Nokea
A patient with a history of nephrolithiasis presents with sudden-onset severe colicky flank pain radiating to the groin. On physical examination, there is tenderness over the costovertebral angle and hematuria. What is the most likely diagnosis?
- A. Acute pyelonephritis
- B. Renal artery embolism
- C. Renal colic due to ureteral calculus
- D. Renal infarction
Correct Answer: C
Rationale: The correct answer is C: Renal colic due to ureteral calculus. The sudden-onset severe colicky flank pain radiating to the groin along with tenderness over the costovertebral angle and hematuria are classic symptoms of kidney stones (ureteral calculus). The pain results from the obstruction of urine flow by the stone, leading to increased pressure and spasm in the ureter. Acute pyelonephritis (choice A) presents with fever, chills, and systemic symptoms. Renal artery embolism (choice B) typically presents with acute onset severe flank pain but is associated with risk factors like atrial fibrillation. Renal infarction (choice D) presents with sudden-onset severe flank pain but is less likely than ureteral calculus in a patient with a history of nephrolithiasis.
You may also like to solve these questions
The nurse is aware that which occurrence in the patient 's health history suggests the diagnosis of GBS?
- A. viral illness few weeks before
- B. encephalitis
- C. severe bacterial infection
- D. meningitis
Correct Answer: A
Rationale: The correct answer is A because a viral illness few weeks before can trigger Guillain-Barre Syndrome (GBS) due to the body's immune response attacking the peripheral nerves. Encephalitis (B), severe bacterial infection (C), and meningitis (D) are not directly linked to GBS pathophysiology. Viral infections are known to precede GBS development, making choice A the most appropriate option.
Bel1le has a difficulty tolerating frustration The GOAL Of the nurse is to assist Belle to ________.
- A. increase her self-esteem
- B. recognize her need
- C. cope with anxiety
- D. mobilize her resources
Correct Answer: C
Rationale: The correct answer is C: cope with anxiety. The nurse's goal is to address Belle's difficulty tolerating frustration, which likely leads to anxiety. By helping Belle develop coping strategies for managing her anxiety, the nurse can assist her in handling frustration more effectively. Options A, B, and D are incorrect because increasing self-esteem, recognizing needs, and mobilizing resources may be important aspects of Belle's overall care but are not directly related to addressing her difficulty with frustration and anxiety. Focusing on coping with anxiety directly targets the root issue and is the most appropriate goal in this context.
A patient expresses distrust in the healthcare system due to previous negative experiences. What is the nurse's best approach to rebuild trust?
- A. Dismiss the patient's concerns and assure them that the healthcare team is trustworthy.
- B. Listen actively to the patient's concerns, acknowledge their past experiences, and work to rebuild trust through transparency and reliability.
- C. Ignore the patient's distrust and proceed with providing care.
- D. Tell the patient that their distrust is unfounded and they should trust the healthcare system.
Correct Answer: B
Rationale: The correct answer is B because actively listening, acknowledging the patient's concerns, and working towards rebuilding trust through transparency and reliability are essential steps in addressing distrust. By validating the patient's experiences and actively involving them in the process, the nurse can foster a supportive and trusting relationship.
Choice A is incorrect because dismissing the patient's concerns can further damage trust and undermine the patient's feelings. Choice C is incorrect as ignoring the distrust can lead to a breakdown in communication and trust. Choice D is incorrect because telling the patient to trust the healthcare system without addressing their concerns is dismissive and unhelpful.
A patient presents with recurrent episodes of brief, severe, stabbing pain in the distribution of the trigeminal nerve. Episodes are triggered by touch, chewing, or cold exposure. Which of the following neurological conditions is most likely responsible for these symptoms?
- A. Migraine headache
- B. Cluster headache
- C. Tension-type headache
- D. Trigeminal neuralgia
Correct Answer: D
Rationale: The correct answer is D: Trigeminal neuralgia. This condition is characterized by recurrent, severe, stabbing pain in the trigeminal nerve distribution triggered by touch, chewing, or cold exposure. The key feature is the characteristic lancinating pain, which is not typical of migraine (choice A), cluster headache (choice B), or tension-type headache (choice C). Migraine typically presents with pulsating, moderate to severe headache associated with nausea and sensitivity to light and sound. Cluster headache is characterized by severe, unilateral pain around the eye associated with autonomic symptoms. Tension-type headache presents with bilateral, pressing or tightening pain without specific triggers. Therefore, based on the description of the symptoms in the question, trigeminal neuralgia is the most likely diagnosis.
Which of the following variables will he likely EXCLUDE in his study?
- A. Salary of nurses
- B. Responsiveness of staff
- C. Caring attitude of nurses
- D. Competence of nurses
Correct Answer: A
Rationale: The correct answer is A: Salary of nurses. In a study, the researcher is likely to exclude salary as it is not directly related to the quality of patient care. The focus should be on factors like responsiveness, caring attitude, and competence of nurses, which directly impact patient outcomes. Including salary may introduce bias and distract from the main objective of studying patient care quality. Responsiveness, caring attitude, and competence are crucial aspects of nursing care that directly influence patient satisfaction and health outcomes. Salary, on the other hand, is an external factor that may not directly correlate with the quality of care provided.