The nurse is caring for several patients in the Intensive Care Unit. Which of the following patients is at greatest risk of anoxic brain injury? A patient who:

was found facedown in water for unknown length of time.

has had multiple concussions in a short period of time.

was in an assault resulting in a basilar skull fracture.

suffered an epidural hematoma.

Answer and Explanation

The Correct Answer is A

A. A patient found facedown in water is at high risk of anoxic brain injury due to potential prolonged oxygen deprivation, which is directly associated with lack of oxygen to the brain.

B. Multiple concussions can lead to other types of brain injury but are less associated with anoxic injury than prolonged oxygen deprivation.

C. A basilar skull fracture can cause complications such as CSF leaks but does not directly cause an anoxic brain injury.

D. An epidural hematoma may increase ICP, but with timely intervention, anoxic injury may be avoided; anoxic brain injury is more directly related to oxygen deprivation.

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Correct Answer is C

Explanation

A. Penicillins are generally safe but are not specific for ototoxicity considerations.

B. Aminoglycosides are avoided in cases of tympanic membrane rupture due to their ototoxic potential, which can lead to hearing loss.

C. Fluoroquinolones, particularly those formulated for otic use, are preferred for tympanic membrane ruptures as they are not ototoxic and are safe for middle ear exposure.

D. Cephalosporins are not typically ototoxic but are less commonly used for tympanic membrane ruptures compared to fluoroquinolones.

A. Drug dependence B. Cardiac rhythm C. Pulse oximetry D. Pain level

Correct Answer is C

Explanation

A. While drug dependence can be a concern with long-term use, it is not the immediate priority in an emergency setting where the goal is to stabilize the patient in status epilepticus.

B. Cardiac rhythm monitoring is important when administering certain medications, but lorazepam primarily affects the central nervous system and respiratory system, making oxygen saturation monitoring more critical.

C. Pulse oximetry is the priority assessment as IV lorazepam can depress the respiratory system, leading to hypoxia. Monitoring oxygen saturation helps ensure the patient maintains adequate respiratory function during administration.

D. Assessing pain is important in patient care, but it is not the priority in managing a patient in status epilepticus, where stabilization is essential.

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Naxlex Comprehensive Predictor Exams

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