D444 Adult Health I - Set 2 - Part 2

Correct Answer: Maintain NPO status

Option c is correct because NPO status prevents food-stimulated pancreatic enzyme secretion, allowing the inflamed pancreas to rest and heal.
Option a is incorrect because oral fluids stimulate pancreatic secretions, worsening inflammation and pain in acute pancreatitis patients requiring rest.
Option b is incorrect because any oral intake, especially meals, stimulates pancreatic enzyme release exacerbating inflammation and pain significantly.
Option d is incorrect because pancreatic enzymes are for chronic pancreatitis with insufficiency, not acute pancreatitis where rest is needed.

Correct Answer: Diarrhea and pain

Option b is correct because gluten exposure in celiac disease triggers intestinal inflammation causing diarrhea, cramping, and abdominal pain typically.
Option a is incorrect because celiac disease typically causes diarrhea not constipation when gluten triggers the inflammatory response in intestines.
Option c is incorrect because gluten exposure causes nausea and decreased appetite rather than increased appetite in celiac disease patients.
Option d is incorrect because celiac disease causes malabsorption and weight loss, not weight gain when exposed to gluten triggers.

Correct Answer: Autosomal dominant

Option b is correct because Huntington's disease follows autosomal dominant inheritance, meaning one affected parent gives fifty percent transmission risk.
Option a is incorrect because autosomal recessive requires two carrier parents; Huntington's only needs one affected parent for transmission risk.
Option c is incorrect because X-linked recessive primarily affects males; Huntington's affects both genders equally through autosomal dominant inheritance pattern.
Option d is incorrect because Huntington's follows clear Mendelian inheritance not the complex multifactorial pattern involving multiple genes and environment.

Correct Answer: Preoxygenate before suctioning

Option a is correct because preoxygenation prevents hypoxemia, the most common and dangerous complication during suctioning of airways procedures.
Option b is incorrect because while sterile technique prevents infection, hypoxemia is more common and immediately dangerous during suctioning procedures.
Option c is incorrect because limiting suction time helps prevent hypoxemia but preoxygenation is the primary preventive measure used first.
Option d is incorrect because lubrication aids insertion but does not prevent hypoxemia, the most common complication requiring prevention strategies.

Correct Answer: Rapid deep breathing

Option b is correct because Kussmaul breathing with rapid deep respirations helps blow off CO2 to compensate for metabolic acidosis.
Option a is incorrect because slow shallow breathing would retain CO2, worsening acidosis rather than providing compensatory pH correction needed.
Option c is incorrect because irregular breathing does not provide consistent CO2 elimination needed for metabolic acidosis compensation effectively overall.
Option d is incorrect because periodic breathing like Cheyne-Stokes indicates neurological issues not respiratory compensation for metabolic acidosis specifically occurring.

Correct Answer: Soft mechanical diet

Option a is correct because soft foods reduce mechanical trauma risk to fragile esophageal varices while providing adequate nutrition needed.
Option b is incorrect because regular solid foods with rough textures could traumatize fragile varices causing life-threatening hemorrhage in patients.
Option c is incorrect because clear liquids alone provide insufficient nutrition though they are safe for varices mechanically speaking overall.
Option d is incorrect because consistency of liquids is less important than avoiding rough solid foods that could cause variceal trauma.

Correct Answer: Decreased abdominal pain

Option c is correct because H. pylori eradication reduces gastric inflammation and ulceration, directly relieving the characteristic abdominal pain experienced.
Option a is incorrect because while appetite may improve, pain relief is the most direct indicator of successful H. pylori treatment.
Option b is incorrect because weight gain occurs gradually after treatment and is not an immediate indicator of treatment success.
Option d is incorrect because energy improvement is nonspecific and could result from various factors beyond H. pylori eradication specifically.

Correct Answer: Bronchospasm development

Option c is correct because timolol is a beta-blocker that can cause systemic bronchospasm requiring immediate medical intervention for breathing.
Option a is incorrect because mild stinging upon instillation is common and temporary, not requiring immediate medical attention for safety.
Option b is incorrect because temporary vision blurring after eye drop instillation is expected and resolves quickly without intervention needed.
Option d is incorrect because mild eye redness may occur with eye drops and does not require immediate medical attention typically.

Correct Answer: Insulin and glucose

Option c is correct because insulin drives potassium into cells while glucose prevents hypoglycemia, rapidly lowering dangerous potassium levels effectively.
Option a is incorrect because calcium gluconate stabilizes cardiac membranes but does not lower potassium levels, only protecting heart temporarily initially.
Option b is incorrect because sodium bicarbonate is less effective than insulin for acute hyperkalemia and may cause fluid overload concerns.
Option d is incorrect because potassium chloride would worsen hyperkalemia; this patient needs potassium-lowering not replacement therapy immediately given.

Correct Answer: Peripheral edema

Option a is correct because peripheral edema indicates right heart failure from pulmonary hypertension, defining cor pulmonale in COPD.
Option b is incorrect because increased sputum suggests infection or exacerbation but not specifically right heart failure from COPD complications.
Option c is incorrect because worsening dyspnea occurs with COPD progression generally and does not specifically indicate cor pulmonale development.
Option d is incorrect because fever suggests infection rather than the right-sided heart failure that characterizes cor pulmonale in COPD.

Correct Answer: Transparent film

Option b is correct because transparent films maintain moisture for wounds with minimal drainage while allowing wound visualization and protection.
Option a is incorrect because wet-to-dry gauze causes tissue trauma during removal and is inappropriate for minimally draining wounds needing moisture.
Option c is incorrect because calcium alginate is for moderate to heavy drainage, providing excessive absorption for minimally draining wounds described.
Option d is incorrect because foam dressings absorb moderate drainage and would dry out wounds with minimal drainage requiring moisture retention.

Correct Answer: Acetaminophen regularly

Option a is correct because acetaminophen is hepatotoxic especially with existing liver disease, requiring strict dose limitations or avoidance completely.
Option b is incorrect because calcium carbonate as an antacid does not cause hepatotoxicity and is safe in hepatitis B patients.
Option c is incorrect because docusate sodium is a stool softener that does not affect liver function or cause hepatotoxicity concerns.
Option d is incorrect because diphenhydramine is metabolized by liver but does not cause significant hepatotoxicity like acetaminophen does regularly.

Correct Answer: Apply pressure patch

Option c is correct because pressure on a ruptured globe can expel intraocular contents, causing permanent vision loss and damage.
Option a is incorrect because protective shields without pressure are appropriate to prevent further injury while awaiting surgical repair needed.
Option b is incorrect because gentle visual assessment may be performed if patient cooperative, though not priority over protective measures initially.
Option d is incorrect because head elevation reduces intraocular pressure and is beneficial for eye trauma unless contraindicated by other injuries.

Correct Answer: Wear cotton socks

Option b is correct because cotton socks absorb moisture keeping feet dry, preventing the warm moist environment fungus needs for growth.
Option a is incorrect because while helpful, bedding is less critical than daily foot care and moisture control for preventing reinfection.
Option c is incorrect because daily bathroom disinfection is excessive; regular cleaning and keeping feet dry are more important prevention strategies.
Option d is incorrect because avoiding pools is unnecessary if wearing footwear; moisture control is more important than location avoidance completely.

Correct Answer: Cholestatic jaundice

Option b is correct because bile duct obstruction from gallstones causes cholestatic jaundice with dark urine from conjugated bilirubin excretion.
Option a is incorrect because pancreatitis causes epigastric pain and elevated pancreatic enzymes, not primarily jaundice with dark urine symptoms.
Option c is incorrect because hepatic failure involves multiple organ dysfunction beyond isolated biliary obstruction causing jaundice and dark urine.
Option d is incorrect because portal hypertension results from chronic liver disease causing varices and ascites, not acute biliary obstruction.

Correct Answer: Propranolol and aspirin

Option c is correct because propranolol blocks bronchodilation while aspirin triggers bronchoconstriction in sensitive asthmatics, potentially causing severe exacerbation.
Option a is incorrect because albuterol and ipratropium work synergistically as bronchodilators, improving rather than worsening asthma control effectively.
Option b is incorrect because prednisone reduces inflammation while montelukast blocks leukotrienes, both beneficial for asthma management not harmful.
Option d is incorrect because theophylline and salmeterol are both bronchodilators that improve asthma control when used together appropriately.

Correct Answer: Eat smaller bites

Option c is correct because smaller bites pass more easily through the surgically tightened gastroesophageal junction after fundoplication surgery procedures.
Option a is incorrect because fiber does not address the mechanical swallowing difficulty from surgical changes at the gastroesophageal junction specifically.
Option b is incorrect because fluids alone may cause bloating; the issue is mechanical restriction requiring smaller boluses not more liquid.
Option d is incorrect because protein content does not affect the mechanical passage through the surgically altered gastroesophageal junction directly overall.

Correct Answer: C. difficile infection

Option b is correct because antibiotics disrupt normal flora allowing C. difficile overgrowth causing antibiotic-associated diarrhea requiring specific treatment immediately.
Option a is incorrect because medication allergies typically cause rash, itching, or respiratory symptoms rather than isolated diarrhea after three days.
Option c is incorrect because lactose intolerance would not suddenly develop during antibiotic therapy without previous history of dairy issues present.
Option d is incorrect because viral gastroenteritis is less likely than C. difficile in the setting of recent antibiotic use specifically.

Correct Answer: Refractory hypoxemia develops

Option c is correct because refractory hypoxemia unresponsive to oxygen therapy is the hallmark of ARDS requiring mechanical ventilation support.
Option a is incorrect because productive cough is expected in pneumonia and does not specifically indicate ARDS development requiring intervention immediately.
Option b is incorrect because continued fever suggests ongoing infection but not specifically the lung injury characteristic of ARDS development occurring.
Option d is incorrect because chest pain relates to pleuritic involvement in pneumonia rather than the diffuse lung injury of ARDS.

Correct Answer: Ammonia

Option b is correct because asterixis or flapping tremor results from ammonia accumulation affecting the brain in hepatic encephalopathy development.
Option a is incorrect because elevated bilirubin causes jaundice and pruritus but not the neurological sign of asterixis seen clinically.
Option c is incorrect because sodium imbalances cause different neurological symptoms like seizures or confusion, not specifically asterixis tremor observed.
Option d is incorrect because potassium imbalances affect cardiac and muscle function but do not cause the characteristic asterixis of encephalopathy.