A 22-year-vintage guy is admitted to the in depth care unit after a motor vehicle collision. There
are lacerations on his face and head. The nurse observes a steady drip of clear fluid coming
from his left ear. Which of the following is the ideal movement to comprise the drainage of
cerebrospinal fluid (CSF)?
A.
Applying sterile ear packing
B.
Connecting low suction to the ear
C.
Applying loose sterile dressing
D.
Leaving ear uncovered - ANS-It is vital no longer to impede CSF drift due to the fact this can
increase intracranial stress. Introducing suction may want to purpose bleeding, contamination,
or similarly structural harm.
A 23-yr-vintage guy is admitted via the emergency department after a motorcycle collision. His
Glasgow Coma Scale rating changed into 12 in the emergency department, and it's miles still 12
upon his admission to the neurologic intensive care unit. Both eyes are ecchymotic and swollen
shut, and he has a couple of abrasions on his face. Which of the following is the most possibly
analysis?
A.
Linear cranium fracture
B.
Basal cranium fracture
C.
Orbital fracture
D.
Mandibular fracture - ANS-Basal cranium fracture
A 24-year-vintage female is admitted with a closed head harm after a fall from a cliff. She is
much less responsive and has a nonreactive dilated proper pupil. These signs recommend
strain in which place of the brain?
,A.
Right hemisphere
B.
Left hemisphere
C.
Cerebellum
D.
Hypothalamus - ANS-Right hemisphere
CN III controls student constriction. Hemispheric strain in this nerve will bring about a dilated
scholar on the equal aspect because the stress.
A 28-12 months-antique girl is admitted to the important care unit from the emergency
department with a diagnosis of asthma. Her preliminary arterial blood gases on a 28% Venturi
mask are as follows:
pH 7.Forty eight
PaCO2 30 mm Hg
HCO3 24 mEq/L
PaO2 64 mm Hg
Which of the subsequent repeat arterial blood gases on forty% oxygen indicate that the affected
person's situation is worsening?
A.
PH 7.48, PaCO2 30 mm Hg, PaO2 68 mm Hg
B.
PH 7.Forty six, PaCO2 32 mm Hg, PaO2 sixty one mm Hg
C.
PH 7.Forty, PaCO2 forty mm Hg, PaO2 62 mm Hg
D.
PH 7.39, PaCO2 30 mm Hg, PaO2 60 mm Hg - ANS-C.
PH 7.Forty, PaCO2 40 mm Hg, PaO2 62 mm Hg
The case study indicates level II asthma. Option c shows level III allergies. The patient remains
respiration at a quick rate, however carbon dioxide is beginning to be retained as evidenced by
way of the growth of the PaCO2 into ordinary range. Options a and b are still degree II. Option d
suggests a breathing alkalosis with a metabolic acidosis because you would have expected the
pH to be in an alkalotic range with the PaCO2 of 30.
,A 29-year-old girl has been a affected person within the critical care unit for 2 weeks with acute
tubular necrosis (ATN) because of overwhelm injuries experienced in a motor vehicle collision.
She become normotensive on admission. Which electrolyte imbalances are in all likelihood to
end result from ATN?
A.
Hypomagnesemia, hypocalcemia, hypokalemia
B.
Hypomagnesemia, hypercalcemia, hypokalemia
C.
Hypermagnesemia, hypercalcemia, hyperkalemia
D.
Hypermagnesemia, hypocalcemia, hyperkalemia - ANS-Hypermagnesemia, hypocalcemia,
hyperkalemia
Hypermagnesemia and hyperkalemia result from the incapability of the kidneys to excrete these
electrolytes. Hypocalcemia is the end result of the inability of the kidneys to provide the lively
element of diet D, 1,25-dihydroxycholecalciferol and the trade in calcium due to the
hyperphosphatemia this is visible in ATN.
A 30-yr-vintage man is inside the surgical intensive care unit after exploratory laparotomy
carried out after he sustained a gunshot wound to the stomach. He now has evolved a
pancreatic fistula. Which acid-base imbalance is that this patient at danger for developing?
A.
Respiratory acidosis
B.
Metabolic acidosis
C.
Respiratory alkalosis
D.
Metabolic alkalosis - ANS-Metabolic acidosis
The belly is acidic, however the gastrointestinal tract below the belly is alkaline. Pancreatic
secretions are wealthy in bicarbonate, and those losses might cause metabolic acidosis.
A 34-year-antique man admitted with Pneumocystis carinii pneumonia asks the nurse what
protecting measures he ought to use at domestic to save you transmission of human
immunodeficiency virus (HIV) to own family members. The excellent reaction would encompass
which of the subsequent?
, A.
Wear a masks to defend the circle of relatives contributors.
B.
Use plastic eating utensils and paper plates.
C.
Launder apparel and linens one at a time.
D.
Clean up body secretion spills with a weak chlorine bleach answer. - ANS-D - throw out the
extremes and don't forget than frame secretions are the priority. I susceptible chlorine bleach
will kill HIV
A 42-yr-vintage female is admitted with "the worst headache I've ever had." Computed
tomography famous an aneurysm in the circle of Willis. Vasospasm can be handled with which
of the subsequent?
A.
Fluid administration
B.
Loop diuretics (e.G., furosemide)
C.
Antifibrinolytic (aminocaproic acid [Amicar])
D.
Osmotic diuretics (e.G., mannitol [Osmitrol]) - ANS-Give fluids for remedy. Diuretics which
include mannitol/lasix will excacerbate the trouble with a hypovolemic kingdom. Antifibrin may
motive re-bleeding and is not indicated for the remedy of vasospasm.
A forty six-yr-antique female is admitted to the essential care unit with acute respiration failure
due to pneumonia.
Vital Signs
Blood pressure one hundred forty/88 mm Hg
Heart charge 108 beats/min
Respiratory rate 26 breaths/min
Temperature 39.8° C (103.8° F)
Arterial Blood Gases
pH 7.29
PaCO2 fifty four mm Hg
HCO3 24 mEq/L
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