NU335 Spring 2026 T2 CA CV Disorder Shock Emergency at Baton Rogue General School of Nursing
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Free NU335 Spring 2026 T2 CA CV Disorder Shock Emergency at Baton Rogue General School of Nursing Questions
A patient receiving radiation to the head and neck area as treatment for laryngeal cancer develops ulcerations and bleeding of the oral mucosa. What should the nurse consider as the primary goal for this patient?
- Relief of anxiety
- Pain relief
- Increase in self-esteem
- Adequate nutrition
Explanation
Explanation
The primary concern for patients undergoing radiation therapy to the head and neck area, particularly for conditions like laryngeal cancer, is maintaining adequate nutrition. Radiation often causes oral mucosal ulcerations, pain, and difficulty swallowing, which can significantly impact a patient's ability to eat and maintain proper nutrition. Ensuring that the patient receives adequate nutrition is essential to support their recovery, prevent malnutrition, and maintain strength during cancer treatment. The nurse should prioritize addressing the patient's nutritional needs and consider interventions such as enteral feeding, modified diets, or nutritional supplements。Correct Answer Is:
D. Adequate nutritionA patient who has been involved in a motor-vehicle crash is admitted to the emergency department in shock. Of the prescribed orders below, which order will the nurse implement first?
- Administer oxygen at 100% per non-rebreather mask
- Draw blood to type and crossmatch for transfusions
- Insert two 20-gauge IV catheters
- Place the patient on continuous cardiac monitor
Explanation
Explanation
In the case of shock, oxygenation is the first priority to ensure tissue perfusion and prevent further complications from hypoxia. Administering oxygen at 100% via a non-rebreather mask helps to maximize oxygen delivery, especially in trauma patients who may have hypovolemic shock or respiratory distress. Immediate oxygenation can improve oxygen saturation and tissue perfusion, which is crucial in stabilizing the patient before moving on to other interventions。Correct Answer Is:
A. Administer oxygen at 100% per non-rebreather maskA patient with a myocardial infarction has developed cardiogenic shock. What would the nurse expect as treatment for the patient?
- Administration of nitroglycerin
- Administration of norepinephrine
- Fluid resuscitation with lactated Ringer's solution
- Insertion of pacemaker
Explanation
Explanation
In cardiogenic shock, the heart is unable to pump sufficient blood to meet the body's needs, often due to a myocardial infarction (MI). Treatment typically involves improving cardiac output and peripheral perfusion. Norepinephrine, a vasopressor, is used to increase systemic vascular resistance and raise blood pressure, which can improve perfusion to vital organs. It helps to support the cardiovascular system by increasing the contractility and constriction of blood vessels, improving circulation in a shock state。Correct Answer Is:
B. Administration of norepinephrineAn unresponsive patient is admitted to the emergency department during a summer heat wave. The patient's core temperature is 106.2° F, blood pressure (BP) 86/52, and pulse 102. The nurse anticipates which intervention for this patient?
- Administer an acetaminophen suppository
- Apply ice packs to the groin and axillae.
- Insert a urinary catheter.
- Obtain arterial blood gases.
Explanation
Explanation
The patient’s presentation with a core temperature of 106.2° F indicates severe hyperthermia, likely caused by heat stroke, which is a medical emergency. In this condition, the body is unable to regulate temperature, leading to potential organ damage. The first priority is to cool the body down rapidly. One of the most effective methods is applying ice packs to the groin and axillae, where major blood vessels are close to the skin, helping to cool the body efficiently. Other interventions like ice baths or cooling blankets are also considered, but ice packs in the groin and axillae are commonly used in the initial stages。Correct Answer Is:
B. Apply ice packs to the groin and axillae.The nurse is completing the primary survey on a trauma patient, understanding that the E stands for what?
- Emergent - notify next of kin
- Evaluate - draw blood samples for lab
- Examine - head-to-toe assessment
- Expose - remove patient's clothes
Explanation
Explanation
The E in the primary survey (which follows the ABCDE mnemonic) stands for Expose. This means the nurse should remove the patient’s clothing to assess for any hidden injuries that may not be immediately visible. The primary survey focuses on identifying life-threatening issues and ensuring the patient is not bleeding or injured in ways that are not visible when the clothes are still on. Exposing the patient helps ensure a thorough and complete assessment。Correct Answer Is:
D. Expose - remove patient's clothesMild to moderate dementia
Prosthetic aortic valve replacement related to aortic insufficiency
Infective endocarditis in 2018: staphylococcus aureus
Physician orders:
20 mg/kg intravenous (IV) vancomycin every 12 hours
15 mg/kg IV rifampin daily
Repeat blood cultures × 2
What are the 4 priorities of care for this client?
- A Discuss the importance of communicating with the dentist about treatment for endocarditis.
- B Plan to repeat blood culture in 30 minutes from the same venipuncture site.
- C Anticipate availability of blood culture result and report to healthcare provider.
- D Recognize healthcare provider has access to blood culture results and avoid unnecessary communication.
- E Plan to repeat blood culture in 30 minutes from a different venipuncture site.
- F Prioritize focused renal, endocrine and gastrointestinal assessment.
- G Question necessity of repeat blood culture.
- H Prioritize focused cardiac, skin and musculoskeletal assessments
Explanation
Explanation
A. Discuss the importance of communicating with the dentist about treatment for endocarditis.Infective endocarditis can result from dental procedures that may cause bacteremia, which can lead to reinfection. For patients with prosthetic heart valves (like this patient), it is critical to communicate with the dentist about the need for antibiotic prophylaxis before certain dental procedures. This will help prevent the recurrence of infective endocarditis。
C. Anticipate availability of blood culture result and report to healthcare provider.
Blood cultures are essential in identifying the causative organism of infective endocarditis, particularly the Staphylococcus aureus that this patient previously had in 2018. The result of the blood cultures will help guide antibiotic therapy, and the nurse should be prepared to report the results to the healthcare provider quickly, as it will influence treatment decisions, including the appropriate duration and type of antibiotics。
E. Plan to repeat blood culture in 30 minutes from a different venipuncture site.
To ensure accurate results and to avoid contamination, it is standard practice to obtain blood cultures from two different venipuncture sites. This allows for more accurate detection of bacteremia or any ongoing infection. Cultures should be taken separately to avoid false positives from contamination at a single site。
Correct Answer Is:
A, C, E, FFollowing primary survey using the ABC mnemonic on a trauma patient, the emergency department nurse proceeds to D, which stands for what?
- Deformities -- splint and x-ray
- Disability -- neurologic status
- Disrobe -- cut clothes off
- Drugs -- usually antibiotics and tetanus immunization
Explanation
Explanation
In the primary survey of a trauma patient, after ensuring airway, breathing, and circulation (ABC) are stabilized, the nurse proceeds to D, which stands for Disability. This refers to a quick neurologic assessment to determine the patient's level of consciousness and neurological function. The Glasgow Coma Scale (GCS) is commonly used to assess level of consciousness, and the nurse will also check for pupillary response and any signs of neurologic deficits (such as paralysis or altered sensation) that might indicate brain or spinal cord injury。Correct Answer Is:
B. Disability -- neurologic statusA nurse is caring for a patient with metastatic breast cancer. The nurse finds that the patient has developed facial and periorbital edema, and has distention of veins of the face, neck, and chest. Based on these findings, the nurse should suspect which oncologic emergency?
- Third space syndrome
- Spinal cord compression
- Tumor lysis syndrome
- Superior vena cava syndrome
Explanation
Explanation
The symptoms described—facial and periorbital edema, as well as distention of veins in the face, neck, and chest—are classic signs of superior vena cava syndrome (SVCS). SVCS occurs when the superior vena cava is compressed or obstructed, often by a tumor (in this case, metastatic breast cancer). This compression impairs the return of blood from the head, neck, and upper extremities, leading to venous congestion, swelling, and distention of veins. SVCS is an oncologic emergency that requires prompt diagnosis and treatment, such as stenting or radiation therapy to relieve the obstruction。Correct Answer Is:
D. Superior vena cava syndromeAfter receiving information about four patients during change-of-shift report, which patient would the nurse assess first?
- Patient with acute pericarditis who has a pericardial friction rub.
- Patient who has just returned to the unit after balloon valvuloplasty.
- Patient who has hypertrophic cardiomyopathy and a heart rate of 116.
- Patient with a mitral valve replacement who has an anticoagulant scheduled.
Explanation
Explanation
The patient who has just returned from a balloon valvuloplasty should be assessed first, as this is an invasive procedure that can have complications such as perforation, bleeding, or thromboembolism. After any cardiac procedure, particularly one like balloon valvuloplasty, it is essential to monitor the patient closely for signs of complications such as arrhythmias, hypotension, or chest pain, which could indicate issues with the procedure. Ensuring that the patient is stable after the procedure is the priority。Correct Answer Is:
B. Patient who has just returned to the unit after balloon valvuloplasty.A patient is being treated for shock. The nurse knows that shock is a clinical syndrome characterized by which physiologic state?
- Inadequate tissue perfusion
- Loss of blood
- Hypotension
- Severe infection
Explanation
Explanation
Shock is a clinical syndrome characterized by inadequate tissue perfusion, which leads to insufficient oxygen and nutrient delivery to the tissues. This can occur due to hypovolemia, cardiogenic failure, distributive causes (such as septic shock), or other conditions. The lack of proper perfusion can result in cellular dysfunction and, if untreated, can lead to organ failure and death. The priority in shock management is to restore adequate perfusion to tissues and organs to prevent irreversible damage。Correct Answer Is:
A. Inadequate tissue perfusionHow to Order
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