Medical-Surgical Nursing Exam Question Qbank, Test 3
Medical-Surgical Nursing Exam Question Qbank, Test 5
A 35-year-old male experiences severe bleeding following a car accident, leading to hemorrhagic shock. What is the primary goal of treatment in the management of hemorrhagic shock?
Explanation: The primary goal in the management of hemorrhagic shock is to control bleeding and replace lost fluids to restore perfusion and prevent further complications.
Correct Answer:
POP QUIZ Medical Surgical Nursing Question
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Patient Case: A 45-year-old female with hemorrhagic shock requires blood transfusion. Which blood component is typically transfused to restore oxygen-carrying capacity in this condition?
Explanation: Packed red blood cells (PRBCs) are typically transfused in hemorrhagic shock to restore oxygen-carrying capacity and improve tissue oxygenation.
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Patient Case: A 55-year-old male with hemorrhagic shock is at risk of developing coagulopathy. What blood component is often administered to correct coagulopathy?
Explanation: Fresh frozen plasma is often administered to correct coagulopathy by providing clotting factors in patients with hemorrhagic shock.
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Medical-Surgical Nursing Questions: Shock Treatments
Patient Case: A 40-year-old female with hemorrhagic shock receives a blood transfusion. Which vital sign should the nurse closely monitor for signs of fluid overload during the transfusion?
Explanation: During a blood transfusion, it is essential to closely monitor the patient’s respiratory rate for signs of fluid overload, such as increased respiratory rate and shortness of breath.
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Patient Case: A 50-year-old male with hemorrhagic shock is receiving crystalloid fluids. What is the primary purpose of administering crystalloid fluids in this situation?
Explanation: The primary purpose of administering crystalloid fluids in hemorrhagic shock is to expand intravascular volume and improve perfusion.
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Medical-Surgical Nursing Questions Focus on Shock: Causes and Diagnosis
Patient Case: A 35-year-old male experiences severe bleeding following a car accident, leading to hemorrhagic shock. What is the primary goal of treatment in the management of hemorrhagic shock?
Explanation: The primary goal in the management of hemorrhagic shock is to control bleeding and replace lost fluids to restore perfusion and prevent further complications.
Correct Answer:
Patient Case: A 45-year-old female with hemorrhagic shock requires blood transfusion. Which blood component is typically transfused to restore oxygen-carrying capacity in this condition?
Explanation: Packed red blood cells (PRBCs) are typically transfused in hemorrhagic shock to restore oxygen-carrying capacity and improve tissue oxygenation.
Correct Answer:
Medical-Surgical Nursing Questions Focus on Shock: Delegation Questions
Patient Case: A 55-year-old male with hemorrhagic shock is at risk of developing coagulopathy. What blood component is often administered to correct coagulopathy?
Explanation: Fresh frozen plasma is often administered to correct coagulopathy by providing clotting factors in patients with hemorrhagic shock.
Correct Answer:
Patient Case: A 40-year-old female with hemorrhagic shock receives a blood transfusion. Which vital sign should the nurse closely monitor for signs of fluid overload during the transfusion?
Explanation: During a blood transfusion, it is essential to closely monitor the patient’s respiratory rate for signs of fluid overload, such as increased respiratory rate and shortness of breath.
Correct Answer:
Medical-Surgical Nursing Questions Focus on Shock: Medications
Patient Case: A 50-year-old male with hemorrhagic shock is receiving crystalloid fluids. What is the primary purpose of administering crystalloid fluids in this situation?
Explanation: The primary purpose of administering crystalloid fluids in hemorrhagic shock is to expand intravascular volume and improve perfusion.
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Medical-Surgical Nursing Questions: Understanding Shock Causes and Symptoms
Patient Case: A 60-year-old male presents with peripheral vascular disease (PVD) and intermittent claudication. Which of the following interventions is most appropriate for managing his symptoms?
Explanation: The most appropriate intervention for managing intermittent claudication in PVD is encouraging smoking cessation and supervised exercise programs to improve arterial blood flow and reduce symptoms.
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Understanding Shock: Causes and Symptoms
Patient Case: A 55-year-old female with peripheral vascular disease (PVD) develops an open ulcer on her lower leg. Which of the following interventions is essential for promoting wound healing in PVD patients?
Explanation: Ensuring adequate blood flow to the wound is essential for promoting wound healing in PVD patients. Elevation and revascularization may be necessary interventions.
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Patient Case: A 70-year-old male with peripheral vascular disease (PVD) experiences severe pain at rest in his lower extremities. Which medication is commonly prescribed to alleviate rest pain in PVD patients?
Explanation: Analgesics are commonly prescribed to alleviate rest pain in PVD patients as they provide pain relief and improve quality of life.
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Patient Case: A 65-year-old female with peripheral vascular disease (PVD) is at risk for developing gangrene. What is the most crucial nursing intervention to prevent gangrene in PVD patients?
Explanation: Ensuring adequate perfusion and oxygenation to the extremities is the most crucial nursing intervention to prevent gangrene in PVD patients.
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Understanding Shock: Medical-Surgical Nursing Questions
Patient Case: A 58-year-old male with peripheral vascular disease (PVD) undergoes a bypass graft surgery. Which complication should the nurse closely monitor for postoperatively?
Explanation: The nurse should closely monitor for signs of infection postoperatively in a patient who has undergone bypass graft surgery for PVD.
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Understanding Shock: Medical-Surgical Nursing High Yield Questions
Patient Case: A 50-year-old male collapses suddenly, and you suspect cardiac arrest. What is the most critical initial step in the management of this patient?
Explanation: The most critical initial step in the management of a suspected cardiac arrest is to start chest compressions to provide circulation.
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Patient Case: A 60-year-old female experiences cardiac arrest. Which of the following rhythms is shockable and requires defibrillation?
Explanation: Ventricular fibrillation (VF) is a shockable rhythm that requires defibrillation in the management of cardiac arrest.
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Patient Case: You are performing chest compressions on a 55-year-old male in cardiac arrest. How should you coordinate chest compressions and rescue breaths in adult CPR?
Explanation: The correct coordination for chest compressions and rescue breaths in adult CPR is a 30 compressions to 2 breaths ratio.
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Medical-Surgical Nursing Questions: Shock Questions, Answers and Rationales
Patient Case: A 45-year-old female experiences cardiac arrest in the hospital. Which of the following medications is commonly administered during advanced cardiac life support (ACLS) to treat pulseless ventricular tachycardia (VT) or ventricular fibrillation (VF)?
Explanation: Amiodarone is commonly administered during ACLS to treat pulseless VT or VF, as it helps stabilize these life-threatening rhythms.
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Patient Case: After successful defibrillation and return of spontaneous circulation (ROSC) in a 70-year-old male following cardiac arrest, what is a crucial step in post-cardiac arrest care to optimize the patient’s outcome?
Explanation: Initiating therapeutic hypothermia is a crucial step in post-cardiac arrest care to optimize neurological outcomes and reduce brain injury.
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Patient Case: A 55-year-old male with a history of coronary artery disease (CAD) experiences chest pain during physical activity. What diagnostic test is commonly used to evaluate the presence and severity of CAD in this patient?
Explanation: A stress test (Exercise ECG or Treadmill test) is commonly used to assess CAD by evaluating the heart’s response to physical activity and detecting exercise-induced ischemia.
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Patient Case: A 60-year-old female with a history of valvular heart disease is experiencing symptoms of heart failure. Which diagnostic test can provide information about her heart’s structure and function, including valve abnormalities?
Explanation: An echocardiogram is a diagnostic test that provides information about the heart’s structure and function, making it valuable for assessing valve abnormalities in patients with valvular heart disease.
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Understanding Shock: Medical-Surgical Nursing Priority Questions
Patient Case: A 45-year-old male presents with chest pain. Which diagnostic test can help determine whether the chest pain is due to reduced blood flow to the heart muscle (ischemia) or a heart attack (myocardial infarction)?
Explanation: Coronary angiography is a diagnostic test that can determine whether chest pain is due to reduced blood flow (ischemia) or a heart attack (myocardial infarction) by visualizing coronary arteries.
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Explanation: Coronary angiography is indicated in patients with ST-segment elevation on ECG to assess coronary artery blockages and determine the need for revascularization procedures.
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Patient Case: A 55-year-old female is admitted with symptoms of angina. Her ECG shows T-wave inversion. Which diagnostic test can help evaluate her coronary arteries and detect blockages?
Explanation: Coronary angiography is used to assess coronary arteries and detect blockages. T-wave inversion on ECG may indicate ischemia or coronary artery disease.
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Patient Case: A 45-year-old male presents with chest pain. An ECG shows no significant changes. Which diagnostic test is commonly performed as an initial assessment for this patient?
Explanation: When ECG shows no significant changes but the patient has chest pain, an initial assessment often includes a cardiac stress test to evaluate for ischemia.
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atient Case: A 50-year-old female with a history of heart disease experiences palpitations. Her ECG shows irregular electrical activity. What diagnostic test may be ordered to assess her heart’s electrical conduction system?
Explanation: An electrophysiology study (EPS) is used to assess the heart’s electrical conduction system and is indicated in patients with palpitations and irregular electrical activity on ECG.
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Patient Case: A 65-year-old male with a history of cardiovascular disease presents with chest pain and shortness of breath. His ECG reveals a bundle branch block. What diagnostic test can help assess his heart’s electrical conduction and rule out other heart conditions?
Explanation: An electrophysiology study (EPS) can assess the heart’s electrical conduction system and is useful in patients with bundle branch blocks to rule out other heart conditions.
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Patient Case: A 70-year-old patient presents with bradycardia and syncope. After assessment, it is determined that the patient’s atrioventricular (AV) node is not functioning properly. Which intervention is most appropriate to address this issue?
Explanation: In this case, the patient’s symptomatic bradycardia due to AV node dysfunction warrants the implantation of a pacemaker to restore normal heart rhythm.
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Patient Case: A 60-year-old patient presents with unstable angina. Coronary angiography reveals a significant blockage in a coronary artery. What intervention is typically performed to address this blockage and improve blood flow to the heart muscle?
Explanation: To address significant coronary artery blockages, coronary stenting is commonly performed to improve blood flow to the heart muscle and relieve angina symptoms.
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Patient Case: A 75-year-old patient with heart block presents with fatigue and dizziness. The ECG reveals third-degree heart block. Which intervention is indicated to manage this condition and ensure adequate heart rate and rhythm?
Explanation: In cases of third-degree heart block with symptomatic bradycardia, implantation of a pacemaker is indicated to maintain adequate heart rate and rhythm.
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Patient Case: A 50-year-old patient experiences a myocardial infarction (heart attack) due to a blocked coronary artery. After assessment, which procedure is typically performed to restore blood flow to the affected area of the heart?
Explanation: To restore blood flow in a blocked coronary artery during a heart attack, coronary angiography and coronary stenting are commonly performed procedures.
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Patient Case: A 65-year-old patient with recurrent bradycardia and syncope is evaluated. Which intervention is typically recommended to manage this patient’s condition and maintain an appropriate heart rate?
Explanation: Implantation of a pacemaker is indicated in patients with recurrent bradycardia to maintain an appropriate heart rate and prevent syncope.
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Patient Case: A 65-year-old patient with symptomatic bradycardia is scheduled for a pacemaker insertion. The patient is concerned about the procedure and its long-term effects. What would be an appropriate explanation to provide to the patient about the pacemaker?
Explanation: Pacemakers are implanted to regulate the heart’s rhythm in patients with bradycardia. They may require periodic replacement as their battery life depletes.
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Patient Case: A 70-year-old patient with a pacemaker reports feeling dizzy and lightheaded when near household appliances. What explanation should the nurse provide to the patient regarding this issue?
Explanation: Household appliances are generally safe to use, but it’s advisable to maintain a safe distance (usually at least six inches) from the pacemaker to prevent electromagnetic interference.
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Patient Case: A 55-year-old patient with a dual-chamber pacemaker experiences fatigue and shortness of breath. What could be a potential cause of these symptoms in a patient with a pacemaker?
Explanation: Pacemaker malfunction can cause symptoms such as fatigue and shortness of breath. Evaluation by a healthcare provider is necessary.
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Patient Case: A 60-year-old patient with a pacemaker plans to travel. What advice should the nurse provide to the patient regarding airport security and the pacemaker?
Explanation: Patients with pacemakers should inform airport security, who will provide alternative screening methods like a pat-down to avoid potential interference with the pacemaker.
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Patient Case: A 75-year-old patient has a temporary external pacemaker following heart surgery. What should the nurse monitor for in a patient with an external pacemaker?
Explanation: Monitoring for skin irritation at the pacemaker site is important in patients with an external pacemaker. It helps prevent infection and discomfort.
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Patient Case: A 60-year-old patient with coronary artery disease (CAD) presents with angina. The physician recommends a revascularization procedure. What is the primary difference between stenting and CABG in the treatment of CAD?
Explanation: The primary difference is that stenting is a minimally invasive procedure that uses a mesh-like device to keep arteries open, while CABG is open-heart surgery that creates new bypasses using vessels from elsewhere in the body.
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Patient Case: A 55-year-old patient with multiple comorbidities is considering revascularization for CAD. The patient asks about the recovery time for stenting and CABG. What can the nurse explain regarding the recovery periods for these procedures?
Explanation: CABG usually involves a shorter recovery time and hospital stay compared to stenting. However, individual factors can influence recovery.
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Patient Case: A 45-year-old patient is scheduled for a coronary revascularization procedure. The patient has a preference for a minimally invasive approach. Which procedure should the nurse explain as a minimally invasive option?
Explanation: Stenting is considered a minimally invasive procedure compared to CABG, which is open-heart surgery.
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Patient Case: A 65-year-old patient underwent stenting for CAD. What medication is essential for the nurse to educate the patient about post-stenting?
Explanation: Post-stenting, patients are often prescribed dual antiplatelet therapy, such as aspirin and clopidogrel, to prevent stent thrombosis.
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Patient Case: A 70-year-old patient with complex CAD is being evaluated for revascularization. The patient has a history of stroke. What consideration is important when discussing stenting versus CABG for this patient?
Explanation: CABG may carry a higher risk of stroke compared to stenting, and the patient’s history of stroke should be considered when discussing revascularization options.
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Patient Case: A 3-year-old child presents to the emergency room with sudden choking, coughing, and difficulty breathing after swallowing a small toy. What is the initial nursing intervention for suspected foreign body airway obstruction in a conscious child?
Explanation: The initial nursing intervention for foreign body airway obstruction in a conscious child is to encourage the child to cough forcefully, as coughing may help dislodge the object.
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Patient Case: A 45-year-old adult is dining at a restaurant and suddenly grabs their throat, unable to speak or breathe. The individual is conscious. What is the appropriate nursing intervention for suspected foreign body airway obstruction in a conscious adult?
Explanation: For a conscious adult with foreign body airway obstruction, the appropriate nursing intervention is to perform abdominal thrusts (Heimlich maneuver).
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Patient Case: A 60-year-old patient with dementia is at risk of swallowing small objects. The patient suddenly becomes agitated and starts coughing. What should the nurse do if foreign body airway obstruction is suspected in an individual with altered mental status?
Explanation: In a patient with altered mental status, it is not safe to perform abdominal thrusts or a finger sweep. The nurse should call for assistance and provide support while waiting for trained medical personnel.
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Patient Case: A 25-year-old patient in a dental clinic suddenly starts gasping for air and clutching their throat after a dental procedure. The patient is conscious. What is the initial nursing intervention for suspected foreign body airway obstruction in a conscious patient in a dental clinic?
Explanation: For a conscious patient with foreign body airway obstruction, the initial nursing intervention is to administer abdominal thrusts (Heimlich maneuver).
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Patient Case: An elderly patient with a history of stroke is known to have difficulty swallowing. The patient suddenly becomes pale and cannot speak. What is the appropriate nursing intervention for suspected foreign body airway obstruction in this patient?
Explanation: In an elderly patient with a history of stroke, abdominal thrusts (Heimlich maneuver) may be contraindicated due to the risk of injury. The nurse should attempt a finger sweep if trained to do so and provide support while waiting for medical assistance.
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Patient Case: A 65-year-old patient with a history of chronic obstructive pulmonary disease (COPD) presents with sudden severe shortness of breath and audible wheezing. You suspect a mucous plug airway obstruction. What is the initial nursing intervention to treat this condition?
Explanation: The initial nursing intervention for mucous plug airway obstruction is to encourage the patient to cough forcefully, which can help clear the obstruction from the airway.
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Patient Case: A 40-year-old patient post-surgery starts experiencing increased difficulty breathing, chest tightness, and cyanosis. You suspect a mucous plug airway obstruction. What should the nurse do immediately to manage this situation?
Explanation: In the case of a suspected mucous plug airway obstruction, the nurse should administer supplemental oxygen immediately to ensure adequate oxygenation while further interventions are prepared.
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Patient Case: A pediatric patient with a respiratory illness suddenly becomes distressed, with increased respiratory rate and audible wheezing. What should the nurse do first when suspecting a mucous plug airway obstruction in a child?
Explanation: In a pediatric patient with suspected mucous plug airway obstruction, the initial intervention should be to administer nebulized saline solution to help thin and loosen the mucus, making it easier to clear the airway.
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Patient Case: A 55-year-old patient recovering from a lower abdominal surgery suddenly experiences increased difficulty breathing and noisy breathing sounds. You suspect a mucous plug airway obstruction. What should the nurse do immediately in this situation?
Explanation: In this scenario, the nurse should encourage the patient to cough forcefully to try to dislodge the mucous plug. If the condition worsens, supplemental oxygen may be needed as well.
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Patient Case: A postoperative patient suddenly exhibits signs of respiratory distress, including stridor and restlessness. You suspect a mucous plug airway obstruction. What should the nurse do as the initial intervention?
Explanation: In this case, the initial nursing intervention should be to administer nebulized saline solution to help liquefy the mucous plug, making it easier for the patient to clear the airway.
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Patient Case: A 68-year-old patient with a history of COPD is admitted with worsening dyspnea, productive cough, and fever. The chest X-ray shows consolidation in the right lower lobe. What is the first-line antibiotic treatment for this patient’s suspected bacterial pneumonia?
Explanation: The first-line antibiotic treatment for suspected bacterial pneumonia in a patient with COPD is typically a combination of ceftriaxone and azithromycin to cover common pathogens including Streptococcus pneumoniae and Haemophilus influenzae.
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Patient Case: A 55-year-old patient with COPD is admitted with fever, increased sputum production, and chest discomfort. The sputum culture reveals Pseudomonas aeruginosa. What is the appropriate antibiotic therapy for this patient’s exacerbation of COPD with Pseudomonas infection?
Explanation: In cases of COPD exacerbation with Pseudomonas infection, Piperacillin-tazobactam is an appropriate choice of antibiotics due to its activity against Pseudomonas aeruginosa.
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Patient Case: A 70-year-old patient with COPD presents with increased dyspnea, wheezing, and thick, yellowish sputum. The arterial blood gas (ABG) analysis shows respiratory acidosis. What is the initial treatment to improve this patient’s respiratory status?
Explanation: The initial treatment for a COPD exacerbation with respiratory acidosis should focus on improving oxygenation, so oxygen therapy is the first-line intervention.
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Patient Case: A 60-year-old patient with COPD presents with increased shortness of breath, wheezing, and chest tightness. Which bronchodilator medication is commonly used to relieve acute bronchoconstriction in COPD exacerbations?
Explanation: Ipratropium bromide is a commonly used bronchodilator in COPD exacerbations to relieve acute bronchoconstriction and improve airflow.
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Patient Case: A 65-year-old patient with COPD is prescribed pulmonary rehabilitation. What is the primary goal of pulmonary rehabilitation in patients with COPD?
Explanation: The primary goal of pulmonary rehabilitation in patients with COPD is to enhance their quality of life and functional capacity, as COPD is a chronic condition that cannot be cured.
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Patient Case: A 45-year-old obese patient presents with loud snoring, excessive daytime sleepiness, and witnessed apneas during sleep. What is the gold standard diagnostic test for confirming obstructive sleep apnea (OSA)?
Explanation: The gold standard diagnostic test for confirming obstructive sleep apnea (OSA) is polysomnography (PSG), which monitors various parameters during sleep, including airflow, oxygen saturation, and brain activity.
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Patient Case: A 50-year-old patient with sleep apnea is prescribed continuous positive airway pressure (CPAP) therapy. What is the primary purpose of CPAP in the treatment of sleep apnea?
Explanation: The primary purpose of continuous positive airway pressure (CPAP) therapy in the treatment of sleep apnea is to prevent apneas and maintain the patency of the airway by delivering a continuous flow of air pressure.
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Patient Case: A 60-year-old patient with sleep apnea is non-compliant with CPAP therapy. What alternative treatment option can be considered for patients with moderate to severe obstructive sleep apnea who cannot tolerate CPAP?
Explanation: For patients who cannot tolerate CPAP, surgical options such as uvulopalatopharyngoplasty (UPPP) can be considered in cases of moderate to severe obstructive sleep apnea.
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Patient Case: A 55-year-old patient with sleep apnea is advised to avoid alcohol and sedative medications. Why is it important for individuals with sleep apnea to avoid these substances?
Explanation: Alcohol and sedative medications can worsen sleep apnea and impair airway muscle function, leading to more frequent apneas and disrupted sleep patterns.
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Patient Case: A 40-year-old patient with sleep apnea asks about positional therapy. What is the role of positional therapy in the management of sleep apnea?
Explanation: Positional therapy involves maintaining a specific sleep position (usually side-sleeping) to reduce the frequency of obstructive sleep apnea (OSA) events, particularly in individuals whose OSA is primarily positional.
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managing this pleural effusion?
Explanation: The initial intervention for managing a large pleural effusion is to perform a thoracentesis, which involves removing excess fluid from the pleural space to relieve symptoms and obtain diagnostic samples.
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Patient Case: A 55-year-old patient with a known pleural effusion develops a fever, chills, and increased pleuritic chest pain. The healthcare provider suspects an infection. What diagnostic test should be performed to confirm the presence of infection?
Explanation: To confirm the presence of infection in a pleural effusion, pleural fluid analysis including pleural fluid culture should be performed to identify any pathogens causing the infection.
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Patient Case: A 70-year-old patient is admitted with a suspected pleural effusion. Which of the following physical examination findings is suggestive of a pleural effusion?
Explanation: Decreased chest expansion on the affected side is a physical examination finding suggestive of a pleural effusion. It indicates restricted lung movement due to the accumulation of fluid in the pleural space.
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Patient Case: A 60-year-old patient with a pleural effusion is scheduled for a thoracentesis. What should the nurse instruct the patient to do before the procedure to maximize safety and comfort?
Explanation: Before a thoracentesis, the nurse should instruct the patient to empty the bladder to reduce the risk of discomfort and ensure the procedure can be performed safely.
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Patient Case: A patient with a pleural effusion is started on antibiotic therapy due to suspected infection. What is the primary purpose of obtaining a blood culture in this case?
Explanation: The primary purpose of obtaining a blood culture in a patient with a pleural effusion and suspected infection is to identify any pathogens causing the infection and guide appropriate antibiotic therapy.
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Patient Case: A 25-year-old patient presents with a sore throat, fever, and swollen tonsils. On examination, the throat appears red and inflamed with white patches. What is the most likely cause of the patient’s symptoms?
Explanation: The patient’s symptoms of sore throat, fever, swollen tonsils, redness, and white patches are suggestive of bacterial pharyngitis, commonly caused by Streptococcus pyogenes (Group A Streptococcus).
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Patient Case: A 35-year-old patient complains of a sore throat and hoarseness. On examination, the throat appears red and swollen. The patient mentions recent voice overuse. What is the likely cause of the patient’s symptoms?
Explanation: The patient’s symptoms and history of voice overuse suggest non-infectious pharyngitis (phonotrauma), which is often caused by excessive strain on the vocal cords and is not due to an infectious agent.
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Patient Case: A 30-year-old patient with a sore throat and cough presents with viral pharyngitis. Which of the following medications should be recommended to manage the symptoms?
Explanation: Viral pharyngitis is typically managed with supportive care, including over-the-counter pain relievers (e.g., acetaminophen or ibuprofen) to alleviate symptoms such as sore throat and fever.
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Patient Case: A 40-year-old patient presents with recurrent episodes of fungal pharyngitis. Which antifungal medication is commonly used to treat fungal pharyngitis?
Explanation: Fluconazole is an antifungal medication commonly used to treat fungal pharyngitis, especially in cases of recurrent or persistent fungal infections.
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Patient Case: A 50-year-old patient with bacterial pharyngitis is prescribed antibiotics. Which class of antibiotics is typically recommended as the first-line treatment for Streptococcal pharyngitis?
Explanation: Penicillins, such as amoxicillin, are typically recommended as the first-line treatment for Streptococcal pharyngitis (bacterial pharyngitis).
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Patient Case: A 15-year-old adolescent presents with wheezing, shortness of breath, and coughing, especially during the night and early morning. The patient’s symptoms worsen with exposure to allergens and cold air. What is the most likely diagnosis for this adolescent?
Explanation: The adolescent’s symptoms of wheezing, coughing, and worsening with allergens and cold air are indicative of asthma, a chronic respiratory condition common in adolescents.
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Patient Case: A 16-year-old adolescent with asthma experiences an acute exacerbation, with increased wheezing and shortness of breath. What is the initial intervention that should be administered to this patient?
Explanation: In an acute asthma exacerbation, the initial intervention is the administration of a bronchodilator inhaler (e.g., albuterol) to relieve bronchoconstriction and improve airflow.
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Patient Case: A 17-year-old adolescent with asthma is prescribed a daily controller medication to prevent exacerbations. Which of the following is a common controller medication used in the management of asthma in adolescents?
Explanation: Montelukast is a common controller medication used to manage asthma in adolescents by reducing inflammation and bronchoconstriction.
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Patient Case: A 14-year-old adolescent with asthma is experiencing nighttime awakenings due to coughing and wheezing. What type of asthma is characterized by nighttime symptoms that interfere with sleep?
Explanation: Nighttime symptoms interfering with sleep are characteristic of moderate persistent asthma in adolescents, indicating a need for daily controller medications.
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Patient Case: A 16-year-old adolescent with asthma is prescribed a peak flow meter to monitor respiratory function at home. How should the adolescent use the peak flow meter for accurate measurements?
Explanation: To use a peak flow meter accurately, the adolescent should inhale deeply, then exhale forcefully into the meter to measure peak expiratory flow rate (PEFR).
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Patient Case: A 35-year-old patient with a positive tuberculin skin test (TST) presents with a persistent cough, fever, night sweats, and unintentional weight loss. Which diagnostic test is most appropriate for confirming the diagnosis of active tuberculosis?
Explanation: To confirm the diagnosis of active tuberculosis, a sputum culture and acid-fast bacilli (AFB) smear are the most appropriate tests, as they identify the presence of Mycobacterium tuberculosis in respiratory secretions.
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Patient Case: A 28-year-old patient with active tuberculosis is prescribed a combination of four drugs for treatment. Which of the following drugs is a first-line agent commonly used to treat tuberculosis?
Explanation: Isoniazid (INH) is a first-line drug used in the treatment of tuberculosis due to its effectiveness in killing Mycobacterium tuberculosis.
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Patient Case: A 40-year-old patient with tuberculosis is receiving antituberculosis medications. The nurse educates the patient about potential side effects, including hepatotoxicity. Which medication is most commonly associated with hepatotoxicity in tuberculosis treatment?
Explanation: Among the antituberculosis medications, Pyrazinamide is most commonly associated with hepatotoxicity. Patients should be monitored for liver function while on this medication.
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Patient Case: A 55-year-old patient with tuberculosis has been started on antituberculosis medications. The patient asks about the duration of treatment. What is the typical duration of the initial phase of treatment for drug-susceptible tuberculosis?
Explanation: The initial phase of treatment for drug-susceptible tuberculosis typically lasts for 2 months.
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Patient Case: A 30-year-old patient with tuberculosis is experiencing peripheral neuropathy as a side effect of antituberculosis treatment. Which vitamin supplement is commonly given to prevent or treat peripheral neuropathy associated with isoniazid (INH) therapy?
Explanation: Vitamin B6 (pyridoxine) is commonly given to prevent or treat peripheral neuropathy associated with isoniazid (INH) therapy.
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