A 38-Year-Old Man Comes to the Emergency Department with High-Grade

question 1269

Multiple Choice

A 38-year-old man comes to the emergency department with high-grade fever, shaking chills, productive cough, and shortness of breath.  He has had 2 hospital admissions for alcohol-withdrawal seizures in the past year but continues to drink alcohol every day.  The patient has no other medical problems and takes no medications.  Temperature is 39.7 C (103.5 F) , blood pressure is 100/70 mm Hg, pulse is 110/min, and respirations are 20/min.  Skin and mucous membranes are dry.  Physical examination reveals crackles and bronchial breath sounds in the right lower lung field.  Cardiac examination is unremarkable.  Chest x-ray reveals right lower lobe consolidation.  The patient is prescribed intravenous antibiotics.  Twelve hours later, he develops significant shortness of breath.  Respirations are 38/min.  Oxygen saturation is 80% on a nonrebreather mask.  A repeat chest x-ray is shown in the image below. The patient is intubated immediately.  Which of the following is most likely to be present in this patient just prior to intubation?

• A)Decreased lung compliance
• B)Increased left ventricular end-diastolic pressure
• C)Increased ratio of PaO₂ to FiO₂
• D)Normal alveolar-arterial oxygen gradient
• E)Normal pulmonary arterial pressure

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Definitions:

Administrative Expense

Costs related to the general operation of a company, such as salaries of executive officers, legal and corporate office expenses.

Planning Budget

A budget designed for a particular level of activity, used for planning purposes at the beginning of a period.

Spending Variance

The difference between the actual amount spent and the budgeted amount in a specific period.

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The process of persuading potential buyers to purchase a product or service, often involving marketing, negotiation, and sales strategies.