You are called to assist a 50-year-old patient with rapid-onset pain in his right lower calf. The patient denies trauma but has a past medical history of hypertension and heart disease. The right lower leg is cool and pale, and the patient reports cramp-like pain in the area that began while he was sitting. His left leg remains asymptomatic. Which of the following conditions should be suspected until proven otherwise?

Correct Answer: A

Rationale: In this scenario, the correct answer is A) Acute femoral artery occlusion. When a patient presents with sudden-onset pain, coolness, pallor, and cramping in the lower extremity, it raises suspicion for acute arterial occlusion. The femoral artery supplies blood to the lower extremities, and occlusion can lead to severe ischemia and tissue damage. Prompt recognition and intervention are crucial to prevent complications like tissue necrosis or limb loss. Option B) Acute iliac artery occlusion is less likely in this case because the symptoms are localized to the right lower calf and not involving the entire leg or both legs. Option C) Acute abdominal aorta occlusion typically presents with severe abdominal pain and is not consistent with the symptoms described. Option D) Acute mesenteric artery occlusion presents with abdominal pain after eating due to inadequate blood supply to the intestines, which is not reflected in this case. Educationally, understanding the different presentations of arterial occlusions is vital for healthcare providers to provide timely and appropriate care. Recognizing the signs and symptoms of acute femoral artery occlusion can help prevent further complications and improve patient outcomes. This knowledge is crucial for nurses, physicians, and other healthcare professionals caring for patients at risk for vascular conditions.

Correct Answer: D

Rationale: In this scenario, the correct answer is D) Respiratory rate of 40 breaths per minute. This finding should prompt immediate management during the primary survey because an elevated respiratory rate can indicate respiratory distress or impending respiratory failure, which requires urgent intervention to maintain adequate oxygenation and prevent further deterioration. Option A) Distended abdomen is not typically a priority during the primary survey unless it is causing respiratory compromise or other life-threatening issues. Option B) GCS of 11 indicates a decreased level of consciousness but is not as immediately life-threatening as a high respiratory rate. Option C) Temperature of 36.5 is within the normal range and would not typically require immediate intervention during the primary survey. In an educational context, it is essential for healthcare providers to prioritize and address the most life-threatening issues first during a primary survey to ensure the best outcomes for the patient. Understanding the significance of abnormal vital signs and clinical findings helps in making quick and accurate decisions in emergency situations, especially when caring for patients with complex conditions like Alzheimer's disease.

Correct Answer: A

Rationale: In the context of caring for burn patients, adequate fluid resuscitation is crucial to prevent hypovolemic shock and maintain organ perfusion. The best guide for assessing the adequacy of fluid resuscitation in burn patients is monitoring "adequate urinary output" (Option A). Urine output serves as a direct indicator of renal perfusion and overall fluid status. In burn patients, a target urine output of 0.5-1 mL/kg/hour is often recommended to ensure adequate tissue perfusion and prevent acute kidney injury. Option B, "Reversal of systemic acidosis," while important in managing burn patients, is not the most reliable guide for fluid resuscitation. Acidosis can be influenced by various factors other than fluid status, such as tissue perfusion and metabolic processes. Option C, "Normalization of the heart rate," is also not the most reliable indicator of fluid resuscitation adequacy in burn patients. While tachycardia can be a sign of hypovolemia, it is a non-specific marker and can be influenced by factors other than fluid status. Option D, "A normal central venous pressure," is not routinely used as a guide for fluid resuscitation in burn patients. Central venous pressure monitoring may have limitations in accurately reflecting the patient's fluid status and responsiveness to resuscitation. Educationally, understanding the rationale behind using "adequate urinary output" to guide fluid resuscitation in burn patients is essential for nursing students and healthcare professionals caring for these patients. It emphasizes the importance of continuous monitoring, individualized care, and recognizing the significance of specific parameters in assessing patient response to treatment.

Correct Answer: B

Rationale: In injured pediatric patients, the most common acid-base disturbance is caused by changes in ventilation, making option B the correct answer. This is because injury can lead to respiratory distress, altering the normal exchange of carbon dioxide and oxygen in the lungs, resulting in respiratory acidosis or alkalosis. Option A, "Hemorrhage," typically leads to metabolic acidosis due to the loss of bicarbonate in the blood. Option C, "Renal failure," is more likely to cause metabolic acidosis or alkalosis rather than a primary respiratory acid-base disturbance. Option D, "Injudicious bicarbonate administration," can lead to metabolic alkalosis but is not the most common acid-base disturbance in injured pediatric patients. Educationally, understanding acid-base disturbances in pediatric patients is crucial for nurses caring for these vulnerable populations. Recognizing the underlying causes of these disturbances allows for prompt intervention and treatment to maintain physiological balance and improve patient outcomes. Nurses need to be knowledgeable about the specific acid-base disturbances common in pediatric patients to provide safe and effective care.

Correct Answer: D

Rationale: In the context of caring for patients with Alzheimer's Disease, understanding the use of supraglottic airway devices is crucial for maintaining airway patency and ensuring adequate oxygenation. The correct answer, option D, "Are of value as part of a difficult or failed intubation plan," is the most appropriate because supraglottic airway devices serve as a rescue airway management option when traditional intubation methods are challenging or unsuccessful. Option A, "Are equivalent to endotracheal intubation," is incorrect because supraglottic airway devices do not provide the same level of airway protection and control as endotracheal intubation, especially in cases where securing the airway is critical. Option B, "Require neck extension for proper placement," is incorrect as supraglottic airway devices are designed to be inserted without the need for extensive neck manipulation, making them a valuable tool in situations where neck movement may be restricted or contraindicated. Option C, "Are preferable to endotracheal intubation in a patient who cannot lie flat," is incorrect because while supraglottic airway devices may be easier to insert in patients who cannot lie flat, they do not replace the definitive airway control provided by endotracheal intubation in critical scenarios. Educationally, it is important for healthcare providers to understand the specific indications, contraindications, and limitations of supraglottic airway devices in order to make informed decisions in airway management, especially in challenging clinical situations such as difficult intubations or patients with Alzheimer's Disease who may have unique airway management needs.