The nurse is caring for a group of patients. Which patient will the nurse see first?

Correct Answer: A

Rationale: In this scenario, the nurse should see the patient who had cataract surgery and is coughing first. The rationale behind this choice is based on the principle of ABC prioritization in nursing - Airway, Breathing, Circulation. Coughing could indicate a potential airway obstruction or respiratory distress, which requires immediate attention to ensure the patient's airway is clear and their breathing is adequate. The other options are not the priority because they do not pose an immediate threat to the patient's life or well-being. The patient who had vascular repair of the right leg not doing leg exercises may need encouragement and reinforcement of the importance of the exercises but does not require immediate attention. The patient after knee surgery with compression devices and heparin is stable and following the standard post-operative care protocol. The patient with vital signs taken at specific intervals is also stable and does not require immediate intervention. From an educational perspective, this question helps students understand the importance of prioritizing patient care based on the urgency of the situation. It reinforces the concept of triaging patients based on their condition and the potential risks involved. Understanding the rationale behind prioritization in nursing care is crucial for providing safe and effective patient care.

Correct Answer: D

Rationale: In this scenario, the correct answer is D) Bell's palsy. Bell's palsy is a condition characterized by the sudden onset of one-sided facial droop and paralysis due to inflammation of the facial nerve, resulting in weakness or paralysis of the facial muscles. This condition can mimic the symptoms of a stroke but without other associated neurological deficits. It is crucial to recognize Bell's palsy promptly to differentiate it from more serious conditions like stroke. Option A) Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disease that affects motor neurons, leading to muscle weakness and paralysis throughout the body, not just on one side of the face. Option B) Multiple sclerosis is an autoimmune disease that affects the central nervous system, causing a wide range of symptoms such as fatigue, mobility issues, and vision problems, but it does not typically present with isolated one-sided facial droop and paralysis. Option C) Huntington's disease is a genetic disorder that affects muscle coordination and leads to cognitive decline and psychiatric symptoms, but it does not typically manifest as one-sided facial droop and paralysis. In an educational context, understanding the specific clinical manifestations of different neurological conditions is crucial for accurate diagnosis and appropriate management. Recognizing the distinct features of Bell's palsy, such as isolated facial nerve involvement, can help healthcare professionals provide timely and effective care for patients presenting with these symptoms.

Correct Answer: D

Rationale: In this scenario, the correct answer is D) Propranolol. Propranolol is a beta-blocker medication that acts by blocking beta-adrenergic receptors in the heart. By doing so, it effectively inhibits sympathetic nervous system stimulation of the beta cells in the heart, leading to a reduction in heart rate and force of contraction. This makes it an effective choice for managing conditions like hypertension, angina, and arrhythmias associated with increased sympathetic activity. A) Aldactone is a potassium-sparing diuretic that works on the kidneys to increase water excretion while retaining potassium. It does not directly affect the sympathetic stimulation of the heart beta cells. B) Cardizem and C) Verapamil are both calcium channel blockers that primarily act on calcium channels in the heart and blood vessels, not on beta-adrenergic receptors. They are more effective in reducing heart rate and blood pressure through different mechanisms than beta-blockers. Educationally, understanding the mechanism of action of different medications is crucial for nurses and healthcare providers in making informed decisions about drug therapy for patients. Knowing which medications target specific receptors or pathways allows for more precise and effective treatment strategies, ultimately improving patient outcomes and safety.

Correct Answer: B

Rationale: In a closed-head injury patient, an increase in intracranial pressure coupled with a decrease in mean arterial pressure can lead to a potentially life-threatening condition known as brainstem herniation. This occurs due to the pressure exerted on the brainstem, causing it to shift or herniate through openings in the skull. This can result in compression of vital structures, leading to respiratory and cardiac compromise, ultimately resulting in death if not promptly addressed. Option A, stating that cerebral blood flow decreases, is incorrect. In this scenario, the brain's blood flow may actually increase as a compensatory mechanism in response to the increased intracranial pressure. Option C, suggesting a marked increase in blood glucose level, is also incorrect. While stress responses can lead to transient increases in blood glucose levels, it is not a direct consequence of increased intracranial pressure. Option D, the formation of an intracranial abscess, is not associated with the scenario described in the question. Intracranial abscesses typically result from infections rather than changes in intracranial pressure. Educationally, understanding the consequences of increased intracranial pressure and decreased mean arterial pressure is crucial for healthcare providers managing patients with head injuries. Recognizing signs of brainstem herniation is vital for timely intervention to prevent further neurological deterioration and improve outcomes for these patients.

Correct Answer: D

Rationale: In this question, the correct answer is D) Emphysema. Emphysema is a chronic lung condition characterized by enlarged airspaces beyond the terminal bronchioles, leading to collapse and destruction of the alveoli. This results in reduced gas exchange capacity and impaired lung function. Option A) Pneumonia is an infection in the lungs that causes inflammation and consolidation of lung tissue, not enlargement of airspaces. Option B) Asthma is a chronic respiratory condition characterized by inflammation and constriction of the airways, not enlargement of airspaces. Option C) Bronchitis is inflammation of the bronchial tubes, causing coughing and excess mucus production, but it does not involve enlargement of airspaces. Educationally, understanding the pathophysiology of different respiratory conditions is crucial for providing effective care to patients with respiratory issues. Recognizing the specific characteristics of each condition helps healthcare professionals in accurate diagnosis, treatment planning, and patient education. In the case of Emphysema, knowledge of its destructive effects on alveoli guides interventions to manage symptoms, slow disease progression, and improve quality of life for patients.