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DHA Medical Surgical Nursing (DHA-MedSurg) Practice Exams & Exam Prep - Review


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DHA Medical Surgical Nursing - Reviews


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See why our users from 154 countries love us for their exam prep! Including 85 reviews for the DHA Medical Surgical Nursing exam.

Exam Edge is an industry leader in online test prep. We work with institutional partners to offer a wide array of practice tests that will help you prepare for your big exam. No matter how niche your field of interest might be, we're here to help you prepare for test day.

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DHA Medical Surgical Nursing - Test Reviews Sample Questions

For a patient suffering from intracranial pressure (ICP) the head of his or her bed should be in which of the following positions?

Correct Answer:
elevated 30 to 45 degrees


when managing a patient with increased intracranial pressure (icp), positioning is a critical aspect of care. the recommended position for such a patient is to have the head of the bed elevated to an angle of 30 to 45 degrees. this specific range is chosen based on its effectiveness in promoting venous outflow from the brain, thereby helping to reduce intracranial pressure.

elevating the head of the bed aids in utilizing gravity to facilitate venous drainage through the jugular veins. when the head is raised, blood flows more easily from the brain towards the heart, which can help in reducing the pressure inside the skull. proper venous drainage is crucial because it helps in decreasing the blood volume within the cranial vault and, consequently, reduces the intracranial pressure.

it is also important to maintain the patient’s neck in a neutral position without any flexion, extension, or rotation. misalignment of the neck can lead to jugular vein compression, which impedes venous outflow from the brain and potentially worsens the intracranial pressure. ensuring that the neck is not bent or twisted is therefore essential for maintaining optimal venous drainage.

positions other than an elevation of 30 to 45 degrees are generally less effective or not recommended in cases of increased icp. for instance, a flat position may cause venous blood pooling in the head and can increase intracranial pressure. elevating the bed to 90 degrees might shift too much blood away from the brain, potentially leading to decreased cerebral perfusion. similarly, a slight elevation, such as 10 degrees, may not be sufficient to significantly affect venous drainage and reduction of icp.

thus, consistently keeping the head of the bed elevated to 30 to 45 degrees, while maintaining the neck in a neutral position, is a key non-pharmacological strategy in the management of patients with elevated intracranial pressure. this practice, combined with other medical interventions, forms an integral part of the treatment protocol aimed at stabilizing the patient’s condition and preventing further complications related to increased icp.

Which of the following will interfere with a patient's use of hydantoins?

Correct Answer:
antacids.


hydantoins, a class of medications primarily used to manage and treat seizures, can have their effectiveness significantly reduced by certain substances, including antacids. this interaction is crucial for patients who are on hydantoins to understand, as maintaining the proper therapeutic level of the medication is essential for controlling seizures.

antacids, commonly used to neutralize stomach acid and relieve indigestion, can interfere with the absorption of hydantoins in the gastrointestinal tract. the primary reason for this interference is that antacids alter the gastric ph and can increase gastrointestinal motility. an altered gastric ph affects the solubility of hydantoins, making them less available for absorption. additionally, some antacids contain divalent cations like magnesium and calcium, which can form complexes with hydantoins, further reducing their absorption.

as a result of this interference, patients taking both hydantoins and antacids may experience a decrease in the plasma concentration of the seizure medication, which could potentially lead to breakthrough seizures or decreased seizure control. healthcare providers often advise spacing the administration of hydantoins and antacids by several hours to minimize this interaction, ensuring that the hydantoins have sufficient time to be absorbed before the antacid is introduced into the system.

other substances listed such as beta blockers, glucose, and aspirin do not have the same pronounced effect on the absorption of hydantoins as antacids do. while drug interactions can vary, and some of these substances might interact with hydantoins in other ways, their impact on the absorption of hydantoins is not as significant as that of antacids.

in conclusion, for patients prescribed hydantoins for seizure control, it's essential to manage the timing and use of antacids carefully. patients should consult with their healthcare provider or pharmacist to understand the best practices for taking their medications, ensuring optimal effectiveness and minimizing potential negative interactions. this careful management helps maintain the therapeutic efficacy of hydantoins, thereby providing reliable seizure control.