A nurse is caring for a patient with a diagnosis of sepsis who is on a ventilator in the intensive care unit. To reduce the risk of developing a physiologic stress ulcer, the nurse should anticipate an order to administer which medication?

Methylprednisolone

Enoxaparin

Pantoprazole

Ibuprofen

Answer and Explanation

The Correct Answer is C

A.   Methylprednisolone is a corticosteroid used to reduce inflammation and suppress the immune system. While corticosteroids are sometimes used in critical care settings, they are not specifically used to prevent stress ulcers. In fact, corticosteroids can increase the risk of gastrointestinal bleeding and may require additional measures to protect the stomach lining.
B.   Enoxaparin is a low molecular weight heparin (LMWH) used primarily for the prevention of deep vein thrombosis (DVT) and pulmonary embolism (PE). It works as an anticoagulant, preventing blood clots. While enoxaparin is important for preventing thromboembolic events in critically ill patients, it does not specifically address the prevention of stress ulcers.
C.   Pantoprazole is a proton pump inhibitor (PPI) that reduces gastric acid production by inhibiting the proton pumps in the stomach lining. PPIs are commonly used to prevent and treat stress ulcers because they help decrease gastric acid secretion, thereby reducing the risk of ulcer formation and bleeding. This makes pantoprazole the appropriate medication to administer to prevent physiologic stress ulcers in a patient with sepsis on a ventilator.
D.   Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that is used for pain relief and inflammation. NSAIDs can actually increase the risk of gastrointestinal bleeding and ulceration, especially in critically ill patients.

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Correct Answer is D

Explanation

A. The ACTH stimulation test measures the adrenal glands' response to ACTH, not the kidneys.
B. In Addison’s disease, the adrenal glands are damaged and unable to produce sufficient cortisol even when stimulated by ACTH. Therefore, plasma cortisol levels will not rise significantly in response to
ACTH administration in individuals with Addison’s disease.
C. The ACTH stimulation test involves administering ACTH via injection, not orally.
D. ACTH (adrenocorticotropic hormone) is produced by the pituitary gland and stimulates the adrenal glands to produce cortisol. The ACTH stimulation test assesses how well the adrenal glands respond to ACTH, which is crucial for diagnosing conditions like Addison’s disease, where the adrenal glands do not respond appropriately.

A. Cool, clammy skin B. Chest pain radiating into the back and jaw C. Nausea and vomiting D. Peripheral edema

Correct Answer is D

Explanation

A. Cool, clammy skin can be a sign of a myocardial infarction. It occurs due to the body's stress response during an MI, leading to decreased perfusion and sweating. This symptom is consistent with the autonomic response to a heart attack.
B. Chest pain radiating into the back, jaw, or arms is a classic symptom of myocardial infarction. This radiation of pain is due to the way pain signals are transmitted and referred from the heart to other parts of the body. It is a common and significant symptom of MI.

C. Nausea and vomiting can occur during a myocardial infarction, particularly in older adults. These symptoms are related to the autonomic nervous system's response to the stress of an MI and can sometimes be the presenting symptoms, especially in women and older adults.
D. Peripheral edema is generally not a direct symptom of myocardial infarction. It is more commonly associated with chronic heart failure or other conditions leading to fluid overload. While MI can lead to heart failure over time, peripheral edema itself is not a typical acute symptom of an MI.

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A nurse is caring for a patient with a diagnosis of sepsis who is on a ventilator in the intensive care unit. To reduce the risk of developing a physiologic stress ulcer, the nurse should anticipate an order to administer which medication?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client is scheduled for an adrenocorticotropic hormone (ACTH) stimulation test to help diagnose suspected Addison's disease. What should the nurse include when teaching the client about this test?

Correct Answer is D

Explanation

A nurse is providing education to a group of older adults about the signs and symptoms of a myocardial infarction. Which of the following is not a sign of a myocardial infarction?

Correct Answer is D

Explanation

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