Nursing Elites

1. What are the early signs of increased intracranial pressure (IICP)?

• A. Restlessness, irritability, and confusion
• B. Sudden onset of seizures
• C. Decreased heart rate and pupillary response
• D. Loss of consciousness

Correct answer: A

Rationale: The correct answer is A: Restlessness, irritability, and confusion are early signs of increased intracranial pressure (IICP). These signs indicate that the brain is starting to experience pressure, often due to conditions such as trauma, tumors, or hemorrhage. Sudden onset of seizures (choice B) is not typically an early sign of IICP but can occur later as the pressure increases. Decreased heart rate and pupillary response (choice C) are more indicative of late-stage IICP as the brainstem becomes compromised. Loss of consciousness (choice D) is a late sign of IICP when the pressure has significantly increased and is causing significant brain dysfunction.

2. A healthcare professional is preparing a client for a colonoscopy. Which of the following medications should the professional anticipate the provider to prescribe as an anesthetic for the procedure?

• A. Propofol
• B. Pancuronium
• C. Promethazine
• D. Pentoxifylline

Correct answer: A

Rationale: The correct answer is A, Propofol. Propofol is a short-acting anesthetic medication commonly used for procedures like colonoscopies to induce moderate sedation. Pancuronium (Choice B) is a neuromuscular blocking agent used as a paralyzing agent during surgery, not for sedation. Promethazine (Choice C) is an antihistamine often used for nausea and vomiting, not as an anesthetic. Pentoxifylline (Choice D) is a medication used to improve blood flow and is not indicated for anesthesia.

3. What are the expected symptoms in a patient with compartment syndrome?

• A. Unrelieved pain, pallor, and pulselessness
• B. Localized swelling and redness
• C. Fever and swelling
• D. Weakness and fatigue

Correct answer: A

Rationale: The correct answer is A: Unrelieved pain, pallor, and pulselessness. These symptoms are classic signs of compartment syndrome, which is a serious condition characterized by reduced circulation in a closed muscle compartment. The pain is typically severe and disproportionate to the injury, and if left untreated, it can lead to tissue damage and loss of function. Choices B, C, and D are incorrect because they do not represent the hallmark symptoms of compartment syndrome. Localized swelling and redness may be present but are not specific to this condition. Fever and swelling are more indicative of inflammation or infection, while weakness and fatigue are nonspecific and do not typically occur in isolation in compartment syndrome.

4. What is the initial nursing action for a patient with chest pain and acute coronary syndrome?

• A. Administer sublingual nitroglycerin
• B. Check the patient's urine output
• C. Check cardiac enzymes
• D. Obtain IV access

Correct answer: A

Rationale: Administering sublingual nitroglycerin is the priority initial action for a patient with chest pain and acute coronary syndrome. Nitroglycerin helps vasodilate coronary arteries, improving blood flow to the heart muscle and reducing chest pain. Checking the patient's urine output (choice B) and cardiac enzymes (choice C) are important assessments but are not the first priority when managing acute chest pain. Obtaining IV access (choice D) is essential for administering medications and fluids, but administering sublingual nitroglycerin takes precedence in the initial management of chest pain in acute coronary syndrome.

5. A nurse misreads a blood glucose level and administers excess insulin. What should the nurse monitor for?

• A. Monitor for hyperglycemia
• B. Monitor for hypoglycemia
• C. Administer glucose IV
• D. Monitor for increased thirst

Correct answer: B

Rationale: The correct answer is to monitor for hypoglycemia. Excess insulin can lead to low blood glucose levels, causing hypoglycemia. Symptoms of hypoglycemia include sweating, trembling, dizziness, confusion, and in severe cases, loss of consciousness. Options A, C, and D are incorrect because administering excess insulin would not lead to hyperglycemia or increased thirst, and administering glucose IV would exacerbate the issue by further lowering blood glucose levels.

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