What is the appropriate ratio of chest compressions to rescue breaths for adult CPR?

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Adult Health Nursing First Chapter Quizlet Questions

Question 1 of 9

What is the appropriate ratio of chest compressions to rescue breaths for adult CPR?

Correct Answer: C

Rationale: The appropriate ratio of chest compressions to rescue breaths for adult CPR is 30 compressions to 2 breaths. This means that after every 30 chest compressions, two rescue breaths should be given. This ratio helps in maintaining oxygen circulation in the body while also ensuring that the heart is being effectively pumped to circulate blood. The emphasis on chest compressions is critical in maintaining blood flow to vital organs during cardiac arrest, while the rescue breaths help in providing oxygen to the patient's lungs. This ratio is recommended by organizations like the American Heart Association for performing high-quality adult CPR.

Question 2 of 9

A patient presents with a target-like rash with concentric erythematous rings and central clearing on the trunk and extremities. The patient reports recent exposure to a new medication. Which of the following conditions is most likely responsible for this presentation?

Correct Answer: A

Rationale: Erythema multiforme is a skin condition characterized by the sudden onset of a target-like rash with concentric erythematous rings and central clearing on the trunk and extremities. It typically presents with a distinctive "iris" or "bull's eye" pattern. Erythema multiforme is often triggered by exposure to certain medications, such as antibiotics, anticonvulsants, and other drugs. The rash is usually accompanied by symptoms like fever, malaise, and joint pain. It is important to identify and discontinue the offending medication causing the reaction in cases of drug-induced erythema multiforme.

Question 3 of 9

A patient with a history of heart failure is prescribed digoxin. Which assessment finding indicates a potential adverse effect of digoxin therapy?

Correct Answer: D

Rationale: Confusion is a potential adverse effect of digoxin therapy. Digoxin toxicity can manifest as various central nervous system symptoms, including confusion, delirium, and disorientation. It is important to monitor for signs of digoxin toxicity in patients taking this medication, especially those with a history of heart failure or renal impairment. Other common signs of digoxin toxicity may include visual disturbances (like halos around lights), gastrointestinal symptoms (like nausea and vomiting), and cardiac arrhythmias. Monitoring serum digoxin levels can help guide therapy and identify toxicity early.

Question 4 of 9

Nurse Edna admits a patient from the ER to the medical unit. The patient is very restless with IV lines and a urinary catheter. She was put to bed and the nurse applied a body restraint without the doctor's order. Nurse Edna's action can be liable for _____.

Correct Answer: B

Rationale: Battery in the context of healthcare refers to the intentional and unauthorized touching of a patient. By applying a body restraint without a doctor's order, Nurse Edna has potentially committed battery against the patient. It is important for healthcare providers to obtain proper authorization before implementing any physical restraints on a patient to avoid legal liabilities such as battery.

Question 5 of 9

The nurse assists a health care provider in performing a liver biopsy. After the biopsy, the nurse should place the client in which position?

Correct Answer: C

Rationale: Placing the client in a left side-lying position after a liver biopsy helps to promote pressure on the puncture site, which can reduce the risk of bleeding. Placing a small pillow or folded towel under the puncture site provides additional support and helps to maintain pressure on the area. This position also helps prevent the client from putting pressure on the abdomen, which could potentially affect the biopsy site and increase the risk of bleeding or complications. Overall, positioning the client on the left side with support under the puncture site is the most appropriate and safest option after a liver biopsy.

Question 6 of 9

A patient presents with sudden-onset severe lower abdominal pain, nausea, vomiting, and inability to pass urine. On physical examination, there is suprapubic tenderness and a palpable bladder. What is the most likely diagnosis?

Correct Answer: B

Rationale: The patient's presentation with sudden-onset severe lower abdominal pain, nausea, vomiting, inability to pass urine, suprapubic tenderness, and a palpable bladder is classic for acute urinary retention. Acute urinary retention is a urological emergency characterized by the sudden inability to pass urine due to the inability to empty the bladder completely. The palpable bladder on physical examination indicates significant bladder distension. This condition can be caused by multiple factors such as bladder outlet obstruction, neurogenic causes, or medications affecting bladder function. Prompt intervention is necessary to relieve the bladder distension, alleviate symptoms, and prevent complications like bladder rupture.

Question 7 of 9

Which of the following actions is appropriate when managing a patient with a suspected heat stroke?

Correct Answer: D

Rationale: When managing a patient with a suspected heat stroke, the appropriate action is to remove the patient from the hot environment and start cooling the body. Heat stroke is a medical emergency that can be life-threatening if not promptly treated. Cooling the body is essential to lower the core body temperature as quickly as possible. Ice packs should not be directly applied to the skin as they can cause vasoconstriction and may actually hinder heat dissipation. Administering warm intravenous fluids and encouraging the patient to drink cold water rapidly are also not recommended in the initial management of a heat stroke. The priority is to cool the patient down and seek medical attention immediately.

Question 8 of 9

A health care provider instructs the nurse to bladder train a patient. The nurse clamps the patient's indwelling urinary catheter but forgets to unclamped it. The patient develops a urinary tract infection. What do the nurse's actions' exemplify ?

Correct Answer: D

Rationale: The nurse's actions exemplify negligence. Negligence is a failure to provide reasonable care that results in harm to a patient. In this scenario, the nurse failed to unclamp the patient's indwelling urinary catheter as instructed by the healthcare provider. This failure to follow proper procedure led to the patient developing a urinary tract infection, which could have been prevented if the nurse had acted with reasonable care. This action does not meet the criteria for malpractice, assault, or battery as those involve intentional harm or professional misconduct, whereas negligence involves a lack of appropriate care or attention.

Question 9 of 9

Patients like Emmy who have experienced delayed hypersensivity to latex FREQUENTLY complains of ______.

Correct Answer: C

Rationale: Patients like Emmy who have experienced delayed hypersensitivity to latex typically present with symptoms such as rhinitis (runny or stuffy nose) and conjunctivitis (inflammation of the eyes). In addition, delayed hypersensitivity reactions often involve skin manifestations, such as blisters. These symptoms are reflective of the inflammatory response triggered by exposure to latex in individuals with delayed hypersensitivity. Symptoms like flushing, bronchospasm, urticaria, laryngeal edema, papules, vesicles, and pruritus are more commonly associated with immediate-type hypersensitivity reactions rather than delayed hypersensitivity reactions in latex-sensitive individuals.

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