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. Myasthenia gravis is an autoimmune disorder characterized by weakness and rapid fatigue of voluntary muscles due to impaired communication between nerves and muscles. It is not directly related to HSV infection.
B. Multiple sclerosis (MS) is a chronic autoimmune disorder that affects the central nervous system, leading to demyelination of nerve fibers. While the exact cause of MS is not completely understood, it is thought to involve a combination of genetic and environmental factors. HSV is not directly associated with the development of MS.
C. Guillain-Barre syndrome (GBS) is an acute, autoimmune condition that affects the peripheral nervous system, leading to progressive muscle weakness and paralysis. GBS is often preceded by an infection, and while it is most commonly associated with infections like Campylobacter jejuni, other infections, including HSV, have also been implicated as potential triggers for GBS.
D. Bell's palsy is a condition characterized by sudden, unilateral facial paralysis or weakness due to inflammation of the facial nerve (cranial nerve VII). HSV has been identified as a potential cause of Bell's palsy, as the virus can lead to inflammation of the facial nerve.

A. Laparoscopic splenectomy B. Transfusion of platelets C. Replacement of ADAMTS-13 D. Administration of protamine sulfate

Correct Answer is A

Explanation

A. Laparoscopic splenectomy involves the surgical removal of the spleen. The spleen is an organ where platelets are often destroyed in ITP. Removing the spleen can reduce the destruction of platelets and potentially improve platelet counts. This procedure is considered when medical therapy fails to adequately control the condition and is often effective in increasing platelet counts for many patients with chronic ITP.
B. Transfusion of platelets is generally not effective in ITP because the underlying problem is that the platelets are being destroyed by the immune system. Platelet transfusions may provide a temporary increase in platelet count but do not address the underlying cause of platelet destruction.
C. ADAMTS-13 is a von Willebrand factor-cleaving protease associated with thrombotic thrombocytopenic purpura (TTP), not ITP. Replacement of ADAMTS-13 is relevant for treating TTP, a different condition that also involves thrombocytopenia but has a different pathophysiology.
D. Protamine sulfate is used to reverse the effects of heparin, an anticoagulant. It is not used to treat ITP and does not affect platelet destruction or platelet count. This procedure is not relevant to the management of ITP.

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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?

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Naxlex Comprehensive Predictor Exams

A client with a cold sore on the lip has been diagnosed with herpes simplex virus. Which neurological disorder may the client be at risk for in the future?

Correct Answer is D

Explanation

A nurse is caring for a client who has a diagnosis of immune thrombocytopenic purpura (ITP). Despite medication therapy, the client's platelet count remains low. Which of the following procedures would reduce the destruction of platelets for a client who has ITP?

Correct Answer is A

Explanation

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