causes and Symptoms

A 25-year-old patient with a history of seizures is scheduled for an EEG (Electroencephalogram) to evaluate brain activity. What is the primary purpose of an EEG in this case?

A) To visualize structural brain abnormalities
B) To assess blood flow in the brain
C) To record electrical activity in the brain
D) To measure intracranial pressure

Explanation: The primary purpose of an EEG is to record and analyze the electrical activity in the brain, helping in the diagnosis and management of seizure disorders.

Correct Answer:

Select an answer C) To record electrical activity in the brain

Understanding Stroke: Medical-Surgical Nursing Questions

A 40-year-old patient with a recent history of head trauma is scheduled for a brain MRI to assess for potential brain injuries. What type of information can a brain MRI provide in this situation?

A) Electrical activity of the brain
B) Blood pressure in the brain vessels
C) Detailed images of brain structures and abnormalities
D) Brain neurotransmitter levels

Explanation: A brain MRI can provide detailed images of brain structures and abnormalities, making it useful for assessing potential brain injuries resulting from head trauma.

Correct Answer:

Select an answer C) Detailed images of brain structures and abnormalities

Understanding Stroke: Medical-Surgical Nursing High Yield Questions

A 55-year-old patient with a history of epilepsy is undergoing an EEG. During the EEG, the nurse observes the presence of abnormal, synchronous brain wave discharges. What type of seizure activity is likely indicated by this EEG finding?

A) Absence seizure
B) Simple partial seizure
C) Complex partial seizure
D) Tonic-clonic seizure

Explanation: Abnormal, synchronous brain wave discharges on an EEG may indicate a tonic-clonic seizure, characterized by generalized convulsions.

Correct Answer:

Select an answer D) Tonic-clonic seizure

A 30-year-old patient with suspected epilepsy is scheduled for an EEG. The patient asks the nurse about the preparations required for this test. What should the nurse advise the patient to do before the EEG?

A) Consume a large meal
B) Avoid caffeine for 24 hours
C) Wash hair with shampoo and conditioner
D) Take regular medications as usual

Explanation: Before an EEG, patients are often advised to wash their hair with shampoo but to avoid using conditioner, as some electrodes need to make direct contact with the scalp for optimal results.

Correct Answer:

Select an answer C) Wash hair with shampoo and conditioner

Medical-Surgical Nursing Questions: Stroke Questions, Answers and Rationales

A 60-year-old patient with a history of migraine headaches is undergoing a brain MRI to assess for possible causes of recurring headaches. What information can a brain MRI provide in this case?

A) Electroencephalogram (EEG) findings
B) Blood flow in the cerebral arteries
C) Structural abnormalities in the brain
D) Serum levels of headache-related hormones

Explanation: A brain MRI can provide detailed images of brain structures, helping to identify structural abnormalities that may be contributing to recurrent migraine headaches.

Correct Answer:

Select an answer C) Structural abnormalities in the brain

A 35-year-old patient with a history of epilepsy is admitted to the neurology unit. The nurse is preparing to administer an anticonvulsant medication. Which of the following is the primary goal of anticonvulsant therapy in this patient?

A) Reduce fever and inflammation
B) Relieve acute pain
C) Control and prevent seizures
D) Lower blood pressure

Explanation: The primary goal of anticonvulsant therapy in a patient with epilepsy is to control and prevent seizures, allowing for a better quality of life.

Correct Answer:

Select an answer C) Control and prevent seizures

Understanding Stroke: Medical-Surgical Nursing Priority Questions

A 50-year-old patient is receiving anticonvulsant therapy for the management of seizures. The nurse should closely monitor the patient for potential side effects of anticonvulsants, such as the development of a serious skin rash known as:

A) Urticaria
B) Eczema
C) Stevens-Johnson syndrome
D) Psoriasis

Explanation: Anticonvulsants, such as carbamazepine and phenytoin, can potentially cause serious skin reactions, including Stevens-Johnson syndrome.

Correct Answer:

Select an answer C) Stevens-Johnson syndrome

A 60-year-old patient with a history of seizures is admitted to the hospital following a seizure episode. The nurse is performing a neurological assessment and observes rhythmic, jerking movements of the patient’s right arm. What type of seizure is the patient likely experiencing?

A) Absence seizure
B) Tonic-clonic seizure
C) Simple partial seizure
D) Complex partial seizure

Explanation: Rhythmic, jerking movements of an extremity are characteristic of a focal onset (partial) seizure, either simple or complex, depending on the level of consciousness.

Correct Answer:

Select an answer C) Simple partial seizure

A 45-year-old patient with epilepsy is prescribed phenytoin (Dilantin) as an anticonvulsant. The nurse educates the patient about the importance of regular blood tests to monitor phenytoin levels. What is the therapeutic range for phenytoin levels?

A) 2-4 mcg/mL
B) 5-10 mg/dL
C) 100-200 ng/mL
D) 30-60 U/mL

Explanation: The therapeutic range for phenytoin levels is typically 10-20 mcg/mL.

Correct Answer:

Select an answer B) 5-10 mg/dL

30-year-old patient is admitted with a suspected overdose of an anticonvulsant medication. The nurse assesses the patient for signs of overdose, which may include:

A) Hypertension
B) Bradycardia
C) Decreased level of consciousness
D) Hyperactive bowel sounds

Explanation: Anticonvulsant overdose may lead to symptoms such as decreased level of consciousness, respiratory depression, and hypotension.

Correct Answer:

Select an answer C) Decreased level of consciousness

A 70-year-old patient with a history of falls is admitted to the medical-surgical unit. Which of the following interventions should the nurse prioritize for fall prevention in this patient?

A) Administer anticonvulsant medications
B) Encourage frequent ambulation
C) Limit fluid intake
D) Apply wrist restraints

Explanation: Fall prevention strategies for older adults include encouraging frequent ambulation, removing environmental hazards, and providing a safe and supportive care environment.

Correct Answer:

Select an answer B) Encourage frequent ambulation

A 45-year-old patient with a history of epilepsy is admitted to the neurology unit. The nurse is preparing to administer anticonvulsant medications. Which nursing action is essential in seizure precautions for this patient?

A) Ensure a well-lit room
B) Administer a high-sodium diet
C) Place the patient in a prone position
D) Keep the bed rails raised at all times

Explanation: Essential seizure precautions include ensuring a well-lit room, padding the side rails of the bed, and providing a safe environment during and after a seizure episode.

Correct Answer:

Select an answer A) Ensure a well-lit room

A 60-year-old patient with a history of falls is on fall precautions. While ambulating the patient, the nurse observes the patient beginning to lose balance. What should the nurse do first in this situation?

A) Call a Code Blue
B) Apply wrist restraints
C) Lower the bed to the lowest position
D) Let the patient fall to the floor

Explanation: If a patient begins to lose balance while ambulating, the nurse should lower the bed to the lowest position to minimize the risk of injury.

Correct Answer:

Select an answer C) Lower the bed to the lowest position

A 50-year-old patient with a history of seizures is receiving anticonvulsant medications. The nurse educates the patient about seizure precautions. Which statement by the patient indicates understanding of these precautions?

A) “I should limit my fluid intake to prevent seizures.”
B) “I should avoid drinking alcohol and get enough sleep.”
C) “I can skip my medication if I haven’t had a seizure in a while.”
D) “I should engage in strenuous exercise to reduce seizure risk.”

Explanation: Understanding of seizure precautions includes avoiding triggers like alcohol, getting adequate sleep, and adhering to medication therapy.

Correct Answer:

Select an answer B) “I should avoid drinking alcohol and get enough sleep.”

A 35-year-old patient is at risk for falls in the hospital due to a medical condition. What should the nurse prioritize when implementing fall precautions for this patient?

A) Administer sedatives to keep the patient calm
B) Encourage the use of assistive devices
C) Keep the patient isolated in their room
D) Apply physical restraints as needed

Explanation: Prioritizing fall precautions includes encouraging the use of assistive devices, keeping pathways clear, and providing a safe environment.

Correct Answer:

Select an answer B) Encourage the use of assistive devices

A 65-year-old patient with a history of heart failure presents with sudden shortness of breath, pink frothy sputum, and crackles in the lung fields. What is the most likely diagnosis for this patient’s condition?

A) Pneumonia
B) Pulmonary embolism
C) Pulmonary edema
D) Acute bronchitis

Explanation: The patient’s symptoms, including pink frothy sputum and crackles, are indicative of pulmonary edema, which often occurs in individuals with heart failure.

Correct Answer:

Select an answer C) Pulmonary edema

A 70-year-old patient with heart failure is experiencing worsening symptoms, including orthopnea and paroxysmal nocturnal dyspnea. What is the priority nursing intervention for this patient?

A) Administer a diuretic
B) Provide oxygen therapy
C) Initiate chest compressions
D) Schedule an echocardiogram

Explanation: Priority nursing intervention for a patient with worsening heart failure and respiratory distress includes providing oxygen therapy to improve oxygenation.

Correct Answer:

Select an answer B) Provide oxygen therapy

A 55-year-old patient with heart failure is prescribed a loop diuretic. The nurse understands that the primary action of this medication is to:

A) Lower blood pressure
B) Increase heart rate
C) Promote sodium retention
D) Promote diuresis

Explanation: Loop diuretics are prescribed in heart failure to promote diuresis and reduce fluid volume overload, which can alleviate symptoms such as edema and pulmonary congestion.

Correct Answer:

Select an answer D) Promote diuresis

A 60-year-old patient with heart failure is at risk for developing pulmonary edema. The nurse should monitor for early signs of pulmonary edema, which may include:

A) Hypertension
B) Bradycardia
C) Dry cough
D) Crackles in the lungs

Explanation: Early signs of pulmonary edema often include crackles in the lungs, tachycardia, and hypertension.

Correct Answer:

Select an answer D) Crackles in the lungs

A 50-year-old patient with a history of heart failure is prescribed ACE inhibitors as part of the treatment plan. The nurse educates the patient about potential side effects of ACE inhibitors, including:

A) Bradycardia
B) Hyperkalemia
C) Hypotension
D) Respiratory alkalosis

A 62-year-old patient post-surgery is at risk for venous thromboembolism (VTE). Which intervention should the nurse prioritize to prevent VTE in this patient?

A) Administer a sedative
B) Encourage early ambulation
C) Administer an antipyretic
D) Apply cold compresses

Explanation: Early ambulation is crucial to prevent VTE in post-surgery patients by promoting blood flow and preventing stasis in the lower extremities.

Correct Answer:

Select an answer B) Encourage early ambulation

A 45-year-old patient with a history of VTE is prescribed anticoagulation therapy. What is the primary goal of anticoagulation therapy in this patient?

A) Increase platelet count
B) Reduce bleeding risk
C) Prevent further clot formation
D) Improve lung function

Explanation: The primary goal of anticoagulation therapy is to prevent further clot formation and reduce the risk of recurrent VTE in patients with a history of VTE.

Correct Answer:

Select an answer C) Prevent further clot formation

A 55-year-old patient is diagnosed with deep vein thrombosis (DVT). The nurse knows that the most common symptom of DVT is:

A) Chest pain
B) Shortness of breath
C) Leg swelling and pain
D) Headache

Explanation: The most common symptom of DVT is leg swelling and pain, often in the calf muscle.

Correct Answer:

Select an answer C) Leg swelling and pain

A 70-year-old patient has a suspected pulmonary embolism (PE). The nurse recognizes that the priority diagnostic test to confirm this condition is:

A) Electrocardiogram (ECG or EKG)
B) Chest X-ray
C) D-dimer assay
D) Magnetic resonance imaging (MRI)

Explanation: The D-dimer assay is often used as an initial diagnostic test to rule out PE. A positive result may warrant further imaging studies, such as a CT pulmonary angiography.

Correct Answer:

Select an answer C) D-dimer assay

A 50-year-old patient is prescribed warfarin (Coumadin) for VTE prophylaxis. The nurse provides education about warfarin and advises the patient to:

A) Avoid green leafy vegetables
B) Limit fluid intake
C) Take the medication with grapefruit juice
D) Monitor for signs of infection

Explanation: Patients on warfarin should be educated to maintain consistent intake of vitamin K-containing foods, including green leafy vegetables. Grapefruit juice can interact with some medications but is not relevant for warfarin.

Correct Answer:

Select an answer A) Avoid green leafy vegetables

 

Patient Case: A 58-year-old male presents to the emergency department with severe chest pain that radiates to his left arm. He has diaphoresis and reports feeling lightheaded. What is the priority nursing intervention for this patient?

A) Administer pain medication
B) Obtain a detailed health history
C) Perform an electrocardiogram (ECG)
D) Provide emotional support

Explanation: In a patient with suspected acute coronary syndrome (ACS), performing an electrocardiogram (ECG) is the priority to determine if there are any ST-segment changes indicative of myocardial infarction.

Correct Answer:

Select an answer C) Perform an electrocardiogram (ECG)

Patient Case: A 65-year-old female is admitted with unstable angina. She is prescribed sublingual nitroglycerin. The nurse should instruct the patient to use nitroglycerin in response to:

A) Routine chest discomfort
B) Severe chest pain lasting >30 minutes
C) Occasional palpitations
D) Mild dizziness

Explanation: Sublingual nitroglycerin should be used for relief of acute chest pain or discomfort. Patients should be instructed to use it for severe chest pain that lasts more than a few minutes.

Correct Answer:

Select an answer B) Severe chest pain lasting >30 minutes

Patient Case: A 72-year-old male is post-coronary artery bypass graft (CABG) surgery. The nurse is monitoring for complications, including graft occlusion. Which assessment finding suggests graft occlusion in this patient?

A) Bradycardia
B) Hypertension
C) Sudden onset of severe chest pain
D) Elevated body temperature

Explanation: Sudden onset of severe chest pain may indicate graft occlusion in a post-CABG patient and should be assessed promptly.

Correct Answer:

Select an answer C) Sudden onset of severe chest pain

Patient Case: A 50-year-old female with a history of ACS is prescribed dual antiplatelet therapy (aspirin and clopidogrel). The nurse educates the patient that the purpose of this medication regimen is to:

A) Reduce cholesterol levels
B) Prevent clot formation in the coronary arteries
C) Manage chest pain
D) Control blood pressure

Explanation: Dual antiplatelet therapy with aspirin and clopidogrel is prescribed to prevent clot formation in the coronary arteries, reducing the risk of recurrent ACS events.

Correct Answer:

Select an answer B) Prevent clot formation in the coronary arteries

Patient Case: A 60-year-old male with a history of ACS is scheduled for cardiac rehabilitation. The nurse should emphasize the importance of cardiac rehab for:

A) Providing emotional support
B) Monitoring vital signs
C) Reducing hospital costs
D) Improving cardiovascular health and functional capacity

Explanation: Cardiac rehabilitation is essential for improving cardiovascular health, functional capacity, and reducing the risk of future cardiac events in patients with ACS.

Correct Answer:

Select an answer D) Improving cardiovascular health and functional capacity

 

atient Case: A 68-year-old male presents to the emergency department with dizziness and palpitations. An electrocardiogram (ECG) reveals a heart rate of 40 beats per minute and a prolonged PR interval. Which conduction disturbance is likely present in this patient?

A) Sinus bradycardia
B) Atrial fibrillation
C) First-degree heart block
D) Ventricular tachycardia

Explanation: The prolonged PR interval on the ECG indicates first-degree heart block, which is characterized by delayed conduction between the atria and ventricles.

Correct Answer:

Select an answer C) First-degree heart block

Patient Case: A 55-year-old female with a history of hypertension presents with an irregular heart rhythm. An ECG shows no P waves, and irregular, rapid QRS complexes. What conduction disturbance is likely present in this patient?

A) Sinus tachycardia
B) Atrial fibrillation
C) Second-degree heart block
D) Ventricular fibrillation

Explanation: The absence of P waves and irregular, rapid QRS complexes on the ECG are characteristic of atrial fibrillation.

Correct Answer:

Select an answer B) Atrial fibrillation

Patient Case: A 70-year-old male presents with chest pain and an ECG reveals ST-segment elevation in leads II, III, and aVF. Which conduction disturbance is associated with this ECG finding?

A) Sinus bradycardia
B) Atrial fibrillation
C) Complete heart block
D) Myocardial infarction

Explanation: ST-segment elevation in leads II, III, and aVF is indicative of an inferior myocardial infarction, which can affect the heart’s conduction system.

Correct Answer:

Select an answer D) Myocardial infarction

atient Case: A 45-year-old female presents with syncope. An ECG shows a pattern of progressively lengthening PR intervals followed by a dropped QRS complex. Which conduction disturbance is likely present in this patient?

A) Sinus bradycardia
B) Atrial fibrillation
C) Third-degree heart block
D) Ventricular tachycardia

Explanation: The pattern of progressively lengthening PR intervals followed by a dropped QRS complex is indicative of third-degree heart block (complete heart block).

Correct Answer:

Select an answer C) Third-degree heart block

Patient Case: A 60-year-old male with a history of heart conduction disturbances is on a medication that slows the conduction of electrical impulses through the atria. This medication primarily affects which part of the heart’s conduction system?

A) SA node
B) AV node

Patient Case: A 45-year-old male presents with fever, fatigue, and a new-onset heart murmur. Echocardiography reveals vegetations on the heart valves. What is the most appropriate initial treatment for suspected infective endocarditis in this patient?

A) Intravenous antibiotics
B) Coronary artery bypass surgery
C) Percutaneous coronary intervention (PCI)
D) Surgical valve replacement

Explanation: The most appropriate initial treatment for suspected infective endocarditis is intravenous antibiotics to target the infection and reduce the risk of complications.

Correct Answer:

Select an answer A) Intravenous antibiotics

Patient Case: A 38-year-old female presents with sharp, pleuritic chest pain that worsens with inspiration. She also reports fever and malaise. Physical examination reveals a pericardial friction rub. What is the treatment of choice for this patient’s condition?

A) Intravenous fluids
B) Nonsteroidal anti-inflammatory drugs (NSAIDs)
C) Beta-blockers
D) Pericardiocentesis

Explanation: The presence of pleuritic chest pain, pericardial friction rub, and signs of pericarditis suggests acute pericarditis. The treatment of choice is typically NSAIDs to reduce inflammation and pain.

Correct Answer:

Select an answer B) Nonsteroidal anti-inflammatory drugs (NSAIDs)

Patient Case: A 60-year-old male with a history of infective endocarditis develops heart failure symptoms. Echocardiography reveals severe valve damage. What is the most appropriate treatment for this patient’s endocarditis-related heart failure?

A) High-dose diuretics
B) Inotropic agents
C) Valve replacement surgery
D) Cardiac catheterization

Explanation: Severe valve damage in endocarditis may require surgical intervention, such as valve replacement surgery, to address the underlying cause of heart failure.

Correct Answer:

Select an answer C) Valve replacement surgery

Patient Case: A 55-year-old female presents with signs of infective endocarditis, including fever, Roth spots, and Janeway lesions. What is the most appropriate initial diagnostic test for confirming the diagnosis of infective endocarditis?

A) Chest X-ray
B) Echocardiography
C) Magnetic resonance imaging (MRI)
D) Lumbar puncture

Explanation: Echocardiography is the most appropriate initial diagnostic test for confirming the diagnosis of infective endocarditis and assessing valve abnormalities.

Correct Answer:

Select an answer B) Echocardiography

Patient Case: A 50-year-old male with pericarditis develops worsening shortness of breath and hypotension. What procedure may be indicated in this patient for both diagnosis and treatment?

A) Coronary angiography
B) Pulmonary function tests
C) Pericardiocentesis
D) Esophageal manometry

Explanation: In a patient with pericarditis who develops hemodynamic instability, pericardiocentesis may be indicated for both diagnosis (to rule out cardiac tamponade) and treatment (to relieve cardiac compression).

Correct Answer:

Select an answer C) Pericardiocentesis

 

Patient Case: A 68-year-old female presents to the emergency department with dizziness, weakness, and a blood pressure of 80/50 mm Hg. She reports a history of heart disease. What is the most likely cause of her hypotension?

A) Dehydration
B) Vasovagal syncope
C) Cardiogenic shock
D) Orthostatic hypotension

Explanation: Given the patient’s history of heart disease and low blood pressure, the most likely cause is cardiogenic shock, which occurs when the heart cannot pump blood effectively.

Correct Answer:

Select an answer C) Cardiogenic shock

Patient Case: A 45-year-old male in the intensive care unit (ICU) has developed severe hypotension. His central venous pressure (CVP) is low, and he has muffled heart sounds. What is the most likely cause of his condition?

A) Septic shock
B) Hypovolemic shock
C) Cardiac tamponade
D) Neurogenic shock

Explanation: The combination of severe hypotension, muffled heart sounds, and low CVP is indicative of cardiac tamponade, a medical emergency that requires immediate intervention.

Correct Answer:

Select an answer C) Cardiac tamponade

Patient Case: A 30-year-old male with a known history of allergies suddenly develops hypotension, urticaria, and difficulty breathing after eating a seafood dish. What is the most likely diagnosis in this case?

A) Anaphylaxis
B) Orthostatic hypotension
C) Vasovagal syncope
D) Hypovolemic shock

Explanation: The patient’s symptoms of hypotension, urticaria, and difficulty breathing following seafood ingestion are characteristic of anaphylaxis, a severe allergic reaction.

Correct Answer:

Select an answer A) Anaphylaxis

Patient Case: A 60-year-old female with a history of diabetes presents with hypotension, tachycardia, and dry mucous membranes. She reports excessive urination and thirst. What is the likely cause of her hypotension?

A) Dehydration
B) Septic shock
C) Orthostatic hypotension
D) Hypoglycemia

Explanation: The patient’s symptoms of hypotension, excessive urination, thirst, and dry mucous membranes suggest dehydration, which can be common in individuals with uncontrolled diabetes.

Correct Answer:

Select an answer A) Dehydration

Patient Case: A 70-year-old male is admitted with hypotension and confusion. His medical history includes hypertension and heart disease. Which medication could be contributing to his hypotension?

A) Beta-blockers
B) Diuretics
C) Calcium channel blockers
D) ACE inhibitors

Explanation: Medications such as diuretics, particularly in combination with other antihypertensive drugs, can lead to hypotension in elderly patients with a history of hypertension and heart disease.

Correct Answer:

Select an answer B) Diuretics

 

Patient Case: A 55-year-old male is admitted to the ICU with a high fever, tachycardia, hypotension, and signs of systemic infection. Laboratory tests show elevated lactate levels. What is the first-line treatment for this patient?

A) Broad-spectrum antibiotics
B) Corticosteroids
C) Fluid resuscitation
D) Vasopressors

Explanation: The first-line treatment for septic shock is fluid resuscitation to address hypotension and improve perfusion. Broad-spectrum antibiotics are initiated once cultures are obtained.

Correct Answer:

Select an answer C) Fluid resuscitation

Patient Case: A 45-year-old female with septic shock is not responding to fluid resuscitation. Which class of medications may be initiated to increase blood pressure in this patient?

A) Antibiotics
B) Diuretics
C) Vasopressors
D) Anticoagulants

Explanation: In cases where fluid resuscitation is insufficient to raise blood pressure, vasopressors like norepinephrine may be initiated to improve perfusion and address hypotension in septic shock.

Correct Answer:

Select an answer C) Vasopressors

Patient Case: A 60-year-old male with septic shock has a central venous oxygen saturation (ScvO2) of 70%. What does this ScvO2 value suggest, and what intervention is appropriate?

A) High oxygen delivery, consider reducing oxygen
B) Low oxygen delivery, consider increasing oxygen
C) Normal oxygen delivery, no intervention needed
D) High oxygen consumption, consider vasodilators

Explanation: A ScvO2 value of 70% suggests high oxygen delivery, and no intervention is needed. Low ScvO2 would indicate insufficient oxygen delivery to tissues.

Correct Answer:

Select an answer A) High oxygen delivery, consider reducing oxygen

Patient Case: A 70-year-old female with septic shock develops acute kidney injury (AKI). What is an important aspect of managing AKI in septic patients?

A) Aggressive diuretic therapy
B) Avoiding antibiotics
C) Early initiation of renal replacement therapy
D) Limiting fluid resuscitation

Explanation: In septic patients with AKI, early initiation of renal replacement therapy may be necessary to manage fluid overload and correct electrolyte imbalances.

Correct Answer:

Select an answer C) Early initiation of renal replacement therapy

Patient Case: A 50-year-old male with septic shock has a core body temperature of 95°F (35°C). What intervention is essential to address hypothermia in this patient?

A) Administer antipyretic medications
B) Warm intravenous fluids
C) Increase room temperature
D) Administer antibiotics

Explanation: In septic patients with hypothermia, a crucial intervention is to warm intravenous fluids to help raise the patient’s

A 30-year-old female presents to the emergency department with sudden-onset hives, angioedema, and difficulty breathing after being stung by a bee. What is the initial treatment of choice for this patient?

A) Administer an antipyretic medication
B) Initiate corticosteroid therapy
C) Administer epinephrine
D) Provide supplemental oxygen

Explanation: The initial treatment of choice for anaphylactic shock is the administration of epinephrine to reverse bronchoconstriction, vasodilation, and other life-threatening symptoms.

Correct Answer:

Select an answer C) Administer epinephrine

Patient Case: A 25-year-old male develops anaphylactic shock after ingesting peanuts. After administering epinephrine, what should be the next step in the management of this patient?

A) Begin intravenous (IV) corticosteroid therapy
B) Administer a second dose of epinephrine
C) Monitor vital signs and provide supportive care
D) Initiate IV fluid resuscitation

Explanation: After the initial administration of epinephrine, monitoring vital signs and providing supportive care are essential. Additional doses of epinephrine may be administered if symptoms persist or worsen.

Correct Answer:

Select an answer C) Monitor vital signs and provide supportive care

Patient Case: A 40-year-old female with anaphylactic shock has received epinephrine and is stable. What medication can be administered to prevent a secondary reaction and recurrence of symptoms?

A) Antibiotics
B) Antihistamines
C) Corticosteroids
D) Diuretics

Explanation: Corticosteroids may be administered after the initial treatment of anaphylactic shock to prevent secondary reactions and reduce inflammation.

Correct Answer:

Select an answer C) Corticosteroids

Patient Case: A 35-year-old male presents with anaphylactic shock after a bee sting. In addition to epinephrine, what intervention is crucial for managing this patient’s airway?

A) Administer bronchodilators
B) Insert an oropharyngeal airway
C) Perform tracheostomy
D) Administer corticosteroids

Explanation: Managing the patient’s airway is crucial in anaphylactic shock. If there is significant upper airway edema, advanced airway interventions like intubation may be necessary.

Correct Answer:

Select an answer C) Perform tracheostomy

HOMEPAGE

NCLEX QBank

Patient Case: A 50-year-old female in anaphylactic shock is unconscious, and her blood pressure remains low despite epinephrine administration. What is the appropriate treatment to address persistent hypotension in this patient?

A) Administer antihistamines
B) Initiate vasopressor therapy
C) Administer intravenous fluids
D) Apply cold packs to reduce fever

Explanation: In cases of persistent hypotension in anaphylactic shock, vasopressor therapy, such as norepinephrine, may be necessary to increase blood pressure and perfusion.

Correct Answer:

Select an answer B) Initiate vasopressor therapy