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A patient, age 46, is admitted for observation following an auto accident. He hit the steering wheel and has a chest contusion. Which of the following creates a pericardial friction rub?
- A. Inflamed cardiac tricuspid and mitral valves
- B. Decreased cardiac output c.Increased pulmonary pressures
- C. Rubbing of pericardial and epicardial layers
Correct Answer: C
Rationale: A pericardial friction rub is a harsh grating sound caused by the rubbing of the pericardial and epicardial layers of the heart. This rubbing sound can be heard with a stethoscope and is typically indicative of pericarditis, inflammation of the pericardium (the sac surrounding the heart). In the case of the patient with a chest contusion following an auto accident, the trauma could have led to pericardial inflammation and subsequent pericardial friction rub. The other choices do not directly result in the creation of a pericardial friction rub.
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During the nursing interview Toni minimizes her visual problems talks about remaining in school to attempt advanced degrees, requests information about full-time jobs in nursing and mentions her desire to have several more children. The nurse recognizes her emotional responses as being:
- A. An example of inappropriate euphoria characteristic of the disease process
- B. A reflection of coping mechanisms used to deal with the exacerbation of her illness
- C. Indicative of the remission phase of her chronic illness
- D. Realistic for her current level of physical functioning
Correct Answer: A
Rationale: Toni's response of minimizing her visual problems, talking about pursuing advanced degrees, asking about full-time job opportunities in nursing, and mentioning her desire to have more children despite her current health situation may suggest inappropriate euphoria characteristic of the disease process. Inappropriate euphoria can be a sign of an altered mental state that is not in line with the reality of the situation. It is important for healthcare providers to recognize such emotional responses as they may indicate underlying mental health issues or the need for further assessment and support.
When teaching a preoperative older patient, which of the following is a technique to improve learning?
- A. Sit in front of window in bright sunlight.
- B. Speak in high tone.
- C. Use small, white-on-black printed
- D. Eliminate background noise. materials.
Correct Answer: D
Rationale: Eliminating background noise is a beneficial technique when teaching an older patient preoperatively. Older individuals may have age-related hearing impairments, making it difficult for them to focus and understand information in the presence of background noise. By minimizing distractions and background noise, the older patient can better concentrate on the information being taught and improve their learning experience.
Sudden infant death syndrome (SIDS) is one of the most common causes of death in infants. At what age is the diagnosis of SIDS most likely?
- A. At 1 to 2 years of age
- B. At I week to 1 year of age, peaking at 2 to 4 months
- C. At 6 months to 1 year of age, peaking at 10 months
- D. At 6 to 8 weeks of age
Correct Answer: B
Rationale: Sudden infant death syndrome (SIDS) is most likely to occur between the ages of 1 week to 1 year, with the highest risk period being between 2 to 4 months of age. While SIDS can occur up to the age of 1 year, the peak incidence is during the first 6 months of life. It is important to follow safe sleep practices, such as placing infants on their backs to sleep, to reduce the risk of SIDS during this vulnerable period.
What deficits would the nurse expect in a right-handed person experiencing a stroke affecting the left side of the cortex?
- A. Expressive aphasia and paralysis on the right side of the body.
- B. Expressive aphasia and paralysis on the left side of the body. .
- C. Dysarthria and paralysis on the right side of the body.
- D. Mixed aphasia and paralysis on the right side of the body.
Correct Answer: A
Rationale: In a right-handed individual experiencing a stroke that affects the left side of the cortex, the deficits are typically seen on the opposite side of the body due to the way the brain is wired. This phenomenon is known as contralateral organization. In this scenario, the left side of the brain controls the right side of the body.
A patient has cloudy penile discharge. For which additional symptoms of urethritis should the nurse assess?
- A. Throat or rectal infection
- B. Chancres or vesicles on the genitals
- C. Painful and frequent urination
- D. Oliguria and flank pain
Correct Answer: C
Rationale: Cloudy penile discharge is a common symptom of urethritis, which is inflammation of the urethra usually caused by an infection, such as a sexually transmitted infection (STI) like gonorrhea or chlamydia. Painful and frequent urination are also classic symptoms of urethritis. Painful urination, or dysuria, may occur due to the irritation and inflammation of the urethra. Frequency of urination can be a result of the body's response to the infection or inflammation. Therefore, assessing for these additional symptoms helps in confirming the diagnosis of urethritis and determining the appropriate treatment for the patient.