Nursing Elites

1. What is the priority intervention for a patient with possible acute coronary syndrome?

• A. Administer nitroglycerin
• B. Get IV access
• C. Auscultate heart sounds
• D. Administer aspirin

Correct answer: A

Rationale: The correct answer is to administer nitroglycerin. Nitroglycerin is the priority intervention for a patient with possible acute coronary syndrome as it helps dilate blood vessels, reduce chest pain, and improve blood flow to the heart. This intervention is crucial in managing acute coronary syndrome and should be given promptly. Getting IV access may be necessary, but administering nitroglycerin takes precedence to alleviate symptoms and prevent further heart damage. Auscultating heart sounds and administering aspirin are important aspects of the assessment and treatment plan, but they are not the priority interventions in the acute phase of suspected acute coronary syndrome.

2. What is the preferred electrical intervention for a patient with ventricular tachycardia and a pulse?

• A. Synchronized cardioversion
• B. Defibrillation
• C. Medication administration
• D. Pacing

Correct answer: A

Rationale: In a patient with ventricular tachycardia and a pulse, synchronized cardioversion is the preferred electrical intervention. Synchronized cardioversion is used to treat unstable tachyarrhythmias like ventricular tachycardia with a pulse. Choice B, defibrillation, is used for pulseless ventricular tachycardia or ventricular fibrillation. Choice C, medication administration, may not provide immediate correction for unstable ventricular tachycardia. Choice D, pacing, is not the first-line treatment for ventricular tachycardia with a pulse.

3. A patient is receiving discharge instructions for GERD. Which of the following statements by the patient demonstrates an understanding of the teaching?

• A. I should take my medication with orange juice.
• B. Having a bedtime snack will prevent heartburn.
• C. I will lie down after meals.
• D. I will limit activities that require bending at the waist.

Correct answer: D

Rationale: The correct answer is D. Patients with GERD should avoid activities that increase intra-abdominal pressure, such as bending at the waist, as this can lead to reflux. Choice A is incorrect because medications for GERD are usually taken with water, not citrus juices. Choice B is incorrect as having a bedtime snack can worsen GERD symptoms. Choice C is incorrect because lying down after meals can also exacerbate reflux due to the effects of gravity.

4. What are the signs and symptoms of Increased Intracranial Pressure (IICP)?

• A. Irritability, confusion, restlessness
• B. Fatigue and SOB
• C. Changes in pupillary response
• D. Elevated blood pressure

Correct answer: A

Rationale: The correct answer is A: Irritability, confusion, restlessness. These are common signs of Increased Intracranial Pressure (IICP) as they result from the increased pressure on brain tissue. Choices B, C, and D are incorrect. Fatigue and shortness of breath (SOB) are not typical symptoms of IICP. Changes in pupillary response can be seen in other conditions but are not specific to IICP. Elevated blood pressure is not a common sign of IICP.

5. What should the healthcare provider do if a patient presents with chest pain and possible acute coronary syndrome?

• A. Administer sublingual nitroglycerin
• B. Administer aspirin
• C. Obtain cardiac enzymes
• D. Get IV access and auscultate heart sounds

Correct answer: A

Rationale: Administering sublingual nitroglycerin is the priority action in the treatment of chest pain in acute coronary syndrome. Nitroglycerin helps dilate blood vessels, improving blood flow to the heart and relieving chest pain. Aspirin can also be given to reduce clot formation, but nitroglycerin takes precedence in providing immediate relief. Obtaining cardiac enzymes and assessing heart sounds are important steps in the diagnostic process but do not address the immediate need to relieve chest pain and prevent cardiac tissue damage. Therefore, administering sublingual nitroglycerin is the most appropriate initial intervention for a patient presenting with chest pain and possible acute coronary syndrome.

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