A nurse is caring for a 43-year-old female client who reports abdominal pain.

Exhibits

For each potential provider's order, click to specify if the potential order is anticipated or contraindicated for this client.

Begin broad spectrum IV antibiotics.

Transfuse 1 unit of packed red blood cells.

Prepare client for endoscopic retrograde cholangiopancreatography.

Administer morphine sulfate IV push for pain.

Answer and Explanation

The Correct Answer is {"A":{"answers":"A"},"B":{"answers":"B"},"C":{"answers":"A"},"D":{"answers":"B"}}

1.   Begin Broad Spectrum IV Antibiotics Anticipated
The client's symptoms, including right upper quadrant pain, nausea, vomiting, jaundice, fever, and elevated white blood cell count, suggest a potential infection or inflammation in the abdominal area, possibly related to the biliary system (e.g., cholecystitis or cholangitis). Broad-spectrum antibiotics are commonly used to treat infections that could be causing these symptoms, especially if the exact pathogen is not yet identified. The elevated white blood cell count further supports the likelihood of an infection.
2.   Transfuse 1 Unit of Packed Red Blood Cells Contraindicated
There is no indication from the provided information that the client has anemia or a significant drop in hemoglobin that would necessitate a blood transfusion. The hemoglobin level is 15.1 g/dL, which is within normal limits. Blood transfusion would typically be considered if there was evidence of significant blood loss or anemia, neither of which is indicated by the client’s current lab results.
3.   Prepare Client for Endoscopic Retrograde Cholangiopancreatography (ERCP) Anticipated
The symptoms described, including right upper quadrant pain radiating to the right shoulder, jaundice, and the dark amber urine, are suggestive of biliary tract involvement, such as gallstones causing obstruction or infection. ERCP is a diagnostic and therapeutic procedure used to visualize and treat conditions of the bile ducts and pancreatic ducts. Given the symptoms and clinical presentation, preparing the client for an ERCP to assess and potentially address issues in the biliary system is appropriate.

4.   Administer Morphine Sulfate IV Push for Pain Contraindicated
The client has a documented allergy to morphine. Administering morphine could lead to an allergic reaction and is therefore contraindicated. Alternative pain management options should be considered, such as non-opioid analgesics or other opioid medications that the client is not allergic to.

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Correct Answer is B

Explanation

A. Parkinson's disease is not generally considered to be caused by an autoimmune reaction or a recent infection. Autoimmune reactions leading to neurodegeneration are more commonly associated with other conditions such as multiple sclerosis, not Parkinson's disease.
B. The exact cause of Parkinson's disease is indeed unknown, but research suggests that it results from a combination of genetic predispositions and environmental factors. Genetic mutations may contribute to the development of Parkinson's disease in some individuals, while environmental factors such as exposure to certain toxins or other external influences might also play a role. The interplay between these factors is still being studied.
C. There is no evidence to support the idea that Parkinson's disease is caused by the reactivation of a virus affecting cranial nerve VII (the facial nerve). Parkinson's disease involves the degeneration of dopamine-producing neurons in the brain, not specifically related to viral reactivation or isolated to cranial nerve VII.
D. Demyelination of nerves is characteristic of multiple sclerosis, not Parkinson's disease. In Parkinson's disease, the primary issue is the loss of dopamine-producing neurons in the substantia nigra of the brain, not demyelination. This option describes a different pathological process unrelated to Parkinson's disease.

A. The late-phase response occurs due to an influx of additional inflammatory cells B. The symptoms of the late-phase response tend to respond better to a rescue inhaler than the symptoms of the early-phase response C. The late-phase response occurs because the client did not use their rescue inhaler properly D. The late-phase response only occurs if the client continues to be exposed to their trigger after the initial attack

Correct Answer is A

Explanation

A. The late-phase response in asthma is characterized by a delayed and prolonged inflammatory reaction that can occur 4 to 6 hours after exposure to a trigger. It involves the recruitment of additional inflammatory cells, such as eosinophils and T cells, which contribute to ongoing airway inflammation, increased mucus production, and bronchoconstriction. This phase often leads to a return of symptoms or worsening of symptoms after the initial relief provided by a rescue inhaler.
B. The late-phase response does not typically respond as well to rescue inhalers (such as albuterol) as the early-phase response does. Rescue inhalers are primarily effective for the immediate, bronchospastic component of asthma (early-phase response).
C. The late-phase response occurs as part of the natural progression of asthma inflammation and is not necessarily related to improper use of a rescue inhaler. Even with proper use of a rescue inhaler, the late-phase response can still occur due to the underlying inflammatory processes.
D. The late-phase response can occur even if the trigger is no longer present. It is related to the ongoing inflammatory process rather than continued exposure to the trigger. Although continued exposure to triggers can exacerbate symptoms, the late-phase response can still occur independently of further exposure.

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A nurse is caring for a 43-year-old female client who reports abdominal pain. Exhibits For each potential provider's order, click to specify if the potential order is anticipated or contraindicated for this client.

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Correct Answer is B

Explanation

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Explanation

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A nurse is caring for a 43-year-old female client who reports abdominal pain.

Exhibits

For each potential provider's order, click to specify if the potential order is anticipated or contraindicated for this client.