Nokea
A 37-year-old woman has a 10 pack-year smoking history and has been using oral contraceptives for the past 2 years. The nurse should plan health education interventions knowing that this patient faces an increased risk of
- A. osteoporosis.
- B. dementia.
- C. myocardial infarction.
- D. deep vein thrombosis.
Correct Answer: C
Rationale: The correct answer is C: myocardial infarction. Women aged 35 and older who smoke, especially with a history of 10 pack-years like in this case, face an increased risk of cardiovascular disorders, including myocardial infarction, when using oral contraceptives. Choice A, osteoporosis, is incorrect because smoking and oral contraceptives do not significantly increase the risk of osteoporosis. Choice B, dementia, is not directly associated with smoking, oral contraceptives, or their combination. Choice D, deep vein thrombosis, is a risk associated with oral contraceptives, especially in combination with smoking, but the highest increased risk in this case is for myocardial infarction.
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A 10-year-old male is stung by a bee while playing in the yard. He begins itching and develops pain, swelling, redness, and respiratory difficulties. He is suffering from:
- A. Immunodeficiency
- B. Autoimmunity
- C. Anaphylaxis
- D. Tissue-specific hypersensitivity
Correct Answer: C
Rationale: The correct answer is C: Anaphylaxis. Anaphylaxis is a severe, immediate allergic reaction mediated by IgE. In this scenario, the symptoms of itching, pain, swelling, redness, and respiratory difficulties following a bee sting are indicative of anaphylaxis. Choice A, Immunodeficiency, refers to a weakened immune system's inability to protect the body from infections and diseases, which is not the case here. Choice B, Autoimmunity, involves the immune system attacking healthy cells and tissues by mistake, which is not the mechanism at play in anaphylaxis. Choice D, Tissue-specific hypersensitivity, does not accurately describe the immediate, systemic reaction seen in anaphylaxis.
The nurse is planning care for a client with damage to the vestibular area of the vestibulocochlear nerve. What should the nurse include in the plan of care? Select all that apply.
- A. Assistance with ambulation
- B. Regular hearing tests
- C. Monitoring for nausea
- D. Vision assessments
Correct Answer: A
Rationale: Damage to the vestibular area affects balance and may cause nausea. Therefore, the nurse should include assistance with ambulation in the care plan to help the client maintain stability while walking. Regular hearing tests (choice B) are not directly related to damage in the vestibular area of the vestibulocochlear nerve. While nausea (choice C) may occur due to vestibular damage, monitoring for it alone is not as essential as providing assistance with ambulation. Vision assessments (choice D) are important for assessing visual function but are not the priority when dealing with vestibular issues.
What is the purpose of the inflammatory response?
- A. Prevents blood from entering the injured tissue
- B. Elevates body temperature to prevent spread of infection
- C. Prevents formation of abscess
- D. Minimizes injury and promotes healing
Correct Answer: D
Rationale: The inflammatory response is a protective mechanism triggered by tissue damage or infection. It aims to minimize injury by removing harmful stimuli and initiating the healing process. Choice A is incorrect because blood flow to the injured tissue is actually increased to deliver immune cells and nutrients. Choice B is incorrect because while fever is a response to infection, it is not the primary purpose of the inflammatory response. Choice C is incorrect because abscess formation can occur as part of the inflammatory response in an attempt to contain an infection.
A patient being treated for tuberculosis is determined to be drug resistant. Which of the following medications will the patient be resistant to in the treatment of tuberculosis?
- A. Isoniazid (INH) and rifampin
- B. Carbamazepine (Tegretol) and phenytoin (Dilantin)
- C. Dextroamphetamine (Dexedrine) and doxapram (Dopram)
- D. Propranolol (Inderal) and sotalol (Betapace)
Correct Answer: A
Rationale: In the treatment of tuberculosis, drug resistance commonly develops against medications like Isoniazid (INH) and rifampin. These two drugs are key components of the standard anti-tuberculosis treatment regimen. Choices B, C, and D are unrelated medications that are not used in the treatment of tuberculosis. Carbamazepine and phenytoin are anticonvulsants, dextroamphetamine is a stimulant, and propranolol and sotalol are used for cardiovascular conditions.
A client with diabetes mellitus has just undergone a right, below-the-knee amputation following gangrene infection. A few days after the amputation, the client confides in the nurse that he still feels his right foot. Knowing the pathophysiologic principles behind this, the nurse can:
- A. administer a psychotropic medication to help the client cope with the sensation of his amputated leg.
- B. explain that many amputees have this sensation and that one theory surmises the end of a regenerating nerve becomes trapped in the scar tissue of the amputation site.
- C. call the physician and request an order for a psychological consult.
- D. educate the client that this area has an unusually abnormal increase in sensitivity to sensation but that it will go away with time.
Correct Answer: B
Rationale: The correct answer is B. The sensation of feeling the amputated limb is known as phantom limb pain, which is common after amputation. One theory suggests that it occurs because the end of a regenerating nerve becomes trapped in the scar tissue at the amputation site. Administering psychotropic medication (choice A) is not the first-line treatment for phantom limb pain. Requesting a psychological consult (choice C) is premature without first addressing the known pathophysiological basis of phantom limb pain. Educating the client that the sensitivity will go away with time (choice D) is not entirely accurate as phantom limb pain can persist long-term.