D446 Adult Health II - Set 1 - Part 1

Correct Answer: Improves arterial flow

Dangling the legs uses gravity to enhance arterial blood flow to the lower extremities, temporarily relieving ischemic pain associated with peripheral arterial disease and improving tissue oxygenation.
Option a is incorrect because muscle cramping in PAD results from inadequate oxygen delivery during activity, not positioning issues that dangling would directly address.
Option c is incorrect because blood clot prevention requires antiplatelet therapy and movement, not simply dependent positioning which could actually increase venous stasis.
Option d is incorrect because PAD causes sharp ischemic pain from poor oxygen delivery, not nerve pain that positioning would affect differently.

Correct Answer: Administer beta-agonist therapy

Short-acting beta-agonists like albuterol provide rapid bronchodilation within minutes, immediately addressing airway constriction and improving breathing during an acute asthma exacerbation.
Option a is incorrect because obtaining ABGs is important for evaluation but does not provide immediate relief of bronchospasm and respiratory distress.
Option c is incorrect because oxygen therapy addresses hypoxemia but doesn't treat the underlying bronchospasm causing the breathing difficulty in asthma.
Option d is incorrect because corticosteroids reduce inflammation but take hours to work, making them inappropriate for immediate symptom relief.

Correct Answer: Respiratory muscle weakness

Respiratory failure from progressive muscle weakness and paralysis is the leading cause of death in ALS patients, typically occurring within three to five years of diagnosis.
Option a is incorrect because while some ALS patients experience mild cognitive changes, this is not the primary life-threatening complication requiring constant monitoring.
Option c is incorrect because ALS primarily affects motor neurons and skeletal muscles, not cardiac muscle, making heart problems uncommon in this disease.
Option d is incorrect because kidney function is not directly affected by ALS, as the disease specifically targets motor neurons controlling voluntary muscles.

Correct Answer: Jugular vein distention

JVD indicates elevated central venous pressure from blood backing up in the systemic circulation, a hallmark sign of right-sided heart failure affecting venous return.
Option a is incorrect because bilateral crackles indicate fluid in the lungs, which is characteristic of left-sided rather than right-sided heart failure.
Option c is incorrect because orthopnea results from pulmonary congestion when lying flat, indicating left-sided heart failure with fluid backing into lungs.
Option d is incorrect because frothy pink sputum indicates pulmonary edema from left ventricular failure, not systemic venous congestion from right-sided failure.

Correct Answer: Excessive thyroid hormone

Palpitations and dyspnea in a patient taking levothyroxine suggest hyperthyroidism from excessive dosing, requiring immediate dose adjustment to prevent thyroid storm complications.
Option a is incorrect because allergic reactions to levothyroxine typically present with rash, itching, or swelling, not cardiac symptoms like palpitations.
Option c is incorrect because new cardiac disease would be unlikely to coincide with levothyroxine therapy and presents differently than medication-induced hyperthyroidism.
Option d is incorrect because while anxiety can cause similar symptoms, the temporal relationship with thyroid medication makes excessive hormone levels more likely.

Correct Answer: Eighty-eight to ninety-two

COPD patients require controlled oxygen therapy maintaining saturations between eighty-eight and ninety-two percent to prevent hypercapnia from suppressing their hypoxic respiratory drive.
Option a is incorrect because normal oxygen saturations in COPD patients can suppress their hypoxic drive, leading to dangerous carbon dioxide retention.
Option c is incorrect because oxygen saturations below eighty-five percent indicate severe hypoxemia requiring higher oxygen delivery despite retention risks.
Option d is incorrect because these higher saturations risk eliminating the hypoxic drive in COPD patients, potentially causing respiratory failure.

Correct Answer: Lactulose oral solution

Lactulose reduces ammonia absorption from the intestines by converting it to ammonium ions that cannot cross the intestinal wall, decreasing toxic ammonia levels.
Option a is incorrect because spironolactone treats ascites and fluid retention in liver disease but does not address elevated ammonia causing encephalopathy.
Option c is incorrect because furosemide manages fluid overload but has no effect on ammonia levels or hepatic encephalopathy symptoms.
Option d is incorrect because propranolol prevents variceal bleeding in cirrhosis but does not reduce ammonia levels or treat encephalopathy.

Correct Answer: Peritonitis infection developing

Cloudy dialysate with abdominal pain indicates peritonitis, a serious infection requiring immediate antibiotic therapy and dialysate cultures to prevent sepsis development.
Option a is incorrect because catheter bleeding would cause bloody, not cloudy, drainage and typically doesn't cause significant abdominal pain.
Option c is incorrect because reactions to dialysate solution cause allergic symptoms like rash or breathing problems, not cloudy drainage.
Option d is incorrect because bowel perforation would present with severe acute pain, fecal drainage, and signs of acute abdomen.

Correct Answer: Pancreatic enzyme supplements

Pancreatic enzyme replacement therapy provides the lipase, amylase, and protease needed for proper digestion, directly addressing malabsorption causing steatorrhea and weight loss.
Option a is incorrect because while low-fat diets reduce symptoms, they don't address the underlying enzyme deficiency causing fat malabsorption.
Option c is incorrect because PPIs reduce stomach acid but don't provide the digestive enzymes needed for nutrient absorption in pancreatitis.
Option d is incorrect because bile acid sequestrants treat cholesterol and diarrhea but don't replace missing pancreatic enzymes causing malabsorption.

Correct Answer: Light pink-tinged urine

Light pink or slightly blood-tinged urine is expected after TURP as the surgical site heals, indicating normal postoperative drainage without active bleeding.
Option a is incorrect because completely clear drainage immediately post-TURP is unusual, as some blood mixing with urine is expected initially.
Option c is incorrect because bright red bleeding indicates active hemorrhage requiring immediate intervention such as catheter irrigation or surgical review.
Option d is incorrect because dark brown clots suggest old blood accumulation that could obstruct the catheter and indicates inadequate irrigation.

Correct Answer: Low sodium concentration

SIADH causes excessive water retention diluting sodium levels, leading to hyponatremia which manifests as confusion, muscle cramps, and potential seizures.
Option a is incorrect because SIADH affects water and sodium balance, not glucose metabolism, and hyperglycemia causes different neurological symptoms.
Option c is incorrect because SIADH primarily affects sodium concentration through dilution, not potassium levels which remain relatively stable.
Option d is incorrect because calcium levels are not directly affected by SIADH, and hypocalcemia presents with different neuromuscular symptoms.

Correct Answer: Avoid sun exposure

Radiation-treated skin is extremely sensitive to UV radiation, making sun protection essential to prevent severe burns and further skin damage during treatment.
Option a is incorrect because many lotions contain alcohol or fragrances that can irritate radiated skin, and only prescribed products should be used.
Option b is incorrect because even gentle soaps can dry and irritate radiation-sensitive skin; only water or prescribed cleansers are recommended.
Option d is incorrect because scrubbing would traumatize already fragile irradiated skin, increasing the risk of breakdown and delayed healing.

Correct Answer: Daily foot inspection

Daily visual inspection allows early detection of cuts, sores, or infections that diabetics may not feel due to neuropathy, preventing serious complications.
Option a is incorrect because soaking feet can macerate skin and increase infection risk, especially if water temperature isn't carefully monitored.
Option b is incorrect because going barefoot increases injury risk in patients who may have decreased sensation from diabetic neuropathy.
Option d is incorrect because diabetics should never self-treat calluses due to infection risk; professional podiatric care is recommended instead.

Correct Answer: Colchicine treats pain, allopurinol prevents

Colchicine reduces acute inflammation and pain during flares, while allopurinol lowers uric acid levels long-term to prevent future attacks.
Option a is incorrect because only colchicine has anti-inflammatory properties for acute attacks; allopurinol prevents attacks by lowering uric acid.
Option b is incorrect because only allopurinol lowers uric acid levels; colchicine works by reducing inflammatory response to crystals.
Option d is incorrect because only allopurinol prevents crystal formation by lowering uric acid; colchicine treats existing crystal-induced inflammation.

Correct Answer: Sodium and fluid restriction

Sodium and fluid restriction helps manage edema and hypertension in glomerulonephritis by reducing fluid retention while kidneys recover filtering function.
Option a is incorrect because protein restriction is often needed in glomerulonephritis to reduce kidney workload, not increased protein intake.
Option c is incorrect because potassium may need restriction if kidney function is impaired, as hyperkalemia is a common complication.
Option d is incorrect because calcium intake isn't a primary concern in acute glomerulonephritis management compared to sodium and fluid balance.

Correct Answer: Thrombolytic therapy contraindicated

Thrombolytic therapy is absolutely contraindicated in hemorrhagic stroke as it would worsen bleeding, while it's the primary treatment for ischemic stroke.
Option b is incorrect because antiplatelet therapy would worsen bleeding in hemorrhagic stroke and is contraindicated during acute management phase.
Option c is incorrect because hemorrhagic strokes often require urgent surgical intervention to evacuate blood and reduce intracranial pressure.
Option d is incorrect because blood pressure control is critical in hemorrhagic stroke to prevent rebleeding and manage intracranial pressure.

Correct Answer: Excessive fluid removal

Rapid or excessive fluid removal during dialysis causes intravascular volume depletion, leading to hypotension and muscle cramps from poor tissue perfusion.
Option a is incorrect because access site infections cause fever, redness, and drainage at the site, not acute hypotension during dialysis.
Option c is incorrect because medication reactions during dialysis typically cause allergic symptoms like rash or breathing problems, not isolated hypotension.
Option d is incorrect because electrolyte imbalances from dialysis more commonly cause cardiac arrhythmias or confusion rather than acute hypotension.

Correct Answer: Sputum culture positive

Positive sputum culture with acid-fast bacilli confirms active tuberculosis disease requiring immediate isolation and treatment to prevent transmission to others.
Option a is incorrect because positive skin tests indicate exposure to TB but cannot distinguish between latent infection and active disease.
Option b is incorrect because chest x-ray changes suggest TB but aren't definitive, as other conditions can cause similar radiographic findings.
Option d is incorrect because blood tests like interferon-gamma release assays indicate TB exposure but don't confirm active, contagious disease.

Correct Answer: Cover with sterile dressing

Covering exposed bowel with sterile saline-soaked dressing prevents tissue drying, infection, and further trauma while preparing for emergency surgical repair.
Option a is incorrect because while documentation is important, protecting exposed organs from contamination and desiccation is the immediate priority.
Option c is incorrect because repositioning could cause further evisceration or organ damage; the patient should remain still until surgery.
Option d is incorrect because applying direct pressure to exposed bowel could cause tissue damage and increase contamination risk.

Correct Answer: Elevate head position

Elevating the head of bed six to eight inches uses gravity to prevent stomach acid reflux during sleep, significantly reducing nighttime symptoms.
Option a is incorrect because larger meals increase stomach pressure and acid production, worsening GERD symptoms especially when lying down.
Option c is incorrect because excessive fluids, particularly before bed, increase stomach volume and pressure, promoting nighttime reflux episodes.
Option d is incorrect because exercising before bed can increase abdominal pressure and delay gastric emptying, worsening nighttime reflux.