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A nurse working in a busy orthopedic clinic is asked to perform the Tinel sign on a client having problems in her hand/wrist. In order to test Tinel sign, the nurse should give the client which direction?
- A. Stand tall, arms at your side, shut your eyes; place the tip of your index finger to your nose.
- B. Hold your wrist in complete flexion, keep it in this position for 60 seconds. How does your hand feel after placing it in a neutral position?
- C. I'm going to tap (percuss) over the median nerve in your wrist; tell me what sensation you feel while I am doing this. Does the sensation stay in the wrist or go anywhere else?
- D. I'm going to tap this tuning fork; place it on the side of your thumb, then tell me what you are feeling in your hand and wrist.
Correct Answer: C
Rationale: The correct answer is C. The Tinel sign involves percussing over the median nerve in the wrist to test for carpal tunnel syndrome. Choice A is incorrect as it describes a different action unrelated to the Tinel sign. Choice B is also incorrect as it involves holding the wrist in flexion, which is not part of the Tinel sign assessment. Choice D is incorrect as it mentions using a tuning fork on the thumb, which is not the correct technique for assessing the Tinel sign.
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What condition is a result of Polycythemia Vera, which involves excess red blood cells?
- A. Tissue ischemia & necrosis
- B. Chronic pancreatitis
- C. Low blood pressure & heart rate
- D. Increased numbers of infections
Correct Answer: A
Rationale: Polycythemia Vera, characterized by excess red blood cells, can cause tissue ischemia and necrosis due to the increased blood viscosity. This condition restricts blood flow, leading to inadequate oxygen delivery to tissues and subsequent tissue damage. Choices B, C, and D are incorrect because they are not directly associated with the pathophysiology of Polycythemia Vera.
A 55-year-old male patient is taking finasteride (Proscar) for benign prostatic hyperplasia (BPH). What patient teaching should the nurse provide regarding the use of this medication?
- A. Avoid taking over-the-counter antacids while on this medication.
- B. This medication may decrease libido.
- C. This medication may take several months to improve symptoms.
- D. This medication may cause increased hair growth.
Correct Answer: C
Rationale: Correct Answer: The nurse should inform the patient that finasteride may take several months to improve symptoms of BPH. It is essential for patients to understand the delayed onset of action to manage their expectations and compliance. Choice A is incorrect because there is no significant interaction between finasteride and over-the-counter antacids. Choice B is incorrect as finasteride is more commonly associated with decreased libido rather than increased libido. Choice D is incorrect as finasteride is known to reduce hair growth rather than increase it.
Which of the following accurately describes the pathophysiology of asthma?
- A. Chronic inflammation of the bronchial lining
- B. Narrowing of the airway due to bronchoconstriction
- C. Damage to alveoli reducing lung elasticity
- D. Overproduction of mucus by the goblet cells
Correct Answer: B
Rationale: The correct answer is B: "Narrowing of the airway due to bronchoconstriction." In asthma, there is an inflammatory response that leads to bronchoconstriction, causing the airways to narrow and making it difficult to breathe. Choice A is incorrect as chronic inflammation is a feature of asthma but not the primary pathophysiological mechanism. Choice C is incorrect as damage to alveoli is more characteristic of conditions like emphysema. Choice D is incorrect as overproduction of mucus is a feature of chronic bronchitis, not asthma.
A tension pneumothorax requires a needle thoracostomy and/or chest tube placement as treatment to which component of the pathophysiology of the condition?
- A. An accumulation of blood in the pleural space, which makes it difficult for the lungs to exchange gases.
- B. Extreme pain caused by a fractured rib
- C. A large accumulation of trapped air in the pleural space affecting both the lungs and heart.
- D. Sudden failure of the respiratory system due to fluid accumulation in the alveoli
Correct Answer: C
Rationale: A tension pneumothorax is characterized by a large accumulation of trapped air in the pleural space, creating pressure that affects both the lungs and heart. This condition can lead to life-threatening consequences by shifting mediastinal structures and impairing cardiac function. Treatment involves decompressing the trapped air to relieve the tension. Choices A, B, and D are incorrect as they do not describe the primary pathophysiological mechanism of tension pneumothorax, which is the accumulation of air in the pleural space, not blood, rib fractures, or alveolar fluid accumulation.
In a male patient with benign prostatic hyperplasia (BPH) prescribed tamsulosin (Flomax), what is the expected therapeutic effect of this medication?
- A. Decreased urinary frequency and urgency
- B. Increased urinary output
- C. Decreased blood pressure
- D. Increased hair growth
Correct Answer: A
Rationale: The correct answer is A: Decreased urinary frequency and urgency. Tamsulosin is prescribed for patients with BPH to relax the muscles in the prostate and bladder neck. This relaxation helps in relieving the symptoms of BPH, such as decreased urinary flow, frequent urination, and urgency. Choice B is incorrect because tamsulosin does not increase urinary output but rather improves the flow of urine by relaxing the muscles. Choice C is incorrect as tamsulosin is not primarily used for reducing blood pressure. Choice D is also incorrect as tamsulosin does not promote increased hair growth.