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NUR |/ 216 |/Final |/Exam |/NEW |/MATERIAL |/– |/questions |/with
|/answers
- A |/student |/is |/caring |/for |/a |/client |/who |/suffered |/massive |/blood |/loss |/after |/trauma. |/How |/does |/the |/student |/correlate |/the |/blood |/loss |/with |/the |/client's |/mean |/arterial |/pressure |/(MAP)? a. It |/causes |/vasoconstriction |/and |/increased |/MAP. b. Lower |/blood |/volume |/lowers |/MAP. c. There |/is |/no |/direct |/correlation |/to |/MAP. d. It |/raises |/cardiac |/output |/and |/MAP.: |/ B |/~ |/Lower|/blood |/volume |/will |/decrease |/MAP. |/The |/other |/answers |/are |/not |/accurate.
- A |/nurse |/is |/caring |/for |/a |/client |/after |/surgery. |/The |/client's |/respiratory |/rate |/has |/increased |/from |/ 12 |/to |/ 18 |/breaths/min |/and |/the |/pulse |/rate |/increased |/from |/ 86 |/to |/ 98 |/beats/min |/since |/they |/were |/last |/assessed |/ 4 |/hours |/ago. |/What |/action |/by |/the |/nurse |/is |/best? a. Ask |/if |/the |/client |/needs |/pain |/medication. b. Assess |/the |/client's |/tissue |/perfusion |/further. c. Document |/the |/findings |/in |/the |/client's |/chart. d. Increase |/the |/rate |/of |/the |/client's |/IV |/infusion.: |/ B |/~ |/Signs |/of |/the |/earliest |/stage |/of |/shock |/are |/subtle |/and |/may |/manifest |/in |/slight |/increases |/in |/heart |/rate, |/respiratory |/rate, |/or |/blood |/pressure. |/Even |/though |/these |/readings |/are |/not |/out |/of |/the |/normal |/range, |/the |/nurse |/should |/conduct |/a |/thorough |/assessment |/of |/the |/client, |/focusing |/on |/indicators |/of |/perfusion. |/The |/client |/may |/need |/pain
2 |// |/medication, |/but |/this |/is |/not |/the |/priority |/at |/this |/time. |/Documentation |/should |/be |/done |/thoroughly |/but |/is |/not |/the |/priority |/either. |/The |/nurse |/should |/not |/increase |/the |/rate |/of |/the |/IV |/infusion |/without |/an |/order.
- The |/nurse |/gets |/the |/hand-off |/report |/on |/four |/clients. |/Which |/client |/should |/the |/nurse |/assess |/first? a. Client |/with |/a |/blood |/pressure |/change |/of |/128/74 |/to |/110/88 |/mm |/Hg b. Client |/with |/oxygen |/saturation |/unchanged |/at |/94% c. Client |/with |/a |/pulse |/change |/of |/ 100 |/to |/ 88 |/beats/min d. Client |/with |/urine |/output |/of |/ 40 |/mL/hr |/for |/the |/last |/ 2 |/hours: |/ A |/~ |/This |/client |/has |/a |/falling |/systolic |/blood |/pressure, |/rising |/diastolic |/blood |/pressure, |/and |/narrowing |/pulse |/pressure, |/all |/of |/which |/may |/be |/indications |/of |/the |/progressive |/stage |/of |/shock. |/The |/nurse |/should |/assess |/this |/client |/first. |/The |/client |/with |/the |/unchanged |/oxygen |/saturation |/is |/stable |/at |/this |/point. |/Although |/the |/client |/with |/a |/change |/in |/pulse |/has |/a |/slower |/rate, |/it |/is |/not |/an |/indicator |/of |/shock |/since |/the |/pulse |/is |/still |/within |/the |/normal |/range; |/it |/may |/indicate |/the |/client's |/pain |/or |/anxiety |/has |/been |/relieved, |/or |/he |/or |/she |/is |/sleeping |/or |/relaxing. |/A |/urine |/output |/of |/ 40 |/mL/hr |/is |/only |/slightly |/above |/the |/normal |/range, |/which |/is |/ 30 |/mL/hr.
- A |/nurse |/is |/caring |/for |/a |/client |/after |/surgery |/who |/is |/restless |/and |/apprehensive. |/The |/unlicensed |/assistive |/personnel |/(UAP) |/reports |/the |/vital |/signs |/and |/the |/nurse |/sees |/they |/are |/only |/slightly |/different |/from |/previous |/readings. |/What |/action |/does
4 |// |/the |/most |/accurate |/answer.|/The |/stress |/of |/the |/illness |/has |/not |/made |/the |/client |/diabetic.
- A |/nurse |/caring |/for |/a |/client |/notes |/the |/following |/assessments: |/white |/blood |/cell |/count |/3800/mm3, |/blood |/glucose |/level |/ 198 |/mg/dL, |/and |/temperature |/96.2 |/F |/(35. |/C). |/What |/action |/by |/the |/nurse |/takes |/priority? a. Document |/the |/findings |/in |/the |/client's |/chart. b. Give |/the |/client |/warmed |/blankets |/for |/comfort. c. Notify |/the |/health |/care |/provider |/immediately. d. Prepare |/to |/administer |/insulin |/per |/sliding |/scale.: |/ C |/~ |/This |/client |/has |/several |/indicators |/of |/sepsis |/with |/systemic |/inflammatory |/response. |/The |/nurse |/should |/notify |/the |/health |/care |/provider |/immediately. |/Documentation |/needs |/to |/be |/thorough |/but |/does |/not |/take|/priority. |/The |/client|/may |/appreciate|/warm |/blankets, |/but |/comfort |/measures |/do |/not |/take |/priority. |/The |/client |/may |/or |/may |/not |/need |/insulin.
- A |/nurse |/works |/at |/a |/community |/center |/for |/older |/adults. |/What |/self-manage- |/ment |/measure |/can |/the |/nurse |/teach |/the |/clients |/to |/prevent |/shock? a. Do |/not |/get |/dehydrated |/in |/warm |/weather. b. Drink |/fluids |/on |/a |/regular |/schedule. c. Seek |/attention |/for |/any |/lacerations. d. Take |/medications |/as |/prescribed.: |/ B |/~ |/Preventing |/dehydration |/in |/older |/adults |/is
5 |// important |/because |/the |/age-related |/decrease |/in |/the |/thirst |/mechanism |/makes |/them |/prone |/to |/dehydration. |/Having |/older |/adults |/drink |/fluids |/on |/a |/regular |/schedule |/will |/help |/keep |/them |/hydrated |/without |/the |/influence |/of |/thirst |/(or |/lack |/of |/thirst). |/Telling |/clients |/not |/to |/get |/dehydrated |/is |/important, |/but |/not |/the |/best |/answer |/because |/it |/doesn't |/give |/them |/the |/tools |/to |/prevent |/it |/from |/occurring. |/Older |/adults |/should |/seek |/attention |/for |/lacerations, |/but |/this |/is |/not |/as |/important |/an |/issue |/as |/staying |/hydrated. |/Taking |/medications |/as |/prescribed |/may |/or |/may |/not |/be |/related |/to |/hydration.
- A |/client |/arrives |/in |/the |/emergency |/department |/after |/being |/in |/a |/car |/crash |/with |/fatalities. |/The |/client |/has |/a |/nearly |/amputated |/leg |/that |/is |/bleeding |/profusely. |/What |/action |/by |/the |/nurse |/takes |/priority? a. Apply |/direct |/pressure |/to |/the |/bleeding. b. Ensure |/the |/client |/has |/a |/patent |/airway. c. Obtain |/consent |/for |/emergency |/surgery. d. Start |/two |/large-bore |/IV |/catheters.: |/ B |/~ |/Airway |/is |/the |/priority, |/followed |/by |/breathing |/and |/circulation |/(IVs |/and |/direct |/pressure). |/Obtaining |/consent |/is |/done |/by |/the |/physician.
- A |/client |/is |/receiving |/norepinephrine |/(Levophed) |/for |/shock. |/What |/assessment |/finding |/best |/indicates |/a |/therapeutic |/effect |/from |/this |/drug? a. Alert |/& |/oriented, |/answering |/questions b. Client |/denial |/of |/chest |/pain |/or |/chest |/pressure c. IV |/site |/without |/redness |/or |/swelling
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- A |/client |/has |/been |/brought |/to |/the |/emergency |/department |/after |/being |/shot |/multiple |/times. |/What |/action |/should |/the |/nurse |/perform |/first? a. Apply |/personal |/protective |/equipment. b. Notify |/local |/law |/enforcement |/officials. c. Obtain |/universal |/donor |/blood. d. Prepare |/the |/client |/for |/emergency |/surgery.: |/ A|/~ |/The |/nurses |/priority |/is |/to |/care |/for |/the |/client. |/Since |/the |/client |/has |/gunshot |/wounds |/and |/is |/bleeding, |/the |/nurse |/applies |/personal |/protective |/equipment |/(i.e., |/gloves) |/prior |/to |/care. |/This |/takes |/priority |/over |/calling |/law |/enforcement. |/Requesting |/blood |/bank |/products |/can |/be |/delegated. |/The |/nurse |/may |/or |/may |/not |/have |/to |/prepare |/the |/client |/for |/emergency |/surgery.
- A |/nurse |/is |/caring |/for |/several |/clients |/at |/risk |/for |/shock. |/Which |/laboratory |/value |/requires |/the |/nurse |/to |/communicate |/with |/the |/health |/care |/provider? a. Creatinine: |/0.9 |/mg/dL b. Lactate: |/ 6 |/mmol/L c. Sodium: |/ 150 |/mEq/L d. White |/blood |/cell |/count: |/11,000/mm3: |/ B |/~ |/A|/lactate |/level |/of |/ 6 |/mmol/L |/is |/high |/and |/is |/indicative |/of |/possible |/shock. |/A |/creatinine |/level |/of |/0.9 |/mg/dL |/is |/normal. |/A |/sodium |/level |/of |/ 150 |/mEq/L |/is |/high, |/but |/that |/is |/not |/related |/directly |/to |/shock. |/A |/white |/blood |/cell |/count |/of |/11,000/mm3 |/is |/slightly |/high |/but |/is |/not |/as |/critical |/as |/the |/lactate |/level.
- A |/client |/in |/shock |/is |/apprehensive |/and |/slightly |/confused. |/What |/action |/by |/the
8 |// |/nurse |/is |/best? a. Offer |/to |/remain |/with |/the |/client |/for |/awhile. b. Prepare |/to |/administer |/antianxiety |/medication. c. Raise |/all |/four |/siderails |/on |/the |/client's |/bed. d. Tell |/the |/client |/everything |/possible |/is |/being |/done.: |/ A |/~ |/The |/nurses |/presence |/will |/be |/best |/to |/reassure |/this |/client. |/Antianxiety |/medication |/is |/not |/warranted |/as |/this |/will |/lower |/the |/clients |/blood |/pressure. |/Using |/all |/four |/side-rails |/on |/a |/hospital |/bed |/is |/considered |/a |/restraint |/in |/most |/facilities, |/although |/the |/nurse |/should |/ensure |/the |/client's |/safety. |/Telling |/a |/confused |/client |/that |/everything |/is |/being |/done |/is |/not |/the |/most |/helpful |/response.
- A |/client |/is |/being |/discharged |/home |/after |/a |/large |/myocardial |/infarction and |/subsequent |/coronary |/artery |/bypass |/grafting |/surgery. |/The |/client's |/sternal |/wound |/has |/not |/yet |/healed. |/What |/statement |/by |/the |/client |/most |/indicates |/a |/higher |/risk |/of |/developing |/sepsis |/after |/discharge? a. All |/my |/friends |/and |/neighbors |/are |/planning |/a |/party |/for |/me. b. I |/hope |/I |/can |/get |/my |/water |/turned |/back |/on |/when |/I |/get |/home. c. I |/am |/going |/to |/have |/my |/daughter |/scoop |/the |/cat |/litter |/box. d. My |/grandkids |/are |/so |/excited |/to |/have |/me |/coming |/home!: |/ B |/~ |/All |/these |/statements |/indicate |/a |/potential |/for |/leading |/to |/infection |/once |/the |/client |/gets |/back
10 |// |/tations |/of |/this |/condition |/are |/directly |/related |/to |/which |/problems? |/(SATA) a. Anaerobic |/metabolism b. Hyperglycemia c. Hypotension d. Impaired |/renal |/perfusion e. Increased |/perfusion: |/ A, |/C |/~ |/The |/common |/manifestations |/of |/shock, |/no |/matter |/the |/cause, |/are |/directly |/related |/to |/the |/effects |/of |/anaerobic |/metabolism |/and |/hypotension. |/Hyperglycemia, |/impaired |/renal |/function, |/and |/increased |/perfusion |/are |/not |/manifes- |/tations |/of |/shock.
- The |/nurse |/caring |/for |/hospitalized |/clients |/includes |/which |/actions |/on |/their |/care |/plans |/to |/reduce |/the |/possibility |/of |/the |/clients |/developing |/shock? |/(SATA) a. Assessing |/and |/identifying |/clients |/at |/risk b. Monitoring |/the |/daily |/white |/blood |/cell |/count c. Performing |/proper |/hand |/hygiene d. Removing |/invasive |/lines |/as |/soon |/as |/possible e. Using |/aseptic |/technique |/during |/procedures: |/ A, |/C, |/D, |/E |/~ |/Assessing |/and |/identifying |/clients |/at |/risk |/for |/shock |/is |/probably |/the |/most |/critical |/action |/the |/nurse |/can |/take |/to |/prevent |/shock |/from |/occurring. |/Proper |/hand |/hygiene, |/using |/aseptic |/technique, |/and |/removing |/IV |/lines |/and |/catheters |/are |/also |/important |/actions |/to |/prevent |/shock. |/Monitoring |/laboratory |/values |/does |/not |/prevent |/shock |/but |/can |/indicate |/a |/change.
- The |/nurse |/caring |/frequently |/for |/older |/adults |/in |/the |/hospital |/is |/aware |/of |/risk |/factors |/that |/place |/them |/at |/a |/higher |/risk |/for |/shock. |/For |/what |/factors |/would |/the
11 |// nurse |/assess? |/(SATA) a. Altered |/mobility/immobility b. Decreased |/thirst |/response c. Diminished |/immune |/response d. Malnutrition e. Overhydration: |/ A, |/B, |/C, |/D |/~ |/Immobility, |/decreased |/thirst |/response, |/diminished |/immune |/response, |/and |/malnutrition |/can |/place |/the |/older |/adult |/at |/higher |/risk |/of |/developing |/shock. |/Overhydration |/is |/not |/a |/common |/risk |/factor |/for |/shock.
- A |/client |/is |/in |/the |/early |/stages |/of |/shock |/and |/is |/restless. |/What |/comfort |/measures |/does |/the |/nurse |/delegate |/to |/the |/nursing |/student? |/(SATA) a. Bringing |/the |/client |/warm |/blankets b. Giving |/the |/client |/hot |/tea |/to |/drink c. Massaging |/the |/client's |/painful |/legs d. Reorienting |/the |/client |/as |/needed e. Sitting |/with |/the |/client |/for |/reassurance: |/ A, |/D,|/E |/~ |/The |/student |/can |/bring|/the |/client |/warm |/blankets, |/reorient |/the |/client |/as |/needed |/to |/decrease |/anxiety, |/and |/sit |/with |/the |/client|/for |/reassurance. |/The |/client|/should |/be |/NPO |/at |/this |/point, |/so |/hot |/tea |/is |/prohibited. |/Massaging |/the |/legs |/is |/not |/recommended |/as |/this |/can |/dislodge |/any |/clots |/present, |/which |/may |/lead |/to |/pulmonary |/embolism.
- The |/nurse |/is |/caring |/for |/a |/client |/with |/suspected |/severe |/sepsis. |/What |/does
13 |// pressure. |/What |/is |/the |/best |/nursing |/action? a. Assess |/the |/blood |/pressure |/by |/Doppler. b. Estimate |/the |/systolic |/pressure |/as |/ 60 |/mm |/Hg. c. Obtain |/an |/electronic |/blood |/pressure |/monitor. d. Record |/the |/blood |/pressure |/as |/not |/assessable.: |/ A |/~ |/Auscultated |/blood |/pres- |/sures |/in |/shock |/may |/be |/significantly |/inaccurate |/due |/to |/vasoconstriction. |/If |/blood |/pressure |/is |/not |/audible, |/the |/approximate |/value |/can |/be |/assessed |/by |/palpation |/or |/ul- |/trasound. |/If |/brachial|/pulses |/are |/palpable, |/the |/approximate|/measure |/of |/systolic |/blood |/pressure |/is |/ 80 |/mm |/Hg. |/This |/action |/has |/the |/potential |/to |/delay |/further |/assessment |/of |/a |/compromised |/patient |/in |/shock. |/Documenting |/a |/blood |/pressure |/as |/not |/assessable |/is |/not |/appropriate |/without |/further |/attempts |/using |/different |/modalities.
- The |/nurse |/has |/just |/completed |/an |/infusion |/of |/a |/ 1000 |/mL |/bolus |/of |/0.9% |/normal |/saline |/in |/a |/patient |/with |/severe |/sepsis. |/One |/hour |/later, |/which |/laboratory |/result |/requires |/immediate |/nursing |/action? a. Creatinine |/1.0 |/mg/dL b. Lactate |/ 6 |/mmol/L c. Potassium |/3.8 |/mEq/L d. Sodium |/ 140 |/mEq/L: |/ B |/~ |/Lactate |/level |/has |/been |/used |/as |/an |/indicator |/of |/decreased |/oxygen |/delivery |/to |/the |/cells, |/adequacy |/of |/resuscitation |/in |/shock, |/and |/as |/an |/outcome |/predictor. |/All |/other |/listed |/values |/are |/within |/normal |/limits
14 |// |/and |/do |/not |/require|/additional |/follow-up.
- The |/nurse |/has |/been |/administering |/0.9% |/normal |/saline |/intravenous |/fluids |/as |/part |/of |/early |/goal-directed |/therapy |/protocols |/in |/a |/patient |/with |/severe |/sepsis. |/To |/evaluate |/the |/effectiveness |/of |/fluid |/therapy, |/which |/physiological |/parameters |/would |/be |/most |/important |/for |/the |/nurse |/to |/assess? a. Breath |/sounds |/and |/capillary |/refill b. Blood |/pressure |/and |/oral |/temperature c. Oral |/temperature |/and |/capillary |/refill d. Right |/atrial |/pressure |/and |/urine |/output: |/ D |/~ |/Early |/goal-directed |/therapy |/in- |/cludes |/administration |/of |/IV |/fluids |/to |/keep |/central |/venous |/pressure |/at |/ 8 |/mm |/Hg |/or |/greater. |/Combined |/with |/urine |/output, |/fluid |/therapy |/effectiveness |/can |/be |/adequately |/assessed. |/Evaluation |/of |/breath |/sounds |/assists |/with |/determining |/fluid |/overload |/in a |/patient |/but |/does |/not |/evaluate |/the |/effectiveness |/of |/fluid |/therapy. |/Capillary |/refill |/provides |/a |/quick |/assessment |/of |/the |/patient's |/overall |/cardiovascular |/status, |/but |/this |/assessment |/is |/not |/reliable |/in |/a |/patient |/who |/is |/hypothermic |/or |/has |/peripheral |/circu- |/latory |/problems. |/Evaluation |/of |/oral |/temperature |/does |/not |/assess |/the |/effectiveness |/of |/fluid |/therapy |/in |/patients |/in |/shock. |/Evaluation |/of |/oral |/temperature |/does |/not |/assess |/the |/effectiveness |/of |/fluid |/therapy|/in |/patients|/in |/shock. |/Capillary |/refill |/provides |/a |/quick
16 |// |/administering |/which |/therapeutic |/intervention? a. Human |/albumin |/infusion b. Hypotonic |/saline |/solution c. Lactated |/Ringer's |/bolus d. Packed |/red |/blood |/cells: |/ C |/~ |/The |/patient |/is |/experiencing |/symptoms |/of |/hypo- |/volemic |/shock. |/Isotonic |/crystalloids, |/such |/as |/normal |/saline |/and |/lactated |/Ringer's |/solutions, |/are |/the |/priority |/intervention. |/Albumin |/and |/plasma |/protein |/fraction |/(Plas- |/manate) |/are |/naturally |/occurring |/colloid |/solutions |/that |/are |/infused |/when |/the |/volume |/loss |/is |/caused |/by |/a |/loss |/of |/plasma |/rather |/than |/blood, |/such |/as |/in |/burns, |/peritonitis, |/and |/bowel |/obstruction. |/Hypotonic |/solutions |/rapidly |/leave |/the |/intravascular |/space, |/causing |/interstitial |/and |/intracellular |/edema |/and |/are |/not |/used |/for |/fluid |/resuscitation. |/There |/is |/no |/evidence |/to |/support |/a |/transfusion |/in |/the |/given |/scenario.
- The |/nurse |/is |/caring |/for |/a |/patient |/in |/the |/early |/stages |/of |/septic |/shock. |/The |/patient |/is |/slightly |/confused |/and |/flushed, |/with |/bounding |/peripheral |/pulses. |/Which |/hemodynamic |/values |/is |/the |/nurse |/most |/likely |/to |/assess? a. High |/pulmonary |/artery |/occlusive |/pressure |/and |/high |/cardiac |/output b. High |/systemic |/vascular |/resistance |/and |/low |/cardiac |/output c. Low |/pulmonary |/artery |/occlusive |/pressure |/and |/low |/cardiac |/output
17 |// d. Low |/systemic |/vascular |/resistance |/and |/high |/cardiac |/output: |/ D |/~ |/As |/a |/con- |/sequence |/of |/the |/massive |/vasodilation |/associated |/with |/septic |/shock, |/in |/the |/early |/stages, |/cardiac |/output |/is |/high |/with |/low |/systemic |/vascular |/resistance.|/In |/septic |/shock, |/pulmonary |/artery |/occlusion |/pressure |/is |/not |/elevated. |/In |/the |/early |/stages |/of |/septic |/shock, |/systemic |/vascular |/resistance |/is |/low |/and |/cardiac |/output |/is |/high. |/In |/the |/early |/stages |/of |/septic |/shock, |/cardiac |/output |/is |/high.
- The |/nurse |/is |/caring |/for |/a |/patient |/admitted |/with |/severe |/sepsis. |/Vital |/signs |/assessed |/by |/the |/nurse |/include |/blood |/pressure |/80/50 |/mm |/Hg, |/heart |/rate |/ 120 |/beats/min, |/respirations |/ 28 |/breaths/min, |/oral |/temperature |/of |/ 102 |/F, |/and |/a |/right |/atrial |/pressure |/(RAP) |/of |/ 1 |/mm |/Hg. |/Assuming |/physician |/orders, |/which |/interven- |/tion |/should |/the |/nurse |/carry |/out |/first? a. Acetaminophen |/suppository b. Blood |/cultures |/from |/two |/sites c. IV |/antibiotic |/administration d. Isotonic |/fluid |/challenge: |/ D |/~ |/Early |/goal-directed |/therapy |/in |/severe |/sepsis |/includes |/administration |/of |/IV |/fluids |/to |/keep |/RAP/CVP |/at |/ 8 |/mm |/Hg |/or |/greater |/(but |/not |/greater |/than |/ 15 |/mm |/Hg) |/and |/heart |/rate |/less |/than |/ 110 |/beats/min. |/Fluid |/resusci- |/tation |/to |/restore |/perfusion |/is |/the |/immediate |/priority. |/Broad-spectrum |/antibiotics |/are |/recommended |/within |/the |/first |/hour; |/however, |/volume |/resuscitation |/is |/the |/priority |/in |/this |/scenario.
19 |// es, |/cardiac |/output |/and |/index |/increase |/and |/improve |/tissue |/perfusion. |/Administration |/of |/furosemide |/will |/assist |/only |/in |/managing |/fluid |/volume |/overload. |/Phenylephrine |/administration |/enhances |/vasoconstriction, |/which |/may |/increase |/afterload |/and |/further |/reduce |/cardiac |/output. |/Sodium |/nitroprusside |/is |/given |/to |/reduce |/afterload. |/There |/is |/no |/evidence |/to |/support |/a |/need |/for |/afterload |/reduction |/in |/this |/scenario.
- Ten |/minutes |/following |/administration |/of |/an |/antibiotic, |/the |/nurse |/assesses |/a |/patient |/to |/have |/edematous |/lips, |/hoarseness, |/and |/expiratory |/stridor. |/Vital |/signs |/assessed |/by |/the |/nurse |/include |/blood |/pressure |/70/40 |/mm |/Hg, |/heart |/rate |/ 130 |/beats/min, |/and |/respirations |/ 36 |/breaths/min. |/What |/is |/the |/priority |/intervention? a. Diphenhydramine |/(Benadryl) |/ 50 |/mg |/intravenously b. Epinephrine |/ 3 |/to |/ 5 |/mL |/of |/a |/1:10,000 |/solution |/intravenously c. Methylprednisolone |/(Solu-Medrol) |/ 125 |/mg |/intravenously d. Ranitidine |/(Zantac) |/ 50 |/mg |/intravenously: |/ B |/~ |/The |/patient |/is |/exhibiting |/signs |/of |/anaphylaxis. |/For |/anaphylaxis |/with |/hypotension, |/epinephrine |/0.3 |/to |/0.5 |/mg |/(3 |/to |/ 5 |/mL |/of |/1:10,000 |/solution) |/is |/administered |/intravenously. |/Diphenhydramine |/(Benadryl) |/will |/help |/block |/histamine |/release, |/but |/epinephrine |/is |/the |/drug |/of |/choice |/for |/anaphylaxis |/with |/hypotension. |/Corticosteroids, |/such |/as |/methylprednisolone |/(Solu-Medrol), |/are |/used |/to |/reduce |/inflammation, |/but |/epinephrine |/is |/the |/drug |/of |/choice |/for |/anaphylaxis |/with |/hypotension. |/Ranitidine |/(Zantac) |/will |/help |/block|/histamine
20 |// |/release, |/but |/epineph- |/rine |/is |/the |/drug |/of |/choice |/for |/anaphylaxis |/with |/hypotension.
- A |/patient |/is |/admitted |/to |/the |/cardiac |/care |/unit |/with |/an |/acute |/anterior |/myocar- |/dial |/infarction. |/The |/nurse |/assesses |/the |/patient |/to |/be |/diaphoretic |/and |/tachyp- |/neic, |/with |/bilateral |/crackles |/throughout |/both |/lung |/fields. |/Following |/insertion |/of |/a |/pulmonary |/artery |/catheter |/by |/the |/physician, |/which |/hemodynamic |/values |/is |/the |/nurse |/most |/likely |/to |/assess? a. High |/pulmonary |/artery |/diastolic |/pressure |/and |/low |/cardiac |/output b. Low |/pulmonary |/artery |/occlusive |/pressure |/and |/low |/cardiac |/output c. Low |/systemic |/vascular |/resistance |/and |/high |/cardiac |/output d. Normal |/cardiac |/output |/and |/low |/systemic |/vascular |/resistance: |/ A |/~ |/In |/car- |/diogenic |/shock, |/cardiac |/output |/and |/cardiac |/index |/decrease. |/Right |/atrial |/pressure, |/pulmonary |/artery |/pressures,|/and |/pulmonary |/artery |/occlusion |/pressure|/increase |/and |/volume |/backs |/up |/into |/the |/pulmonary |/circulation |/and |/the |/right |/side |/of |/the |/heart. |/Pulmonary |/artery |/occlusion |/pressure |/increases |/in |/cardiogenic |/shock. |/Systemic |/vascular |/resistance |/is |/high |/and |/cardiac |/output |/is |/low |/in |/cardiogenic |/shock. |/Cardiac |/output |/is |/low |/and |/systemic |/vascular |/resistance |/is |/high |/in |/cardiogenic |/shock.
- During |/the |/initial |/stages |/of |/shock, |/what |/are |/the |/physiological |/effects |/of |/decreased |/cardiac |/output? a. Arterial |/vasodilation b. High |/urine |/output
