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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When can AIDS be manifested? The nurse answer was, "It can be as early as _______."
- A. 1 year or as late as 2 years
- B. 2 years or as late as 10 years
- C. 1 year
- D. 6 months
Correct Answer: B
Rationale: After being infected with the human immunodeficiency virus (HIV), it can take an average of 8-10 years before the development of Acquired Immunodeficiency Syndrome (AIDS) if left untreated. However, AIDS can manifest sooner in some cases, typically within 2 years, especially if the person's immune system is already significantly compromised or if they have other underlying health conditions. Thus, the manifestation of AIDS can vary, but it generally occurs within a range of 2 to 10 years after initial HIV infection.
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 patient presents with a painless, slowly enlarging mass in the right neck, just above the clavicle. Fine-needle aspiration cytology reveals clusters of polygonal cells with clear cytoplasm and centrally located nuclei. Which of the following conditions is most likely responsible for this presentation?
- A. Parathyroid adenoma
- B. Thyroglossal duct cyst
- C. Lymphadenopathy
- D. Thyroid carcinoma
Correct Answer: A
Rationale: The described presentation of a painless, slowly enlarging mass in the right neck just above the clavicle, along with the cytology findings of clusters of polygonal cells with clear cytoplasm and centrally located nuclei, is classic for parathyroid adenoma. Parathyroid adenomas are benign tumors arising from one of the parathyroid glands, which are typically located in the neck region close to the thyroid gland. The clear cytoplasm and centrally located nuclei of the cells are characteristic histological features of parathyroid adenomas. This condition can often lead to hyperparathyroidism, characterized by increased levels of parathyroid hormone (PTH) and hypercalcemia. Treatment involves surgical removal of the adenoma.
A patient admitted to the ICU develops acute exacerbation of chronic heart failure (CHF) with pulmonary edema and respiratory distress. What intervention should the healthcare team prioritize to manage the patient's exacerbation?
- A. Administer intravenous loop diuretics for fluid removal.
- B. Initiate positive pressure ventilation for respiratory support.
- C. Perform emergent pericardiocentesis for tamponade relief.
- D. Recommend inotropic medications to improve myocardial contractility.
Correct Answer: B
Rationale: In this scenario, the patient is presenting with acute exacerbation of chronic heart failure (CHF) complicated by pulmonary edema and respiratory distress. The priority intervention for managing this exacerbation is to initiate positive pressure ventilation for respiratory support. Positive pressure ventilation, such as non-invasive positive pressure ventilation (NIPPV) or invasive mechanical ventilation, can help improve oxygenation and decrease the work of breathing for the patient. By providing adequate respiratory support, ventilation can reduce the negative effects of pulmonary edema and respiratory distress due to CHF exacerbation. Administering intravenous loop diuretics (Choice A) might be necessary to address fluid overload, but it is not the initial priority as ensuring adequate ventilation is crucial. Emergent pericardiocentesis (Choice C) is not indicated in this scenario as there is no mention of cardiac tamponade. Inotropic medications (Choice D) may be considered in managing acute exacerbation of CHF but
A patient with a history of chronic obstructive pulmonary disease (COPD) is experiencing respiratory distress. Which nursing intervention is the priority for managing the patient's respiratory status?
- A. Administering bronchodilators
- B. Positioning the patient in high Fowler's position
- C. Performing chest physiotherapy
- D. Administering oxygen therapy
Correct Answer: D
Rationale: Administering oxygen therapy is the priority nursing intervention for managing a patient with COPD experiencing respiratory distress. In COPD, the patient's lungs are less efficient at oxygen exchange, leading to hypoxemia. Oxygen therapy helps improve oxygenation in the body and alleviates respiratory distress in these patients. Positioning the patient in high Fowler's position can also help improve lung expansion, but providing supplemental oxygen takes precedence in addressing the underlying hypoxemia. Administering bronchodilators and performing chest physiotherapy aim to manage airway obstruction and promote airway clearance, but ensuring the patient has adequate oxygenation is crucial in the immediate management of respiratory distress in COPD.
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