Your patient is a four-year-old male with a history of asthma. He ran out of his inhaled bronchodilator while visiting his grandparent's farm. On your arrival, you learn that the patient has been having increasing respiratory distress for 20 minutes. The patient has pale, cool, moist skin with cyanosis of his nail beds. He is sitting on the edge of a kitchen chair, leaning forward to breathe. He
has a respiratory rate of 50 with the use of accessory muscles and a heart rate of 130. He is anxious and unable to speak more than one or two words at a time. Auscultation of the chest reveals scattered wheezing. As you prepare to treat the patient, he becomes drowsy and his respiratory rate decreases to 12. You can no longer auscultate his wheezes. Which of the following best explains the significance of the change in your patient's status?
A) Because of decreased respiratory, cardiovascular, and stored energy reserves, the child's muscles have fatigued and he is now in respiratory failure.
B) The child has realized that you are going to treat him, and he is more relaxed than he was initially and has stopped hyperventilating.
C) This makes no sense in an asthma patient, and it is likely that the child ingested or was exposed to a toxic substance, which explains the decreased level of consciousness.
D) The absence of wheezing indicates that bronchospasm has resolved spontaneously and the child now only needs supplemental oxygen.
A
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Which of the following is an example of a poor or careless construction method involving sequencing?
A) Stockpiling heavy building materials that exceed the final design load on upper floors B) Construction of shear walls several floors below the lift-slab erection operation C) Removing supports before concrete has cured D) Removing temporary bracing before the building frame is complete
A mother has called you for her 9-year-old daughter, who was stung in the right hand by a bee. She states that her older daughter is allergic to bees and she is scared that the patient may also be allergic, although she has never been stung before. Assessment of the patient reveals a red, painful, and swollen area on the back of the girl's right hand. The primary assessment is unremarkable and her vital signs are normal. The mother hands you her older daughter's epinephrine auto-injector. You would:
A) Administer the epinephrine into the patient's thigh B) Ask the mother to administer the auto-injector into the patient's thigh C) Wash the patient's hand with soap and water D) Contact medical direction for permission to use the epinephrine auto-injector
In Abraham Maslow's hierarchy of human needs, the need for basic life (food, shelter), a safe environment, and to belong and be loved are designated "D" needs. What does "D" stand for?
A. deficiency B. deprivation C. destitute D. demanding E. decisive
Natural immunity occurs when a person's body:
A. produces antibodies after being exposed to and experiencing all the symptoms of a disease. B. produces antibodies to a particular disease after he or she is vaccinated against the disease. C. does not produce antibodies after being exposed to or vaccinated against a particular disease. D. produces antibodies, even if he or she is not exposed to or vaccinated against a particular disease.