Your adult patient is experiencing symptomatic bradycardia with a heart rate of 40 bpm. Once on the monitor, it reveals the patient has a complete third-degree atrioventricular block and is found to be hypotensive as well. Which of the following medications should be avoided, if possible?

Correct Answer: D

Rationale: The correct answer is D: Atropine. In third-degree AV block, the electrical signals from the atria to the ventricles are completely blocked. Atropine works by blocking the parasympathetic nervous system, which can further decrease the heart rate in a patient with bradycardia. In this scenario, avoiding Atropine is crucial to prevent worsening bradycardia. Epinephrine (A) and Dopamine (B) are sympathomimetic agents that can help increase heart rate and blood pressure, making them suitable choices in this situation. Dobutamine (C) is a positive inotrope that can increase heart contractility and may be beneficial in improving cardiac output in a hypotensive patient. In summary, Atropine should be avoided in a patient with third-degree AV block and symptomatic bradycardia to prevent further decreasing the heart rate, while the other options can be considered to help improve hem

Correct Answer: C

Rationale: The correct answer is C: Kussmaul respirations. In diabetic ketoacidosis, the body compensates for metabolic acidosis by increasing the respiratory rate to blow off excess carbon dioxide and lower blood pH. Kussmaul respirations are deep, rapid, and labored breathing characteristic of this compensatory mechanism. Bradypnea (A) is slow breathing, which is not typical in diabetic ketoacidosis. Central neurogenic hyperventilation (B) is rapid, deep breathing caused by a neurologic issue, not commonly associated with diabetic ketoacidosis. Cheyne-Stokes respirations (D) are characterized by periods of deep breathing followed by apnea and are not typically seen in diabetic ketoacidosis.

Correct Answer: B

Rationale: Step 1: Chest pain that is not relieved by oxygen therapy alone suggests that the cause of the pain is not related to a lack of oxygen to the heart muscle. Step 2: Acute myocardial infarction (heart attack) is caused by a blockage in the coronary arteries, leading to reduced blood flow and oxygen to the heart muscle. Step 3: If the chest pain is not affected by oxygen therapy, it indicates that the pain is likely due to a problem other than lack of oxygen, such as a heart attack. Step 4: Therefore, choice B is the correct answer as it points to a symptom consistent with an acute myocardial infarction. Summary: Choices A and C mention relief or lack of relief of chest pain with nitroglycerin, which is typically used for angina and may not necessarily indicate a heart attack. Choice D, cyanosis, is a late sign of inadequate oxygenation and not specific to an acute myocardial infarction

Correct Answer: B

Rationale: The correct answer is B (80-110 mg/dL) because this range reflects the optimal blood glucose level to minimize the risk of hypoglycemia and hyperglycemia. A (60-90 mg/dL) is too low and can lead to hypoglycemia. C (186-202 mg/dL) and D (110-160 mg/dL) are higher ranges that can increase the risk of hyperglycemia and related complications. The American Heart Association recommends the 80-110 mg/dL range for healthcare providers to maintain glucose levels within a safe and effective range.

Correct Answer: A

Rationale: Rationale for Correct Answer (A): Children suffer spinal cord injury without x-ray abnormality more commonly than adults. This statement is true because children's spinal cords are more flexible and elastic, making them less likely to show bony abnormalities on x-rays even if there is an injury. This phenomenon is known as SCIWORA (spinal cord injury without radiographic abnormality) and is more common in children due to their unique anatomical characteristics. Summary of Incorrect Choices: B: An infant with a traumatic brain injury may become hypotensive from cerebral edema - This statement is incorrect because hypotension is not a common consequence of cerebral edema in traumatic brain injury. C: Initial therapy for the child with traumatic brain injury includes the administration of methylprednisolone intravenously - This statement is incorrect as the use of methylprednisolone in traumatic brain injury is controversial and not considered standard therapy. D: Children have more focal mass lesions as a result of traumatic brain injury