RIMS Nursing Officer - 2022
Medical Surgical Nursing
Medium
Which of the following is NOT a sign of a drowning victim?
Appeared in: RIMS Nursing Officer - 2022
Explanation
- Drowning causes severe hypoxia (lack of oxygen), which leads to cyanosis, a bluish discoloration of the skin, face, and lips.
- Pink coloration of the face and lips indicates adequate oxygenation, which is the opposite of the physiological state of a drowning victim.
- Aspiration of water into the lungs washes out surfactant, a substance essential for keeping the alveoli open. This leads to alveolar collapse and severe respiratory distress, not normal function.
Why Other Options Were Wrong
- Option A: This is a critical sign of drowning. It results from severe cerebral hypoxia as the brain is deprived of oxygen.
- Option B: This, known as apnea, is a cardinal and late sign in the drowning process, often following initial gasping and laryngospasm as respiratory centers fail.
- Option C: These are classic signs of hypoxia. Restlessness is an early indicator of oxygen deprivation. As hypoxia worsens, it affects the heart muscle, leading to dangerous arrhythmias.
Related Visual
Clinical Relevance
- Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Signs and symptoms of drowning as background academic context rather than a clinical decision trigger.
- Early recognition of cyanosis and respiratory distress is critical for initiating immediate and effective resuscitation, which is the single most important factor for survival.
- Nurses must monitor all rescued drowning victims for at least 4-6 hours for delayed respiratory distress (pulmonary edema), even if they appear stable initially. This is due to the progressive effects of surfactant washout.
- What if? If a victim was submerged briefly and is conscious and coughing but has a normal respiratory exam and pink skin, they are at lower risk but still require hospital observation. The absence of immediate severe signs does not rule out delayed complications.
How to Approach the Question
- First, identify the negative keyword "NOT" in the question stem. This means you are looking for the option that is FALSE or does not occur during drowning.
- Recall the core pathophysiology of drowning: submersion leads to a lack of oxygen (hypoxia) and aspiration of fluid.
- Evaluate each option based on the effects of severe hypoxia.
- Loss of consciousness, cessation of breathing, and cardiac disturbances are all direct and expected consequences of the body being deprived of oxygen.
- Consider the last option. 'Pink face and lips' signifies good oxygenation, and 'normal surfactant function' implies healthy lungs. These conditions are the opposite of what happens in drowning.
- Therefore, the option describing a healthy physiological state is the one that is NOT a sign of drowning.
Concept Tested & Keywords
- Concept Tested: Signs and symptoms of drowning
- Stem keywords: drowning victim, sign
- Lead-in keywords: NOT
- Negative lead-in flag: The question asks for the option that is NOT a sign of drowning.
Question ID
QZxyeiYzZb5Z5DpejItAXK
Reference Book
E6 Physiology Guyton 4SAE Part 2A p. 136-138
E6 Nelson Textbook of Pediatrics(2024) — Volume 1 p. 686-688
Practise the full RIMS Nursing Officer - 2022
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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