the nclex-style question thread.

Where's the "do nothing" option?

 

Not 1... dehydration could be an underlying cause.
2? That should be done with all patients, right?
3.... ummmm...

4! To elaborate on @snowy's response: caffeine's diuretic properties could dehydrate the patient further and better hydration should speed the respiratory healing.

 

4. Caffeine is a stimulant that elevates the heart rate. Monitoring the pulse might be more frequent than once a shift?

 

Yup, I'd got with limiting the caffeine whenever there is a heart rate issue. Until it gets figured out.

 

4 is correct! Caffeine is a stimulant and should be avoided when people are experiencing rapid heartbeat.

I'm too lazy to look up the rationales so I'll just write them myself.

1. Unless a person is in renal failure or has heart failure or some other issue with retaining fluids, you're probably not going to be limiting their water. Other exceptions would be before or after certain medical procedures.

2. Yes, jonie, you would prob. take their pulse more than once per shift. Plus it's not an intervention.

3. I may be wrong, but I don't think you're going to make someone with a respiratory infection get up and walk much.

It's early yet. I'll try and post another one before I leave for school.
Now for some coffee!

 

Bleh, it's a scam - a commercial decision!

Someone with a cold and sinus tach should just go home and man up! :lol:

 

What say you?

 

Yes, I'll go for #1 too.

The clubbing is due to the body trying to increase oxygen in the fingers.

 

1

 

Number 1.
Make it so.

 

Hypoxia (clubbing can be caused by vasodilation, which can be a reaction to the body trying to increase bloodflow to the fingers, basically the same rationale rogue49 used)

 

ack! I can't find that question again now. Might be because there are about 2000 questions in this book and I didn't mark the place.

Hypoxia was my first choice, too, and for now I am going to defer to the intelligence of the TFP medical authority and say, YES!, that is correct.

This one (maybe) is a little more challenging. As of writing, I have no idea what the answer is. Of course, Deadmau5 is PLAYING REALLY LOUD IN HERE RIGHT NOW.
but that's just how i roll.

 

2. Found the answer in the post above mine.

 

i still haven't looked at the answer, but when dealing with spinal cords and assoc. fluids, it's probably never a bad choice to contact the doc.
if I were answering this rogue question on an exam, that would be the one I would choose 'cause it's the only one that can't be wrong.

 

Think anatomically mm.
The catheter is supposed to be in the epidural space, yet it is accessing clear fluid when aspirated.
Where does that suggest the catheter actually is?

 

assuming that it is cerebrospinal fluid, I would guess it is elsewhere in the spinal canal.

 

Yep your epidural has now become a spinal (or dural) catheter.

 

I screwed up and took the nclex book back to the library today before I posted the rationale.

But, the good news, I picked up another one!

I'm going to go with snowy's research and fflowley's expertise. Anesthesiologist should be called because the catheter is misplaced.

Here's a sort of pharm-y one for snowy: