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MedCa CERTIFICATION PRACTICE PATIENT CARE SECTION Q & A WITH RATIONALES 2024
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MedCa CERTIFICATION PRACTICE PATIENT CARE SECTION Q & A WITH RATIONALES 2024
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MedCa Certification PracticePatient Care Section
Q & A w/ Rationales
2024
,1. A 65-year-old male patient with a history of chronic obstructive pulmonary
disease (COPD) is admitted to the hospital with an acute exacerbation of dyspnea
and cough. The nurse assesses his vital signs and oxygen saturation. Which of the
following findings would indicate a need for immediate intervention?
a) Heart rate of 90 beats per minute
b) Respiratory rate of 24 breaths per minute
c) Blood pressure of 150/90 mmHg
d) Oxygen saturation of 88% on room air*
Rationale: The normal range for oxygen saturation is 95-100%. A value below 90%
indicates hypoxemia, which can lead to tissue hypoxia and organ damage. The
patient with COPD may have a lower baseline oxygen saturation, but any drop
below 90% should be reported and treated promptly.
2. A 45-year-old female patient with type 2 diabetes mellitus is scheduled for a
colonoscopy. She asks the nurse how to manage her diabetes medications before
the procedure. What is the best response by the nurse?
a) "You should take your usual dose of oral antidiabetic agents the night before and
skip them on the day of the procedure."*
b) "You should stop taking your oral antidiabetic agents three days before the
procedure and monitor your blood glucose closely."
c) "You should take half of your usual dose of oral antidiabetic agents the night
before and the morning of the procedure."
d) "You should continue taking your oral antidiabetic agents as prescribed until the
day of the procedure and then resume them after the procedure."
Rationale: The patient should take her usual dose of oral antidiabetic agents the
night before and skip them on the day of the procedure to avoid hypoglycemia
during fasting. She should also check her blood glucose before and after the
procedure and resume her medications as instructed by the provider.
3. A 32-year-old male patient with a history of schizophrenia is brought to the
emergency department by his family. He has been non-compliant with his
antipsychotic medication for several weeks and is experiencing auditory
hallucinations, paranoia, and agitation. The nurse administers a dose of haloperido
intramuscularly as ordered by the provider. What is the most important nursing
action after giving the medication?
, a) Monitor the patient's vital signs and level of consciousness
b) Assess the patient for extrapyramidal side effects*
c) Educate the patient about the benefits of medication adherence
d) Reassure the patient that the hallucinations will subside soon
Rationale: Haloperidol is a typical antipsychotic that can cause extrapyramidal side
effects such as dystonia, akathisia, parkinsonism, and tardive dyskinesia. The nurse
should assess the patient for these side effects after giving the medication and
report any abnormal findings to the provider. The nurse should also monitor vital
signs and level of consciousness, educate the patient about medication adherence,
and reassure the patient, but these are not as urgent as assessing for extrapyramida
side effects.
4. A 28-year-old female patient with a history of asthma is admitted to the hospital
with an acute asthma attack. She reports using her albuterol inhaler several times a
day for the past week, but without much relief. The nurse auscultates her lungs and
hears wheezes throughout both lung fields. Which of the following interventions
would be most appropriate for this patient?
a) Administer oxygen via nasal cannula
b) Administer corticosteroids intravenously*
c) Administer antihistamines orally
d) Administer bronchodilators via nebulizer
Rationale: Corticosteroids are anti-inflammatory agents that reduce airway
inflammation and mucus production in asthma. They are indicated for patients
with severe or persistent asthma who do not respond well to bronchodilators alone
Corticosteroids are given intravenously in acute asthma attacks to achieve rapid
effects. Oxygen, bronchodilators, and antihistamines may also be used in asthma
management, but they are not as effective as corticosteroids in this case.
5. A 50-year-old male patient with a history of hypertension and coronary artery
disease is admitted to the hospital with chest pain that radiates to his left arm and
jaw. He rates his pain as 8 out of 10 on a numeric scale. The nurse administers
nitroglycerin sublingually as ordered by the provider. What is the expected
outcome of this medication?
a) It will decrease the heart rate and blood pressure
b) It will dilate the coronary arteries and increase blood flow to the heart*
c) It will reduce the oxygen demand and workload of the heart
d) It will prevent platelet aggregation and thrombus formation
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