A patient presents to the emergency department (ED) complaining of nausea, vomiting, and the “worst headache he has ever experienced.”. While examining the patient, the nurse notes left leg and arm weakness.The patient is immediately sent to the radiology department for a CT scan. The registered nurse (RN) identifies the immediate need for treatment because:
A hemorrhagic brain attack is more common than an ischemic brain attack.
A thrombolytic drug will cause the peripheral and central reflexes to become hyper-reactive.
A hemorrhagic brain attack requires immediate intervention to prevent further damage.
An ischemic brain attack is less severe than a hemorrhagic brain attack.
The Correct Answer is C
Choice A rationale
A hemorrhagic brain attack (stroke) is less common than an ischemic brain attack. Ischemic strokes account for the majority of strokes.
Choice B rationale
Thrombolytic drugs are used to treat ischemic strokes, not hemorrhagic strokes. They do not cause hyper-reactive reflexes.
Choice C rationale
A hemorrhagic brain attack requires immediate intervention to prevent further damage. Hemorrhagic strokes involve bleeding in the brain, which can rapidly worsen and cause severe damage.
Choice D rationale
An ischemic brain attack is not necessarily less severe than a hemorrhagic brain attack. Both types of strokes are serious, but hemorrhagic strokes often require more urgent intervention due to the risk of ongoing bleeding.
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Correct Answer is B
Explanation
Choice A rationale
Decreased breath sounds in the lower lobes can indicate areas of the lung that are not ventilating well, but this finding alone does not specifically indicate an exacerbation of COPD. It could be due to other conditions such as pleural effusion or atelectasis.
Choice B rationale
Increased respiratory rate and use of accessory muscles are signs of respiratory distress and indicate that the patient is working harder to breathe. These findings are consistent with an exacerbation of COPD, where the airways are more obstructed, and the patient has difficulty maintaining adequate ventilation.
Choice C rationale
Elevated blood pressure and heart rate can occur in many conditions and are not specific indicators of a COPD exacerbation. These vital sign changes can be due to pain, anxiety, or other stressors.
Choice D rationale
Presence of wheezing and cyanosis are also indicators of a COPD exacerbation. Wheezing indicates airway obstruction, and cyanosis indicates hypoxemia, both of which are common during an exacerbation.
Correct Answer is A
Explanation
Choice A rationale
Decreasing coronary artery constriction by giving aspirin is a primary objective in managing unstable angina. Aspirin inhibits platelet aggregation, reducing the risk of clot formation and improving blood flow in the coronary arteries. This helps to alleviate chest pain and prevent myocardial infarction.
Choice B rationale
Increasing afterload for the left ventricle to maximize cardiac output is not a desirable objective in managing unstable angina. Increasing afterload would increase the workload on the heart, which is counterproductive in patients with angina. The goal is to reduce the heart’s workload and improve blood flow.
Choice C rationale
Increasing preload to reduce overall cardiac workload is not a primary objective in managing unstable angina. Increasing preload would increase the volume of blood returning to the heart, potentially worsening symptoms. The focus is on reducing myocardial oxygen demand and improving coronary perfusion.
Choice D rationale
Reducing arterial inflammation by administering statins is a long-term strategy for managing cardiovascular disease, but it is not the immediate objective in managing unstable angina. Statins help to lower cholesterol levels and reduce inflammation, but the immediate goal in unstable angina is to relieve chest pain and prevent myocardial infarction.