⌛ Essay On Traction Splint

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Essay On Traction Splint



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Think of and write eight words that start with gl and write a sentence with each of them: A printout about blended consonant sounds and spelling for early readers. Think of and write eight words that start with gr and write a sentence with each of them: A printout about blended consonant sounds and spelling for early readers. Think of and write eight words that start with pl and write a sentence with each of them: A printout about blended consonant sounds and spelling for early readers. Think of and write eight words that start with pr and write a sentence with each of them: A printout about blended consonant sounds and spelling for early readers. Think of and write eight words that start with SC and write a sentence with each of them: A printout about blended consonant sounds and spelling for early readers.

Think of and write eight words that start with Sh and write a sentence with each of them: A printout about blended consonant sounds and spelling for early readers. Think of and write eight words that start with Sk and write a sentence with each of them: A printout about blended consonant sounds and spelling for early readers. Think of and write eight words that start with Sl and write a sentence with each of them: A printout about blended consonant sounds and spelling for early readers.

Think of and write eight words that start with Sm and write a sentence with each of them: A printout about blended consonant sounds and spelling for early readers. Think of and write eight words that start with Sn and write a sentence with each of them: A printout about blended consonant sounds and spelling for early readers. Think of and write eight words that start with Sp and write a sentence with each of them: A printout about blended consonant sounds and spelling for early readers. Think of and write eight words that start with St and write a sentence with each of them: A printout about blended consonant sounds and spelling for early readers.

Think of and write eight words that start with Sw and write a sentence with each of them: A printout about blended consonant sounds and spelling for early readers. Think of and write eight words that start with Th and write a sentence with each of them: A printout about blended consonant sounds and spelling for early readers. Think of and write eight words that start with Tr and write a sentence with each of them: A printout about blended consonant sounds and spelling for early readers. Think of and write eight words that start with Tw and write a sentence with each of them: A printout about blended consonant sounds and spelling for early readers.

Think of and write eight words that start with wh and write a sentence with each of them: A printout about blended consonant sounds and spelling for early readers. Think of and write eight words that start with wr and write a sentence with each of them: A printout about blended consonant sounds and spelling for early readers. Think of and write eight words that start with Scr and write a sentence with each of them: A printout about blended consonant sounds and spelling for early readers.

Think of and write eight words that start with Shr and write a sentence with each of them: A printout about blended consonant sounds and spelling for early readers. Think of and write eight words that start with spl and write a sentence with each of them: A printout about blended consonant sounds and spelling for early readers. Think of and write eight words that start with Spr and write a sentence with each of them: A printout about blended consonant sounds and spelling for early readers.

Think of and write eight words that start with Squ and write a sentence with each of them: A printout about blended consonant sounds and spelling for early readers. Think of and write eight words that start with Str and write a sentence with each of them: A printout about blended consonant sounds and spelling for early readers. Think of and write eight words that start with Thr and write a sentence with each of them: A printout about blended consonant sounds and spelling for early readers.

Think of and write words that start with the blends bl, br, ch, and cl. Then add up how many you have of each. A printout about blended consonant sounds and spelling for early readers. Think of and write words that start with the blends cr, dr, fl, and fr. Think of and write words that start with the blends gl, gr, pl, and pr. Think of and write words that start with the blends sc, sk, sl, and squ.

Think of and write words that start with the blends sm, sn, sp, and st. Think of and write words that start with the blends sw, th, tr, and tw. Think of and write words that start with the blends scr, shr, and spl. Think of and write words that start with the blends spr, str, and thr. Think of and write words that start with the blends sh, wh, and wr. These 2-page print-outs make word wheels; each one consists of a base page together with a wheel that spins around. When you spin the wheel, words that are formed, one at a time.

The student then writes down the words that are formed by the word wheel. Word Wheel - AKE Words: This 2-page print-out makes a word wheel; it consists of a base page together with a wheel that spins around. When you spin the wheel, six words that rhyme with. Word Wheel - AN Words: This 2-page print-out makes a word wheel; it consists of a base page together with a wheel that spins around. Word Wheel - AR Words: This 2-page print-out makes a word wheel; it consists of a base page together with a wheel that spins around.

Word Wheel - AT Words: This 2-page print-out makes a word wheel; it consists of a base page together with a wheel that spins around. Word Wheel - EN Words: This 2-page print-out makes a word wheel; it consists of a base page together with a wheel that spins around. Make Words Wheel : This 2-page print-out makes a words wheel; it consists of a base page together with a wheel that spins around. When you spin the wheel, words appear, combining c, f, g, h, l, p, t, and s with ab, ad, am, an, ap, ar, as, and at. Write as many words as you can that are made using the wheel. Make Words Wheel -e- This 2-page print-out makes a words wheel; it consists of a base page together with a wheel that spins around.

When you spin the wheel, words appear, combining b, g, h, l, m, p, s, and w with eb, ed, eg, em, en, er, et, and ew. Make Words Wheel -i- This 2-page print-out makes a words wheel; it consists of a base page together with a wheel that spins around. When you spin the wheel, words appear, combining b, d, f, h, l, r, s, and w with ib, id, ig, im, in, ip, it, and ix. Make Words Wheel -o- : This 2-page print-out makes a words wheel; it consists of a base page together with a wheel that spins around. When you spin the wheel, words appear, combining b, c, d, h, p, r, s, and t with ob, od, og, on, op, ot, ow, and ox. Make Words Wheel -u- This 2-page print-out makes a words wheel; it consists of a base page together with a wheel that spins around.

When you spin the wheel, words appear, combining b, c, d, h, p, r, s, and t with ub, ud, ug, un, up, ur, us, and ut. Login Sign Up Print Page. Click here to learn more. What are blends? Letter Digraphs - Beginning Readers Books. Print out the AN Words Book early reader book. Print out the AT Words Book early reader book. The emesis is non-bilious. Intussusception typically presents between the ages of 5 and 12 months. Gastroenteritis is characterized by diarrhea as well as vomiting.

Neither constipation nor appendicitis typically present with protracted vomiting, though the latter condition tends to present atypically in young children and elderly adults. A 46 year old woman presents to the emergency department complaining of abrupt onset of intermittent severe pain in the left flank and abdomen that woke her from sleep. She is pacing around the stretcher and appears extremely uncomfortable. She has never experienced this type of pain previously and denies fevers or other symptoms.

Renal calculus is suspected. Which of the following is true regarding the diagnosis of renal calculi in this patient? Urinalysis demonstrating hematuria confirms the diagnosis. Ultrasound is the study of choice for detecting small ureteral calculi. Intravenous pyelogram IVP may be used in patients with renal insufficiency. The answer is C. Helical CT scan has been shown to be both highly sensitive and specific in the diagnosis of renal calculi.

It is the preferred modality for evaluation in many centers. Although urinalysis typically demonstrates hematuria in patients with renal calculi, hematuria is not specific enough to confirm the diagnosis, and imaging is warranted in all first-time presenters. IVP is contraindicated in patients with renal insufficiency due to the dye load necessary to perform the study. A 50 year old man presents with 1 day of gradually worsening, intermittent, left lower quadrant pain associated with loose stools.

He has had no fevers or bloody bowel movements. Similar symptoms in the past were self-limited. All vital signs lie within normal limits. Physical examination shows mild tenderness in the left lower quadrant, normal active bowel sounds and neither masses nor peritoneal signs. His primary-care physician can see him tomorrow in his clinic. What should be done next in the E. Discharge home after a single dose of IV antibiotics B. Discharge home on high-fiber diet, laxatives and stool softeners C.

Gastroenterology consult for endoscopy D. Admit for observation and serial examinations. Discharge home on high-fiber diet, laxatives and stool softeners The answer is B. This patient has classic diverticulosis saclike protrusions of colonic mucosa through the muscularis without signs of acute diverticulitis inflammation of diverticula. Usually these patients can be managed as outpatients with a high-fiber diet and treatments to decrease intestinal spasm.

If the patient develops fever or pain increases he may need further evaluation to rule out abscess formation. Diverticulitis is treated with antibiotics, bowel rest and analgesics. Lesions are typically contiguous B. Small bowel involvement is rare C. Bleeding is common due to superficial bowel wall inflammation D. There is a small increased risk of colon cancer. There is a small increased risk of colon cancer The answer is D. The risk of colon cancer is only slightly elevated above baseline. In contrast, Ulcerative colitis begins in the rectum and may spread to the upper parts of the colon but never involves the small intestine.

The ulcerations are contiguous and involve only the colonic mucosa. The incidence of colon cancer may be increased up to 30 times over baseline. A 53 year old obese woman presents to the emergency department, accompanied by three of her children, complaining of severe abdominal pain that began this afternoon after lunch. Physical exam reveals marked RUQ tenderness. This woman is likely suffering from acute cholecystitis. Predisposing factors include female gender, obesity, increased age and increased parity.

Pain may radiate to the right scapula. Lab studies usually show leukocytosis with or without a left shift, and aminotransferases and bilirubin are usually within normal limits. A 25 year old female presents with epigastric pain radiating straight through to the back. Laboratory tests are notable only for markedly elevated amylase and lipase. An abdominal X-ray is taken see Figure. The most likely explanation for her symptoms is gallstone-related pancreatitis. She probably has an ulcer, since the laboratory results are nonspecific. Alcohol use is only associated with pancreatitis in patients older than this woman, and who have been abusing alcohol for years.

The abdominal X-ray is concerning for early bowel obstruction. The X-ray reveals stones in the gallbladder. In the U. Alcoholic pancreatitis may occur in young patients as well as in older abusers of alcohol. Many other drugs, infectious agents, and conditions are associated with the development of pancreatitis. A few examples include hypertriglyceridemia, trauma, pregnancy, pancreatic carcinoma, atherosclerotic emboli, and scorpion bites.

A 45 year old woman presents with right upper quadrant pain and fever. The pain is worse after eating. The most likely diagnosis is: A. Appendicitis B. Diverticulitis C. Cholelithiasis D. Cholecystitis E. Mesenteric Ischemia. Cholecystitis The answer is D. A 47 year-old male presents, confused, to the ED. He has limited ability to give a history. On physical examination of the skin, it is noted that there are erythematous changes to both palms. Also, the face and arms are characterized by a number of superficial, tortuous arterioles which fill from the center outwards. The examination of the abdomen reveals violaceous lines radiating from the umbilicus, and there are generally increased venous markings on the abdominal wall see Figure.

Rocky Mountain spotted fever B. A year-old homeless woman with a history of schizophrenia presents to the emergency department complaining of nausea and severe abdominal pain for 48 hours. The patient is not cooperative with an upright abdominal image, so a flat plate as shown in the Figure is obtained. Which of the following is the most likely operative finding in this patient? Inflamed appendix B. Rectus sheath hematoma C. Ruptured spleen D. Small bowel obstruction. Small bowel obstruction The answer is D. Dilated loops of small bowel with air-fluid levels which are not well-seen on a flat plate indicate small bowel obstruction. KUB is not often useful in the diagnosis of appendicitis, ruptured spleen, gallstone disease, or a rectus sheath hematoma which is an abdominal wall condition most likely seen in anticoagulated patients with trauma or coughing.

Cecal volvulus occurs as a result of abnormal fixation of the right colon and increased mobility of the cecum. Depending on the degree of rotation around the mesenteric axis, cecal volvulus can lead to twisting of the mesentery and its blood vessels. Cecal volvulus occurs most commonly in people years old and should be suspected in cases of bowel obstruction without known risk factors. Prior abdominal surgery and pregnancy predispose to obstruction or cecal volvulus; however, chronic constipation is not known to predispose to cecal volvulus. Interestingly, marathon runners have been found to have a higher incidence of cecal volvulus, perhaps from having a thin, flexible mesentery that more easily permits rotation of the cecum around the mesenteric pedicle.

A 57 year old ill-appearing man presents with fever, chills, abdominal pain, nausea and vomiting. His abdominal CT is shown in the Figure. Etiologic agents of this condition include bacteroides, E. Elevations of WBC, bilirubin, alkapine phosphatase and serum aminotransferases will be seen on laboratory studies. Emergent percutaneous drainage in the emergency department is indicated. Treatment with triple coverage antibiotics such as gentamicin, metronidazole and ampicillin should be instituted immediately. CXR may demonstrate a right-sided effusion and elevation of the right hemidiaphragm. The patient has a hepatic abscess, typically caused by gram negatives, anaerobic Streptococci or Entameoba histolytica.

Laboratory findings include elevations of WBC, bilirubin, alkaline phosphatase and serum aminotransferases. Treatment with triple coverage antibiotics such as gentamicin, metronidazole and ampicillin should be instituted immediately, however consultation with a general surgeon, interventional radiologist, or gastroenterologist is necessary for definitive treatment, which is drainage of the abscess.

Which of the following pairings of referred pain and causal disease is least likely to be encountered? Ovarian torsion may cause lower abdominal pain, pelvic pain, adnexal tenderness, and cervical motion tenderness, but it is not known to cause sacral pain. A 72 year old man with a history of diverticulosis presents with vague abdominal pain for the past day.

His physical exam is notable for normal vital signs, left lower quadrant abdominal tenderness without rebound or guarding, and guaiac positive brown stool. Of the following choices, which is the most appropriate management of this patient? For mild episodes of diverticulitis in which there is no evidence of perforation or peritonitis, there is no indication for immediate surgical intervention. Conservative management with intravenous fluids and antibiotics as well as bowel rest is typically first attempted. Although colon carcinoma may be a precipitating factor in the development of diverticulitis, barium enema should be avoided in the acute period due to high risk of bowel perforation. Although some patients with mild cases of diverticulitis may be discharged home with conservative treatment, the elderly are at higher risk of perforation and should be admitted.

There is no reason to suspect acute blood loss requiring transfusion in diverticulitis. Esophageal perforation has been reported as a complication of nasogastric tube placement, endotracheal intubation, and esophagotracheal Combitube intubation. Esophageal perforation may result from forceful vomiting, coughing, childbirth or heavy lifting. Iatrogenic perforations of the esophagus usually occur in the proximal esophagus or esophagogastric junction. Foreign body or caustic substance ingestion, severe blunt injury or penetrating trauma, and carcinoma are other causes of esophageal perforation. Working in the ED, you have identified a bony object wedged in the mid-esophagus of a 45 year old patient.

Failure to promptly remove a foreign body impacted in the esophagus could result in: A. Esophageal perforation and mediastinitis B. Epiglottal edema and airway obstruction C. The rapid development of xerostomia D. Esophageal perforation and mediastinitis The answer is A. The complications of esophageal foreign bodies are rare but serious. They include esophageal erosion and perforation, mediastinitis, esophagus-to-trachea or esophagus-to-vasculature fistula formation, stricture formation, diverticuli formation, and tracheal compression from both the esophageal foreign body and resultant edema or infection.

Air trapping is a sign of a foreign body of the airway. Rarely, airway foreign bodies act as one-way valves that could cause hyperinflation of a lung segment, with resultant bleb rupture and pneumothorax formation. A mother brings her 35 year old son to the emergency department because of tremor and mutism for the past three days. His mother found him in his room this morning lying stiffly in his bed, soiled with urine and feces.

He appears confused and will not respond to questions. He was diagnosed with schizophrenia last year and has been on several medications. Last month after his most recent hospital admission for schizophrenia, he was discharged with a prescription for haloperidol. On physical exam, he is visibly diaphoretic and has vital signs as follows: T What is the most likely explanation for these findings? Neuroleptic malignant syndrome NMS is an idiosyncratic, life-threatening reaction to antipsychotic medications, with haloperidol being the most common cause. It is characterized by elevated temperatures, "lead pipe" muscle rigidity, altered mental status, choreoathetosis, tremors, and autonomic dysfunction e.

NMS is thought to be due to too much D2 blockade in the substantia nigra and hypothalamus. Treatment consists of stopping the causative agent and providing supportive care. Medications such as dantrolene, bromocriptine, amantadine, and lorazepam are also often used. Tardive dyskinesia choice A is a chronic movement disorder that results from prolonged use of antipsychotics and can include involuntary and periodic movements of the tongue or lips, mouth puckering, or flailing movements either of the extremities or of the spine. Neuroleptic-induced acute dystonia choice C is an acute spasm of a muscle or muscle group associated with the use of antipsychotic agents. It presents with patients complaining of neck twisting torticollis , fixed upper gaze, facial muscle spasms, or dysarthria from tongue protrusions.

In a similar family with dystonia, neuroleptic-induced akathisia choice D is an extrapyramidal syndrome that is manifest by agitation and restlessness. Schizophrenia, catatonic type choice B , a diagnosis of exclusion, usually does not present with this degree of impairment. A 25 year old man returns to the ED, 24 hours after being released from the hospital with a new diagnosis of schizophrenia. He has recently started to take haloperidal for his psychotic symptoms. In the ED he is noted to have involuntary contractions of the muscles of the face, a protruding tongue, deviation of the head to one side, and sustained upward deviation of the eyes.

Vital signs are stable, and initial labs show no electrolyte or hematological abnormalities. Of the following choices, the preferred medication for this condition is: A. Dystonic reactions, which can occur at any point during long-term therapy and up to 48 hours after administration of neuroleptics in the emergency department, involve the sudden onset of involuntary contraction of the muscles in the face, neck, or back. The patient may have protrusion of the tongue buccolingual crisis , deviation of the head to one side acute torticollis , sustained upward deviation of the eyes oculogyric crisis , extreme arching of the back opisthotonos , or rarely laryngospasm. These symptoms tend to fluctuate, decreasing with voluntary activity and increasing under emotional stress, which occasionally misleads emergency physicians to believe they may be hysterical in nature.

Intravenous administration usually results in near-immediate reversal of symptoms. Patients should receive oral therapy with the same medication for 48 to 72 hours to prevent recurrent symptoms. A 70 year old male with acute delirium requires administration of haloperidol for agitation. Which of the following is a recognized side effect of haloperidol? Nephrogenic diabetes insipidus may be associated with lithium. Potential side effects of haloperidol include acute dystonia, prolonged QT interval, Parkinsonism, and akathisia. A 19 year old woman is brought to the emergency department by her friends because she has been saying that she is a superhero and trying to run into traffic to prove that she is indestructible.

The friends report that she has been using drugs but they do not know which ones. Which of the following pairs of ocular finding and recreational drug is commonly observed? Sympathomimetics cocaine, amphetamines cause dilated pupils. Opiates heroin cause pinpoint pupils. Internuclear ophthalmoplegia is associated with multiple sclerosis. CN VI palsy is not associated with any specific drugs. In choosing an antipsychotic medication, which of the following would be the most appropriate choice? Haloperidol is the most studied high potency antipsychotic agent used in agitated patients.

Typical dosing is mg IM every minutes. Peak serum levels occur in about 30 minutes after IM dosing. Unlike thioridazine, haloperidol does not cause respiratory depression, has negligible anticholinergic side effects, and rarely causes hypotension. Although benzodiazepines can be used in the agitated patient, respiratory depression can occur, and close monitoring is essential. A 20 year old college student is brought to the emergency department by campus police after he was found by his roommate saying people in the TV were trying to kill him.

Which of the following criteria is not an indication for admission? For an acute psychiatric episode, the first goal is medically stabilizing the patient. Subsequently, a patient who presents without previous history of a psychiatric episode does not necessarily need to be admitted. This, of course, depends on the identity and severity of the condition, and whether it can be treated in the emergency department. A 55 year-old male presents with new onset agitation and confusion. Which of the following medical histories would suggest a psychiatric non-organic cause? History of diabetes mellitus only B. History of alcohol abuse only C. History of hypothyroidism only D. History of chronic obstructive pulmonary disease only.

History of hypothyroidism only The answer is C. Although hyperthyroidism may result in an agitated state, hypothyroidism is not generally associated with violent behavior. All other answers are potentially treatable medical problems that could account for the presentation of an agitated or violent patient. After assuring the safety of all parties involved, the emergency department physician should rule out organic causes of agitation. In dealing with the potential violent patient, the emergency physician should: A. Approach the patient in a calm, controlled and professional manner B. Assume that the strength of the doctor-patient relationship will ensure safety C.

Use a loud voice and threaten to call security if the patient becomes agitated. Approach the patient in a calm, controlled and professional manner The answer is A. Excessive eye contact may be interpreted as a sign of aggression answer A. Emergency physicians are encouraged to maintain intermittent eye contact with the patient and to keep a professional and calm demeanor. Also a physician should never deal with an agitated or violent patient alone in an isolated room answer D. Doors should always remain open and exits should never be blocked. Ample security should be close at hand before interviewing the patient answer E.

Finally, involved parties are encouraged to remove any personal effects e. A 35 year-old male is placed on his back on the gurney in physical restraints for violent behavior. Which life-threatening complication can arise? Metabolic acidosis C. Asphyxia D. Metabolic acidosis The answer is B. Bruises and abrasions are the most common complication of physical restraints. After restraint application, patients need to be monitored frequently and positions changed to prevent neurovascular complications such as circulatory obstruction, pressure sores, and rhabdomyolysis. Positional asphyxia can arise when patients are placed into the prone or hobbled position.

Protracted struggle against restraints can promote a significant metabolic acidosis that has been associated with cardiovascular collapse. Patients who continue to struggle with physical restraints should be chemically restrained as well. Which medication is ideal for the agitated or combative patient? Nitrous oxide B. Hydromorphone C. Haloperidol D. Drugs with a relatively short half-life allow for more careful monitoring of chemically restrained patients. Patients may be given multiple administrations of the restraining agent as needed. Antipsychotics such as haloperidol and benzodiazepines such as lorazepam exhibit most of these characteristics and are commonly used in combination in the emergency department. Half doses should be used in the elderly.

No additional history is available. On arrival, the patient is minimally responsive with sonorous respirations and a palpable rapid pulse. The most appropriate initial diagnostic test would be A. Arterial blood gas B. Electrocardiogram C. Fingerstick glucose D. Urine drug screen. Fingerstick glucose The answer is C. Hypoglycemia is a common and readily treatable cause for altered mental status. An ABG is unlikely to be diagnostic and more likely to reflect secondary abnormalities caused by respiratory depression. While a urine drug screen may show positives, it cannot quantitate the amount of a substance or the time period in which the exposure occurred so a positive screen may not reflect cause and effect. An EKG, while a part of a toxicology evaluation, is not an appropriate initiate screening test for an unstable patient until airway and readily reversible causes have been addressed.

A 27 year old is found unresponsive in his car in the hospital parking lot and brought in by security. Radial pulses are present at bpm. Pupils are 1mm bilaterally. Your team is having difficulty finding a vein for an intravenous line due to extensive scarring of his arms. You are suspicious of an overdose, which medication would you want to rapidly administer as a potential antidote in this situation?

Glucose B. Naloxone C. Thiamine D. Naloxone The answer is B. The patient has stigmata of an opiate overdose with hypopnea, cyanosis, and miotic pupils. In addition, intravenous drug users often use up their veins. While hypoglycemia can definitely cause a depressed mental status and needs to be assessed, it should not result in respiratory depression or miotic pupils. Flumazenil can be used to temporarily reverse the respiratory depression caused by benzodiazepines but also carries with it the risk of precipitating withdrawal and uncontrollable seizures in chronic benzodiazepine users. As a result, it is not recommended for routine use in patients with altered mental status. A 53 year-old known alcoholic presents with agitation, vomiting and altered mental status.

His fingerstick glucose is His serum ethanol level is undetectable and his head CT is normal. An ABG shows a pH of 7. His basic chemistry panel includes a sodium of , potassium 4. What substance are you concerned that he may have ingested A. Ethylene glycol B. Salicylates C. Isopropyl alcohol D. Isopropyl alcohol The answer is C. The patient is presenting with a non anion gap metabolic acidosis. Isopropyl alcohol is metabolized via alcohol dehydrogenase to acetone which accumulates and causes significant ketosis but not an anion gap.

Other toxic alcohols such as methanol and ethylene glycol are ultimately metabolized to formic and glycolic acids which cause toxic effects and an anion gap metabolic acidosis. Salicylates result in an anion gap metabolic acidosis with a superimposed respiratory alkalosis. Treatment is primarily supportive including fluids and electrolyte correction. Magnesium replacement should be initiated empirically except in the setting of contraindications such as renal failure or hypermagnesemia.

Coexisting gastritis should be sought out and treated appropriately. Nutritional status should be assessed with attention to possible protein restriction. Alcoholics often have low thiamine levels due to poor nutrition, and low glucose levels due to the suppression of gluconeogenesis by alcohol. Magnesium levels may appear normal on laboratory testing, but alcoholics typically have low magnesium stores and should be given magnesium empirically unless contraindications for magnesium exist. Alcoholics should also be evaluated for gastritis and overall nutritional status and should be referred appropriately.

A 45 year old man is brought to the E. The patient is very confused and obtunded, and unable to provide a cogent history; the person who brought him to the E. As he lays in the stretcher, his appearance is as depicted in the Figure. Of the following choices, which physical finding is most likely to be present on physical examination? This patient has marked ascites which may incidentally account for his mild tachypnea due to impairment of respiratory excursion.

A 60 year old male presents with new onset confusion. Which of the following suggests a functional, as opposed to an organic etiology? The other findings are all characteristic of organic confusional states. Hallucinations can occur with both organic and functional causes of confusion. Hallucinations associated with organic confusion may be visual, tactile, or auditory. Hallucinations in patients with functional disease tend to be auditory. Delirium is defined as: A. Alterations in mental status resulting from extreme emotional stimulus would usually be functional abnormalities. Patients with delirium manifest increases in alertness and psychomotor activity.

Delirium is more than simple alteration of mental status. Delirium is an organic confusional state. Patients with delirium may have hallucinations, but patients who are oriented are more likely to have functional causes for altered mental status. Which of the following statements regarding psychotic behavior is true? Brief psychotic episodes, often precipitated by events such as death of a loved one, can be characterized by extremely bizarre behavior and speech B.

Delusions are defined as false beliefs that are not amenable to arguments or facts to the contrary C. Delusional disorder usually results in impairment in daily functioning D. Schizophreniform disorder is present when a patient meets the diagnostic criteria for schizophrenia but the process has been present for less than one year. Delusions are defined as false beliefs that are not amenable to arguments or facts to the contrary B. Psychosis can be limited to nonbizarre delusions; patients with this disorder delusional disorder rarely have impairment in daily functioning. Fixed, false beliefs that are not held by others with a patient's cultural background are characteristic of delusional thinking.

A 75 year old female is brought the to emergency department by a family member with a history of progressive forgetfulness and confusion. She has a history of dementia. The most common cause of dementia in the elderly patient is: A. Parkinson's disease C. Vascular dementia. Smaller percentages are attributable to causes such as anoxic encephalopathy, hepatolenticular degeneration, tumors, and slow virus infections. A 65 year old male is brought to the emergency department after he was found wandering on the street. He is unkempt and confused.

A diagnosis of delirium, rather than dementia, is more likely if which of the following is true? Patients with delirium have disturbances in consciousness, cognition, and perception. These disturbances tend to occur over a short period of time hours to days. The delirious patient may be somnolent or agitated. Thought process may be mildly disturbed or grossly disorganized. The clinical presentation may be subdued or explosive, and the course can fluctuate over minutes to hours. An acute confusional state can also be one of the protean manifestations of a metabolic or nutritional abnormality, including hepatic encephalopathy, acute renal failure, and diabetic ketoacidosis or hyperosmolarity.

An 80 year old nursing home patient is brought to the emergency department with an acute onset of confusion. Which of the following metabolic abnormalities is the most likely explanation? The differential diagnosis of acute confusional states is lengthy. Hypokalemia alone, however, is not a common cause of altered mental status. Which factor is least reliable in differentiating between organic and inorganic causes of confusion? Vital sign abnormalities C. Presence of attention deficit D.

Signs of trauma. Presence of attention deficit The answer is C. Presence of an attention deficit is common to all confusional states. All the other options may be used to differentiate organic versus non-organic causes of confusion. With regard to specific causes of hypertension, which of the following is true? Hypertensive encephalopathy is more likely than hypertensive stroke in patients whose mental status changes are reversible B. Hypertensive encephalopathy causes adverse outcomes over days or weeks, rather than hours C. Patients with stroke syndromes must have blood pressure normalized as quickly as possible to reduce the risks of worsening neurological deficit D.

Laboratory analysis is rarely useful in cases of confirmed pediatric hypertension E. Laboratory analysis is rarely useful in cases of confirmed hypertension in pregnant patients. Hypertensive encephalopathy is more likely than hypertensive stroke in patients whose mental status changes are reversible The answer is A. Hypertensive encephalopathy is a true medical emergency, and can cause coma and death over hours; however, encephalopathy due to hypertension is more likely reversible than encephalopathy from other causes. Avoidance of overzealous blood pressure lowering is particularly critical for patients with strokes. A 29 year old woman is found seizing by her husband and is rushed to the emergency department. Her husband tells you that they are expecting their first child in a few months.

Control the seizures with magnesium sulfate. Notify the labor floor that the patient is in the emergency department. Perform a CT scan of head if seizures persist. All the other choices A-D are appropriate in the management of the patient with eclampsia. Which of the following is not a feature of febrile seizures? Febrile seizure is not associated with a postictal period. The child usually rapidly regains alertness. Intracranial mass or infection should be a concern if the duration of seizure is greater than 15 minutes or if altered mental status persists after the cessation of seizure activity. A 47 year old man with a history of alcohol abuse presents to the emergency department after having a seizure.

His past includes both seizures and blackouts. His last alcoholic drink was the previous evening. This morning he experienced palpitations, diaphoresis, and dizziness before losing consciousness and having a seizure lasting under a minute. Delegate activities for stable patients because some of these needs are relatively predictable and more frequently encountered. These are somewhat routinized and without the need for high levels of professional judgment and skill.

These needs should not be delegated. Delegate activities that involve standard, consistent, and unchanged systems and procedures. The care of a patient with chest tubes and chest drainage can be delegated to either another RN or a licensed practical nurse. The care of a stable chronically ill patient who is comparatively stable and more anticipated than a seriously ill and unstable acute patient can be assigned to the licensed practical nurse, and assistance with the activities of daily living and basic hygiene and comfort care can be assigned and delegated to an unlicensed assistive staff member like a nursing assistant or a patient care technician.

Activities that frequently occur in daily patient care can be delegated. Bathing, feeding, dressing, and transferring patients are examples. Procedures that are complex or complicated should not be delegated, especially if the patient is highly unstable. It is necessary to know and understand the priorities when deciding which patient the RN should attend to first. Remember that you can see only one patient or perform one activity when answering questions that require you to establish priorities.

Always keep in mind that improper and inappropriate assignments can lead to inadequate quality of care, unexpected care outcomes, the jeopardization of client safety, and even legal consequences. Right assignment of care to others, including nursing assistants, licensed practical nurses, and other registered nurses, is certainly one of the most significant daily decisions nurses make. Prioritization is deciding which needs or problems require immediate action and which ones could be delayed until later because they are not urgent. In the NCLEX, you will encounter questions that require you to use the skill of prioritizing nursing actions.

These nursing prioritization questions are often presented using the multiple-choice format or via ordered-response format. Directions are provided with the question. To help you answer nursing prioritization questions, remember the three principles commonly used:. Patients with obvious respiratory problems or interventions to provide airway management are given priority. The nursing process is a systematic approach to assess and give care to patients. Assessment should always be done first before planning or providing interventions.

Delegation is the transference of responsibility and authority for an activity to other health care members who are competent to do so. The nurse delegator maintains accountability for the decision to delegate and for the appropriateness of nursing care rendered to the patient. The role of a registered nurse also includes delegating care, assigning tasks, organizing and managing care, supervising care delivered by other health care providers while effectively managing time! Very helpful. A LPN graduate who has taken the nclex four times.

It gives me a quick overview. In which order will the nurse perform the following actions as she prepares to leave the room of a client with airborne precautions after performing oral suctioning? Time limit: 0. Quiz Summary 0 of 25 Questions completed Questions:. You have already completed the quiz before. Hence you can not start it again. You must sign in or sign up to start the quiz. You must first complete the following:. Results Quiz complete.

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