A nurse is preparing to assist with a bone marrow biopsy procedure for a patient. What action should the nurse prioritize to ensure patient comfort during the procedure?
- A. Administering intravenous sedation to the patient before the biopsy
- B. Providing distraction techniques such as music or relaxation exercises
- C. Applying a topical anesthetic cream to the biopsy site
- D. Allowing the patient to eat or drink up to one hour before the procedure
Correct Answer: C
Rationale: Prioritizing the application of a topical anesthetic cream to the biopsy site is essential to ensure patient comfort during the bone marrow biopsy procedure. This will help numb the area where the biopsy needle will be inserted, reducing the pain and discomfort experienced by the patient. Administering intravenous sedation may not always be needed for a bone marrow biopsy and should be decided by the healthcare provider based on the patient's individual needs. Providing distraction techniques such as music or relaxation exercises can be helpful, but they may not be as effective at reducing the physical discomfort caused by the procedure. Allowing the patient to eat or drink up to one hour before the procedure is important for other reasons, such as preventing potential complications during sedation or anesthesia, but it is not directly related to ensuring comfort during the biopsy itself.
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One morning during rounds, Nurse Myra noticed that Marlene was unduly sad. The nurse 's BEST way of communicating her concern is _______.
- A. whatever it is, you lift it up to God
- B. saying you are sad again, that is bad for your health
- C. telling Marlene to stop worrying, everything will be okay
- D. placing her hand over Marlene 's shoulder and asking why the sad face
Correct Answer: D
Rationale: Placing her hand over Marlene's shoulder and asking why the sad face is the best way for Nurse Myra to communicate her concern. This approach shows empathy and creates a safe space for Marlene to open up about her feelings. By using physical touch and showing genuine interest in Marlene's well-being, Nurse Myra can effectively address the situation and provide appropriate support or guidance as needed. Simply dismissing Marlene's feelings (option B and C) or resorting to religious advice (option A) may not effectively address the underlying cause of Marlene's sadness. It is important in situations like this to show empathy, compassion, and a willingness to listen in order to provide the best support for the individual in distress.
Which of the following is a common complication associated with benign prostatic hyperplasia (BPH)?
- A. Urinary retention
- B. Erectile dysfunction
- C. Urethral stricture
- D. Renal calculi
Correct Answer: A
Rationale: Benign prostatic hyperplasia (BPH) can lead to urinary retention, which is a common complication associated with this condition. As the prostate gland enlarges, it can obstruct the flow of urine from the bladder through the urethra. This obstruction can result in difficulty starting to urinate, weak urine flow, frequent urination, incomplete bladder emptying, and eventually urinary retention. If left untreated, urinary retention can lead to serious complications such as urinary tract infections, bladder damage, kidney damage, and even kidney stones. Therefore, urinary retention is an important complication to be aware of in patients with BPH.
A nurse is resistant to the change and is not taking an active part in facilitating the process of change. Which is the BEST approach in dealing with the nurse?
- A. Exert coercion on the nurse
- B. Provide a positive reward system for the nurse
- C. Talk and encourage verbalizing feelings of the change
- D. Ignore the resistance of the nurse.
Correct Answer: C
Rationale: The best approach in dealing with a nurse who is resistant to change and not actively participating is to communicate and encourage verbalizing feelings about the change. By talking with the nurse and allowing them to express their concerns and feelings, you can address any underlying issues that may be causing the resistance. This approach can help build trust, improve communication, and ultimately increase the nurse's engagement in the change process. Coercion (Choice A) can create negative feelings and resistance, while ignoring the nurse's resistance (Choice D) will not resolve the issue. Providing positive rewards (Choice B) may be helpful but may not address the underlying reasons for resistance. Communication is key in addressing resistance to change and fostering a positive, open environment for all involved.
A patient presents with generalized weakness, headache, and difficulty concentrating. Laboratory tests reveal normocytic normochromic anemia, normal iron studies, and elevated serum erythropoietin levels. Which of the following conditions is most likely to cause these findings?
- A. Chronic kidney disease (CKD)
- B. Iron deficiency anemia
- C. Thalassemia
- D. Aplastic anemia
Correct Answer: A
Rationale: The patient in this scenario presents with normocytic normochromic anemia, normal iron studies, and elevated serum erythropoietin levels. These findings are characteristic of anemia of chronic disease, which is commonly seen in patients with chronic kidney disease (CKD). In CKD, there is a decrease in renal production of erythropoietin, leading to reduced stimulation of erythropoiesis and subsequent anemia. The normocytic normochromic anemia pattern is typical in anemia of chronic disease, as opposed to microcytic hypochromic anemia seen in iron deficiency anemia and thalassemia. Aplastic anemia is characterized by pancytopenia, which is not described in the scenario. Therefore, the most likely cause of the patient's presentation is chronic kidney disease.
A patient presents with sudden-onset weakness and sensory loss on one side of the body along with difficulty speaking and understanding speech. Imaging reveals an acute infarction involving the right middle cerebral artery territory. Which of the following neurological conditions is most likely responsible for these symptoms?
- A. Transient ischemic attack (TIA)
- B. Intracerebral hemorrhage
- C. Ischemic stroke
- D. Subarachnoid hemorrhage
Correct Answer: C
Rationale: The patient is presenting with sudden-onset weakness and sensory loss on one side of the body along with difficulty speaking and understanding speech, which are classic symptoms of a stroke. The involvement of the right middle cerebral artery territory on imaging suggests an acute infarction, confirming an ischemic stroke. Ischemic stroke occurs due to a blockage or obstruction within a blood vessel supplying blood to the brain, leading to a lack of oxygen and nutrients reaching brain tissue. This results in neurological deficits corresponding to the affected area of the brain. In contrast, a transient ischemic attack (TIA) would present with similar symptoms but resolve within 24 hours without evidence of acute infarction on imaging. Intracerebral hemorrhage and subarachnoid hemorrhage involve bleeding into the brain tissue or the space surrounding the brain, respectively, resulting in different clinical presentations.