Nursing Elites

1. 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.

2. What is the priority lab value for monitoring a patient with HIV?

• A. CD4 T-cell count below 180 cells/mm3
• B. Serum albumin levels
• C. White blood cell count
• D. Hemoglobin levels

Correct answer: A

Rationale: The correct answer is A: CD4 T-cell count below 180 cells/mm3. Monitoring the CD4 T-cell count is crucial in patients with HIV as it serves as a key indicator of immune function. A count below 180 cells/mm3 indicates severe immunocompromise and an increased risk of opportunistic infections. Choice B, serum albumin levels, though important for assessing nutritional status, is not the priority lab value for HIV monitoring. Choice C, white blood cell count, is a nonspecific measure of immune function and may not accurately reflect the status of the immune system in HIV patients. Choice D, hemoglobin levels, are essential for evaluating anemia but are not the primary lab value for monitoring HIV.

3. What are the signs and symptoms of compartment syndrome?

• A. Unrelieved pain, pallor, and pulselessness
• B. Localized redness and swelling
• C. Fever and infection
• D. Loss of sensation in the affected area

Correct answer: A

Rationale: The signs and symptoms of compartment syndrome include unrelieved pain, pallor, and pulselessness. Unrelieved pain is a key characteristic, indicating tissue ischemia due to increased pressure within a closed anatomic space. Pallor results from compromised blood flow, and pulselessness indicates severe ischemia requiring immediate intervention. Choices B, C, and D are incorrect because localized redness and swelling, fever and infection, and loss of sensation are not specific signs of compartment syndrome. Therefore, the correct answer is A.

4. What are the signs of compartment syndrome?

• A. Unrelieved pain, pallor, pulselessness
• B. Muscle weakness, hyporeflexia
• C. Pins-and-needles sensation, swelling
• D. Severe swelling and tightness in the affected extremity

Correct answer: A

Rationale: The correct signs of compartment syndrome include unrelieved pain, pallor, and pulselessness due to increased pressure within a muscle compartment. Choice B, muscle weakness, and hyporeflexia are not typical signs of compartment syndrome. Choice C, pins-and-needles sensation and swelling, are not specific signs of compartment syndrome. Choice D, severe swelling and tightness in the affected extremity, could be seen in compartment syndrome but are not the primary signs.

5. What should be the first medication given for wheezing due to an allergic reaction?

• A. Albuterol via nebulizer
• B. Cromolyn via nebulizer
• C. Methylprednisolone IV
• D. Aminophylline 500 mg IV

Correct answer: A

Rationale: The correct answer is A, Albuterol via nebulizer. Albuterol is the first-line medication for treating wheezing caused by an allergic reaction as it works as a bronchodilator, helping to relieve the symptoms of wheezing and shortness of breath quickly. Cromolyn (choice B) is used more for preventing asthma symptoms rather than for immediate relief. Methylprednisolone IV (choice C) and Aminophylline 500 mg IV (choice D) are not the first-line treatments for wheezing due to an allergic reaction.

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