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NEW QUESTION # 286
Initial treatment for a pulmonary contusion includes all of the following EXCEPT:
Answer: B
Explanation:
A pulmonary contusion is defined as an injury to the lung parenchyma, which commonly occurs after a blunt injury to the chest. It generally involves pulmonary infiltrates with hemorrhage in the lung tissue.
Initial treatment typically includes humidified oxygenation, pulmonary hygiene to keep the airway clear of mucous and secretions, fluid resuscitation, and pain control.
Depending on the severity of the lung contusion, a thoracotomy to obtain surgical control of bleeding vessels and/or a pneumonectomy may be necessary but is not generally part of initial management.
NEW QUESTION # 287
Insulin is produced and secreted from the pancreas by:
Answer: D
Explanation:
Beta islet cells of the pancreas produce insulin and amylin and make up 65-80% of the total islet cells.
Insulin is released in response to an increase in blood glucose and is necessary for cellular uptake of glucose by most cells in the body (except the brain and liver cells). Without insulin, the glucose fails to enter cells and accumulates in the blood, resulting in hyperglycemia and a vascular inflammatory state.
Alpha, gamma, and delta islet cells within the pancreas produce various other hormones (glucagon, polypeptide, and somatostatin) that are secreted directly into the blood flow when necessary.
NEW QUESTION # 288
Of the distributive shock syndromes, which of the following is MOST commonly seen in critically ill patients?
Answer: D
Explanation:
There are three types of shock:
* Hypovolemic
* Cardiogenic
* Distributive
Distributive shock is an abnormal placement or distribution of vascular volume, occurring in three situations:
1. Septic shock
2. Neurologic damage
3. Anaphylaxis
In the critical care setting, septic shock (one of the types of distributive shock syndromes) is most commonly seen. In the field or emergency department settings, anaphylaxis and neurogenic shock are common and typically result from allergic reactions and trauma-related spinal cord injury.
NEW QUESTION # 289
All of the following interventions are appropriate for a patient with Sickle Cell Anemia (SCA) EXCEPT:
Answer: C
Explanation:
Sickle Cell Anemia (SCA) is an inherited abnormality of hemoglobin which results in chronic hemolytic anemia and occlusion of blood vessels. The red blood cells change their shape (to a sickle rather than a rounded shape) and adhere to the endothelial lining of blood vessels where they activate coagulation; they become less flexible and obstruct the microcirculation.
Supplemental oxygen is often necessary to support the hemoglobin carrying capacity of the affected RBCs. When a vaso-occlusive crisis occurs, pain is the most frequent complaint. This causes ischemic injury to limbs and organs and adequate pain control is essential. Hydration is important to maintain circulation and adequate blood flow through arterioles and capillary beds. Blood transfusion may also be indicated to replace depleted blood stores.
Supplemental oral ferrous sulfate is indicated in iron-deficiency anemia, not sickle cell anemia.
NEW QUESTION # 290
Which of the following conditions requires the MOST immediate attention?
Answer: D
Explanation:
A tension pneumothorax occurs when air enters the pleural space and is unable to escape. As this build up continues, pressure develops in the plural space, compressing the thoracic organs and causing hypoventilation, compression of the great vessels, and cardiogenic shock. As a tension pneumothorax is a medical emergency, this condition will require the most immediate attention. An open pneumothorax allows air to escape via the open wound, preventing the increase in intrathoracic pressure and the associated complications. A hemothorax is defined as blood in the pleural space, and only normally requires immediate attention if it is associated with hemorrhage. A pulmonary contusion is a serious condition, but occurs more gradually than a tension pneumothorax, allowing more time to respond.
NEW QUESTION # 291
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