Nursing Elites

1. Septic, anaphylactic, and neurogenic shock are all categorized as:

• A. Hypovolemic shock
• B. Cardiogenic shock
• C. Distributive shock
• D. Obstructive shock

Correct answer: C

Rationale: Septic, anaphylactic, and neurogenic shock are all types of distributive shock. Distributive shock is characterized by a decrease in systemic vascular resistance, leading to poor tissue perfusion. Septic shock is caused by severe infection, anaphylactic shock is an extreme allergic reaction, and neurogenic shock results from damage to the nervous system. Hypovolemic shock (Choice A) is characterized by a decrease in intravascular volume, cardiogenic shock (Choice B) is due to heart failure, and obstructive shock (Choice D) results from obstruction of blood flow. Therefore, the correct categorization for septic, anaphylactic, and neurogenic shock is distributive shock.

2. A patient's chart indicates a history of meningitis. Which of the following would you NOT expect to see with this patient if this condition were acute?

• A. Increased appetite
• B. Vomiting
• C. Fever
• D. Poor tolerance of light

Correct answer: A

Rationale: The correct answer is 'Increased appetite.' In cases of acute meningitis, loss of appetite would be expected rather than an increase. Meningitis is often caused by an infectious agent that colonizes or infects various sites in the body, leading to systemic symptoms. Common symptoms of acute meningitis include fever, vomiting, and poor tolerance of light due to meningeal irritation. The inflammatory response in the meninges can result in symptoms like photophobia. Increased appetite is not typically associated with acute meningitis. Therefore, choice A is the least likely symptom to be observed in a patient with acute meningitis. Choices B, C, and D are symptoms commonly seen in acute meningitis due to the inflammatory process affecting the central nervous system and meninges.

3. Which of the following glands found in the skin secretes a liquid called Sebum?

• A. Apocrine Glands
• B. Sebaceous Glands
• C. Lacrimal Glands
• D. Sweat Glands

Correct answer: B

Rationale: Sebum is a liquid secreted by glands in the skin known as sebaceous glands. Sebum's primary function is to lubricate the skin and help maintain its integrity. Apocrine glands secrete a different type of sweat that is odorless but can develop an odor when combined with bacteria on the skin. Lacrimal glands produce tears to keep the eyes moist, and sweat glands secrete sweat to regulate body temperature through evaporation. Therefore, the correct answer is Sebaceous Glands because they specifically secrete sebum, distinguishing them from the other gland types mentioned.

4. A 23-year-old woman is admitted to the infusion clinic after a Multiple Sclerosis exacerbation. The physician orders methylprednisolone infusions (Solu-Medrol). The nurse would expect which of the following outcomes after administration of this medication?

• A. A decrease in muscle spasticity and involuntary movements
• B. A slowed progression of Multiple Sclerosis-related plaques
• C. A decrease in the length of the exacerbation
• D. A stabilization of mood and sleep

Correct answer: C

Rationale: Methylprednisolone infusion is the first-line treatment during an acute exacerbation of Multiple Sclerosis. It is used to decrease the length and severity of a relapse by reducing inflammation in the central nervous system. Choice A, 'A decrease in muscle spasticity and involuntary movements,' is incorrect because methylprednisolone primarily targets inflammation and does not directly address muscle spasticity. Choice B, 'A slowed progression of Multiple Sclerosis-related plaques,' is incorrect as methylprednisolone is not used to slow the progression of the disease but rather to manage acute exacerbations. Choice D, 'A stabilization of mood and sleep,' is not an expected outcome of methylprednisolone administration for Multiple Sclerosis exacerbation as it primarily targets the inflammatory process associated with the relapse.

5. The nurse analyzes the results of a patient's arterial blood gases (ABGs). Which finding would require immediate action?

• A. The bicarbonate level (HCO3) is 31 mEq/L
• B. The arterial oxygen saturation (SaO2) is 92%
• C. The partial pressure of CO2 in arterial blood (PaCO2) is 31 mm Hg
• D. The partial pressure of oxygen in arterial blood (PaO2) is 59 mm Hg

Correct answer: D

Rationale: While all the values are abnormal, the low PaO2 level of 59 mm Hg indicates that the patient is at a critical point on the oxyhemoglobin dissociation curve. At this level, a small decrease in PaO2 can lead to a significant drop in oxygen saturation and compromise tissue oxygenation. Therefore, immediate intervention is necessary to improve the patient's oxygenation status. Choice A (HCO3 of 31 mEq/L) may indicate metabolic alkalosis or compensation for respiratory acidosis; however, it does not require immediate action in this scenario. Choice B (SaO2 of 92%) is slightly low but not critically low to require immediate action. Choice C (PaCO2 of 31 mm Hg) is within the normal range and does not indicate immediate danger to the patient.

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