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AACN CCRN (Adult) - Direct Care Eligibility Pathway Sample Questions (Q788-Q793):
NEW QUESTION # 788
All the following are psychological responses to sleep deprivation in the critically ill patient EXCEPT:
- A. Suppressed immune system
- B. Irritability
- C. Confusion
- D. Agitation
Answer: A
Explanation:
While a suppressed immune system is a likely response to sleep deprivation, this is a physiologic (not a psychologic) response.
Psychological changes in sleep deprivation include agitation, confusion, and irritability.
NEW QUESTION # 789
A 65-year-old man with a history of chronic pain is admitted to the ICU with severe abdominal pain due to acute pancreatitis. He is currently taking opioids for chronic pain. How should the nurse manage this patient's pain?
- A. Decrease the opioid dose
- B. Increase the opioid dose if it is safe to do so
- C. Maintain the current opioid dose
- D. Switch to non-opioid analgesics
Answer: B
Explanation:
Managing pain in someone who already uses opioids to treat chronic pain is complex. Regular opioid use can build tolerance, making it necessary to increase the dose to achieve adequate analgesia when acute pain requires. Acute pancreatitis is routinely treated using opioids and increasing the dose of opioids if it is safe to do so will be necessary to achieve analgesia.
NEW QUESTION # 790
Assessment of chest pain is often remembered by the nomogram"'PQRST." What does the "T" stand for in this mnemonic?
- A. Timing
- B. Tachycardia
- C. Thrombosis
- D. Trauma
Answer: A
Explanation:
Obtaining an accurate assessment of chest pain history is important to differentiate cardiac chest pain from other sources of pain. The "PQRST" mnemonic prompts the clinician to ask a series of questions which help to clarify the characteristics of the cardiac pain.
* Provoke: What provokes or precipitates the pain?
* Quality: What is the quality of the pain?
* Radiation: Does the pain radiate to other locations besides the chest?
* Severity: What is the severity of the pain (one to ten scale)?
* Timing: What is the time of onset of this episode?
NEW QUESTION # 791
A patient who has type 1 diabetes is taking metformin to treat their blood sugars instead of insulin.
Which of the following is MOST LIKELY to occur?
- A. The patient will develop DKA, but could have a blood glucose level that is close to normal
- B. The patient will develop severe hyperglycemia, eventually resulting in HHS
- C. The patient will be at risk for severe hypoglycemia
- D. Complications will likely result from the patient's blood sugar levels not being well controlled
Answer: A
Explanation:
Patients with type 1 diabetes are unable to transport sugar into their cells. Metformin will lower blood sugar levels, but will not transport glucose into the cells. This results in the cells undergoing a metabolic change, causing Diabetic Ketoacidosis (DKA), even though the patient's blood glucose levels may be relatively normal. Metformin use will prevent severe hyperglycemia from occurring and is not likely to cause severe hypoglycemia. Complications result from the lack of glucose entering the cells, not from poor glycemic control.
NEW QUESTION # 792
The pathologic processes in Acute Respiratory Distress Syndrome (ARDS) are characterized by excessive alveolar-capillary membrane permeability, interstitial edema, and diffuse alveolar injury, leading to severe hypoxemia and poor lung compliance. Lung compliance refers to:
- A. measurement of mean pulmonary artery pressure
- B. ability of the lungs to expand
- C. elastic recoil of the lungs
- D. measurement of Positive End-Expiratory Pressure (PEEP)
Answer: B
Explanation:
Lung compliance, or pulmonary compliance, is a measure of the lung's ability to stretch and expand (distensibility of elastic tissue). In Acute Respiratory Distress Syndrome (ARDS), poor lung compliance, or
"stiff lungs," and hypoxemia are caused by alveolar and interstitial edema, microatelectasis, and ventilation-perfusion mismatching. In addition to poor lung compliance and severe hypoxemia, the ARDS process also disrupts normal macrophage function and increases the risk of infection. Mortality and long-term disability from ARDS are high.
NEW QUESTION # 793
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