SNLE Adult Health Nursing 4 — Questions and Answers
Question 1: A patient with a hip fracture is being assessed for fat embolism syndrome. Which triad of findings is classic?
- Hypoxia, neurological changes, and petechial rash (Correct answer)
- Fever, cough, and chest pain
- Tachycardia, hypotension, and cyanosis
- Bradycardia, hypertension, and confusion
Correct answer: Hypoxia, neurological changes, and petechial rash
Fat embolism syndrome classically presents with the triad of hypoxemia (from lung fat emboli), neurological deterioration (confusion, decreased consciousness), and petechial rash (from fat emboli in dermal capillaries), typically 24–72 hours after long-bone fracture.
Question 2: Which action prevents dumping syndrome in a post-gastrectomy patient?
- Eat small, frequent meals; avoid fluids with meals; lie down after eating (Correct answer)
- Eat large meals three times daily
- Drink large amounts of fluid with meals
- Increase simple carbohydrates in the diet
Correct answer: Eat small, frequent meals; avoid fluids with meals; lie down after eating
Dumping syndrome occurs when food moves too quickly into the small intestine. Small, frequent, low-carbohydrate meals, avoiding fluids during meals, and lying down after eating slow gastric emptying and reduce symptoms.
Question 3: A patient develops sudden confusion, tachycardia, and fever of 39.5°C on post-operative day 2. What should the nurse suspect?
- Infection or sepsis (Correct answer)
- Normal post-operative reaction
- Dehydration only
- Adverse medication reaction requiring no action
Correct answer: Infection or sepsis
New onset confusion, fever >38°C, and tachycardia are components of systemic inflammatory response syndrome (SIRS), suggesting early sepsis. Post-operative infection typically manifests day 2–5. Immediate assessment and physician notification are required.
Question 4: What is the priority assessment for a patient with a cervical spinal cord injury?
- Airway patency and respiratory function (Correct answer)
- Bladder and bowel function
- Skin integrity
- Pain level
Correct answer: Airway patency and respiratory function
Cervical spinal cord injuries at C3–C5 can impair or eliminate phrenic nerve function, causing diaphragmatic paralysis and respiratory failure. Airway and breathing assessment is the absolute priority (ABCs).
Question 5: Which insulin type has the longest duration of action?
- Glargine (Lantus) (Correct answer)
- Regular insulin
- NPH insulin
- Lispro (Humalog)
Correct answer: Glargine (Lantus)
Insulin glargine (Lantus) is a long-acting basal insulin with duration of approximately 20–24 hours and no pronounced peak, providing steady background insulin coverage. It is given once daily.
Question 6: A patient is prescribed morphine for pain. Which side effect requires the most immediate intervention?
- Respiratory depression with rate <10 breaths/min (Correct answer)
- Nausea
- Constipation
- Drowsiness
Correct answer: Respiratory depression with rate <10 breaths/min
Respiratory depression is the most life-threatening opioid side effect. A respiratory rate below 10 breaths/min requires immediate intervention with naloxone (opioid antagonist) and supportive airway measures. Other side effects, while uncomfortable, are not immediately life-threatening.
SNLE Adult Health Nursing 4
A patient with a hip fracture is being assessed for fat embolism syndrome.
Which triad of findings is classic?