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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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During the cellular stage of acute inflammation, which type of cells arrive first and in great numbers?
- A. Basophils
- B. Lymphocytes
- C. Neutrophils
- D. Platelets
Correct Answer: C
Rationale: During the cellular stage of acute inflammation, neutrophils are the first responders. Neutrophils arrive at the site of injury in large numbers to combat pathogens and remove debris. Basophils and lymphocytes are also involved in the inflammatory response, but they are not the first to arrive. Platelets play a role in hemostasis and blood clotting, rather than being the primary cells involved in the initial inflammatory response.
What clinical manifestations would the nurse expect to find in a client who is experiencing anaphylaxis?
- A. Dilated bronchioles, constriction of peripheral blood vessels, decreased capillary permeability
- B. Asthma, deep vein thrombosis, hepatic encephalopathy
- C. Narrowing of the bronchioles, dilation of the peripheral blood vessels, increased capillary permeability
- D. Left-sided heart failure, pulmonary embolism, urinary tract infection
Correct Answer: C
Rationale: In anaphylaxis, the client would present with narrowing of the bronchioles, dilation of the peripheral blood vessels, and increased capillary permeability. These manifestations lead to symptoms such as difficulty breathing, low blood pressure, and swelling. Choices A, B, and D are incorrect because they do not describe the typical clinical manifestations of anaphylaxis.
A patient has acute respiratory failure (ARF). Which of the following would the nurse expect to find?
- A. Alkalosis and hyperventilation
- B. Hypoxemia and hypercapnia
- C. Alkalosis and high potassium
- D. Elevated sodium and acidosis
Correct Answer: B
Rationale: In acute respiratory failure, hypoxemia (low blood oxygen) and hypercapnia (high blood carbon dioxide) are commonly observed. Choice A is incorrect because alkalosis (high pH) and hyperventilation are not typically seen in acute respiratory failure. Choice C is incorrect as it mentions alkalosis and high potassium, which are not characteristic of acute respiratory failure. Choice D is also incorrect because elevated sodium and acidosis are not typically associated with acute respiratory failure.
A 22-year-old was recently diagnosed with acquired immunodeficiency syndrome (AIDS). Which decreased lab finding would be expected to accompany this virus?
- A. CD4 helper T cells
- B. CD8 helper T cells
- C. CDC cells
- D. CDC10 cells
Correct Answer: A
Rationale: In a person diagnosed with AIDS, a decrease in CD4 helper T cells is expected. These cells are critical for the immune system's proper functioning, and their reduction weakens the body's ability to fight infections. CD8 helper T cells (Choice B) are not typically decreased in AIDS. CDC cells (Choice C) and CDC10 cells (Choice D) are not relevant terms in this context, making them incorrect choices.
A 70-year-old man has enjoyed good overall health for all of his adult life, but he has been experiencing urinary frequency and dribbling that has culminated in a diagnosis of benign prostatic hypertrophy (BPH). As a result, the patient has been prescribed finasteride (Proscar). When teaching the patient about the potential adverse effects of the drug, the nurse should ensure that he knows about the possibility of
- A. sexual dysfunction.
- B. urethral burning.
- C. kidney stones.
- D. visual disturbances.
Correct Answer: A
Rationale: The correct potential adverse effect of finasteride (Proscar) that the nurse should educate the patient about is sexual dysfunction. Finasteride is known to cause sexual side effects such as decreased libido, erectile dysfunction, and ejaculation disorders. Urethral burning, kidney stones, and visual disturbances are not commonly associated with finasteride use, making them incorrect choices for this scenario.