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NEW QUESTION # 173
Which of the following is a legal term that reflects judicial involvement in the determination of a patient's decision-making capacity?
- A. Competence
- B. Capacity
- C. Cognition
- D. Intelligence
Answer: A
Explanation:
Correct answer: Competence
Competence is a legal term that reflects judicial involvement in the determination of a patient's decision-making capacity.
Capacity addresses the ability of an individual to participate in the medical decision-making process.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 201.
NEW QUESTION # 174
The Ethical principle that the patient has the right to make decisions about his or her own care is called as:
- A. Bioethics
- B. Autonomy
- C. Informed consent
- D. None of the above
Answer: B
Explanation:
Explanation: The Ethical principle that the patient has the right to make decisions about his or her own care is called as autonomy. Autonomy is the Ethical Principle that gives the patient the right to make decisions about his or her own care. Patient family or parents are the legal autonomy of making decision if the patient is not in the state of making decisions. Nurse must keep the patient and his family well informed about this power of autonomy.
NEW QUESTION # 175
Requiring a mentally competent patient to call for assistance before getting out of bed to use the bathroom is an example of which of the following?
- A. Autonomy
- B. Veracity
- C. Paternalism
- D. Fidelity
Answer: C
Explanation:
Correct answer: Paternalism
Paternalism, in ethics, refers to instances in which the principle of beneficence overrides that of autonomy. In this case, fall prevention overrides the patient's autonomy but is justified by the benefit of ensuring the patient's safety.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 196.
NEW QUESTION # 176
All of the following statements are true related to Ventavis (iloprost) except:
- A. It is an inhibitor of platelet aggregation
- B. It is a systemic vasodilator
- C. It is a prostacyclin vasodilator of the pulmonary arterial vascular beds
- D. It is used in the treatment of pulmonary hypertension and is administered per continuous intravenous infusion
Answer: D
Explanation:
Correct answer: It is used in the treatment of pulmonary arterial hypertension and is administered per continuous intravenous infusion Ventavis (iloprost) is an intermittent inhalation treatment using a medication-specific nebulizer for pulmonary arterial hypertension.
This is a costly medication and patients must be able to self-administer.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 266.
NEW QUESTION # 177
What is seen in the Chest x-ray of a patient suffering from Pneumonia?
- A. Diffuse patches
- B. Consolidation
- C. Cavity
- D. Solitary nodule
Answer: B
Explanation:
Explanation: Consolidation is seen in the Chest x-ray of a patient suffering from Pneumonia. Pneumonia is inflammation of the lung parenchyma which fills the alveoli with exudates. The Chest x-ray of a patient suffering with Pneumonia shows consolidation because lung parenchyma is filled with exudates and finally fibrosis occurs.
NEW QUESTION # 178
A 75 years old lady presented to OPD with severe burning and redness on right side of the chest. She also noticed painful blisters on the right side of the chest. On examination it was confirmed that these blisters were along a nerve supply. What is the likely diagnosis based on history and clinical examination?
- A. Chicken pox
- B. Measles
- C. Herpes zoster
- D. Mumps
Answer: C
Explanation:
Explanation: The most likely diagnosis based on history and clinical examination is herpes zoster because this virus spreads along the nerve root distribution and causes burning and blistering. It usually occurs in immunocompromised state.
NEW QUESTION # 179
All of the following medications are examples of oral medications used in the treatment of pulmonary arterial hypertension except:
- A. Flolan (epoprostenol)
- B. Bosentan (Tracleer)
- C. Ambrisentan (Letairis)
- D. Sildenafil (Revatio)
Answer: A
Explanation:
Correct answer: Flolan (epoprostenol)
Flolan (epoprostenol) is given per intravenous infusion in the treatment of pulmonary arterial hypertension.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 266.
NEW QUESTION # 180
Following the administration of a warfarin dose, the peak depression of coagulation occurs in approximately how long?
- A. 36 hours
- B. 12 hours
- C. 8 hours
- D. 24 hours
Answer: A
Explanation:
Correct answer: 36 hours
Following the administration of warfarin, the peak depression of coagulation occurs in approximately 36 hours. The timing of INR measurements in relation to changes in daily dosing is important. Coagulation tests should be consistently performed at an appropriate time during a given dosing schedule. After the first four to five doses, the fluctuation in the INR over a 24-hour dosing interval is minimal.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 184.
NEW QUESTION # 181
A patient presents in the cardiac emergency department with left-sided chest pain. His ECG shows ST segment elevations. Patient complains that this pain occurs cyclically, i.e., at the same time each day and during rest period. What is the most likely treatment?
- A. Alpha blockers
- B. Beta blockers
- C. ACE inhibitors
- D. Calcium channel blockers
Answer: D
Explanation:
Explanation: The most likely treatment for this case is the Variant Angina. This type of angina is due to the spasm of the coronary arteries. In this case, the most likely treatment for Variant angina is calcium channel blockers. Calcium channel blockers are arterial vasodilators and have affect both the coronary and the peripheral arteries.
NEW QUESTION # 182
All of the following are clinical manifestations of hyperosmolar hyperglycemic state (HHS) except:
- A. Serum glucose at least 600 mg/dL
- B. Serum ketones below 2+
- C. Serum osmolality > 350 mOsm/kg
- D. Kussmaul respirations
Answer: D
Explanation:
Correct answer: Kussmaul respirations
Hyperosmolar hyperglycemic state (HHS) is classified as hyperglycemia with profound dehydration in the absence of ketosis. Kussmaul breathing is a deep and labored breathing pattern and is not a clinical manifestation of hyperosmolar hyperglycemic states.
The severe hyperglycemia in HHS results in profound extracellular fluid volume contraction, marked intracellular dehydration, and excessive loss of electrolytes. Also, because there is some insulin secretion, the breakdown of fat is suppressed, and no overproduction of ketones takes place. In the absence of signs and symptoms of ketosis, patients are not aware their blood sugar is rising and that they need treatment.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 390.
NEW QUESTION # 183
A patient with a tracheostomy spontaneously opens his eyes to verbal stimuli and obeys verbal commands. His Glasgow Coma Scale score is:
- A. 0
- B. 1
- C. 0 or NA
- D. 10T
Answer: D
Explanation:
Correct answer: 10T
Patients with tracheostomies are commonly assigned a verbal score of T and the total Glasgow Coma Scale is (GSC) is denoted as the sum of the eye opening and motor scores followed by T.
Alternately, the examiner assigns a verbal score based on an estimation of the patient's abilities, often determined by noting the patient's response when presented with multiple choices.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 298-299.
NEW QUESTION # 184
A physician has ordered cardiac catheterization for a patient in the progressive care unit. After explaining the procedure, the patient, who is alert, oriented, and competent to make decisions is refusing to give informed consent.
The nurse's role is to:
- A. Try to get the patient to change his mind by providing more information
- B. Threaten to call the physician
- C. Have the consent signed by the patient's spouse, since she has power of attorney
- D. Respect and support the patient's decision
Answer: D
Explanation:
Correct answer: Respect and support the patient's decision
The nurse must respect the competent patient's choice and support the patient's decisions even if the decision is contrary to the judgments of the health care team.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 195, 198.
NEW QUESTION # 185
Upper gastrointestinal bleeding which results in a sudden loss of blood volume and decreased cardiac output triggers the release of:
- A. Norepinephrine and thromboplastin
- B. Epinephrine and norepinephrine
- C. Thrombokinase and aldosterone
- D. Epinephrine and thromboplastin
Answer: B
Explanation:
Correct answer: Epinephrine and norepinephrine
Regardless of the cause, a sudden loss of blood due to upper gastrointestinal bleeding is associated with decreased cardiac output. This triggers the release of epinephrine and norepinephrine, and also aldosterone and antidiuretic hormones.
Thromboplastin is released when platelets rupture; it is not triggered by decreased cardiac output.
Aldosterone is released due to decreased cardiac output, but thrombokinase (thromboplastin) is not triggered by decreased cardiac output.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 342.
NEW QUESTION # 186
Common offenders in causing diarrhea in enterally-fed patients include:
- A. Guaifenesin and aluminum-containing antacids
- B. Lactulose and sucralfate
- C. Acetaminophen elixir and aluminum-containing antacids
- D. Acetaminophen and guaifenesin elixir
Answer: D
Explanation:
Correct answer: Acetaminophen and guaifenesin elixir
Common offenders in causing diarrhea in enterally-fed patients include acetaminophen and guaifenesin elixir.
Aluminum-containing antacids and sucralfate are not likely to cause diarrhea and are more prone to cause constipation.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 181, 366.
NEW QUESTION # 187
Acute respiratory failure (ARF) can occur as a result of many abnormalities but, regardless of the specific underlying condition, the etiology of ARF in adults can be categorized into four main components:
impaired ventilation, impaired gas exchange, airway obstruction, and ventilation-perfusion abnormalities. Which of the following conditions causes airway obstruction?
- A. Spinal cord injury at C4 or higher
- B. Pulmonary embolism
- C. Phrenic nerve damage
- D. Asthma
Answer: D
Explanation:
Correct answer: Asthma
Airway obstruction may occur as a result of the following:
* Conditions that blook the inner airway lumen
o fluid in the airways
o excessive secretions
o inhaled foreign bodies
* Conditions that increase airway wall thickness or decrease airway circumference o increase wall thickness: fibrosis or edema o decrease circumference: asthmatic bronchoconstriction
* Conditions that increase peribronchial compression of the airway
o tumors
o interstitial edema
o enlarged lymph nodes
Phrenic nerve damage and spinal cord injury at C4 or higher cause impaired ventilation. Pulmonary embolism causes ventilation-perfusion abnormalities.
Reference:
Burns,
Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 253-254.
NEW QUESTION # 188
The stages of COPD can be assessed by all of the following except:
- A. Spirometry
- B. Functional dyspnea
- C. Chest x-ray
- D. Body mass index
Answer: C
Explanation:
Explanation: The stages of COPD can be assessed by all of the above except chest x-ray. Functional dyspnea, body mass index, and spirometry are used to assess the different stages of COPD. The spirometry helps in measuring the ratio of forced expiratory volume in the first second of expiration after complete inhalation to total forced vital capacity. The chest x-ray has no role in defining the stages of COPD.
NEW QUESTION # 189
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