Nursing Elites

1. Patients are coming into the emergency room as a result of an apartment house fire. You are examining a patient who is in distress but has no visible burn marks. You suspect that she is suffering from inhalation burns. Which of the following signs would NOT be associated with inhalation burns?

• A. Singed nasal hairs
• B. Conjunctivitis
• C. Hoarseness
• D. Clear sputum

Correct answer: D

Rationale: Clear sputum would not be associated with inhalation burns. Inhalation burns typically present with symptoms like singed nasal hairs, conjunctivitis, hoarseness, and possibly soot in sputum due to smoke inhalation. Clear sputum suggests that there is no significant inflammation or injury to the respiratory tract, which is not consistent with the typical findings in inhalation burns. The other choices are associated with inhalation burns: singed nasal hairs can occur due to exposure to hot air or gases, conjunctivitis can result from irritating substances in smoke, and hoarseness can be due to airway irritation.

2. What is the primary function of surfactant in the lungs?

• A. Reduce surface tension
• B. Enhance oxygen absorption
• C. Facilitate carbon dioxide release
• D. Increase lung volume

Correct answer: A

Rationale: The primary function of surfactant in the lungs is to reduce surface tension in the alveoli. This reduction in surface tension prevents lung collapse and allows for easier breathing. It is particularly crucial in premature infants to help with lung expansion. Choice B is incorrect because surfactant primarily affects surface tension, not oxygen absorption. Choice C is incorrect because surfactant's main role is not in facilitating carbon dioxide release. Choice D is incorrect because surfactant does not directly increase lung volume; its main role is in reducing surface tension.

3. A client who had a right total shoulder replacement is being prepared for discharge. What should the nurse emphasize to the client to prevent complications?

• A. Avoid lifting objects with the right arm until cleared by the surgeon.
• B. Perform shoulder exercises to regain strength.
• C. Use a sling at all times, even during sleep.
• D. Apply heat to the shoulder to reduce stiffness.

Correct answer: A

Rationale: The correct answer is to avoid lifting objects with the right arm until cleared by the surgeon. After a total shoulder replacement, it is essential to protect the new joint to prevent dislocation or injury. Lifting heavy objects prematurely can lead to complications. While performing shoulder exercises is important for strength, they should be done as per the healthcare provider's instructions to avoid strain on the new joint. Using a sling at all times, as in choice C, is not necessary once the client has regained enough strength and mobility. Applying heat, as in choice D, may not be recommended post-surgery; cold therapy is often preferred to reduce swelling and pain.

4. What is the primary role of the sinoatrial (SA) node in the heart?

• A. Pacemaker of the heart
• B. Blood pressure regulation
• C. Electrical conduction delay
• D. Stimulating muscle contraction

Correct answer: A

Rationale: The correct answer is A: Pacemaker of the heart. The SA node, known as the natural pacemaker, initiates the electrical impulses that set the rhythm for the heartbeat. It is responsible for coordinating the heart's contractions by generating electrical signals at regular intervals. Choice B is incorrect as the SA node's primary function is not related to blood pressure regulation. Choice C is incorrect as the SA node does not cause electrical conduction delay but rather initiates and conducts the electrical impulses. Choice D is incorrect as the SA node does not directly stimulate muscle contraction but rather initiates the electrical events that lead to muscle contraction.

5. You are teaching students about how hyperosmotic agents (osmotic diuretics) are used to treat intracranial pressure. Which of the following is NOT one of the functions of hyperosmotic agents?

• A. Reduces brain metabolism and systemic blood pressure
• B. Reduces cerebral edema
• C. Dehydrates the brain
• D. Draws fluids from extravascular spaces into the plasma

Correct answer: A

Rationale: Hyperosmotic agents primarily work by reducing cerebral edema, dehydrating the brain, and drawing fluids from extravascular spaces into the plasma. However, they do not have a direct effect on reducing brain metabolism or systemic blood pressure. Therefore, the correct answer is A. Choice B is correct as hyperosmotic agents do help in reducing cerebral edema. Choice C is accurate as hyperosmotic agents dehydrate the brain. Choice D is also true as these agents draw fluids from extravascular spaces into the plasma.

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