A patient arrives at her follow-up appointment 1 month post-hysterectomy and complains to the nurse that her scars do not seem to be healing properly. Upon inspection, the nurse notices that the scars are raised but still within the boundaries of the original incisions. The nurse tells the patient this kind of dysfunctional wound healing is called:
- A. Hypertrophic scarring
- B. Dehiscence
- C. Contracture
- D. A keloid
Correct Answer: A
Rationale: Hypertrophic scarring occurs when a scar is raised but remains within the boundaries of the original wound, unlike keloids, which extend beyond the wound edges. Dehiscence refers to the separation of wound edges, while contracture involves the tightening or constriction of a scar, leading to limited mobility.
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An 8-year-old boy has been diagnosed with a sex hormone deficiency and has begun a course of treatment with testosterone. What change in the boy's health status would necessitate a stop to the course of treatment?
- A. Excessive growth in height
- B. Signs of puberty
- C. Recurrent urinary tract infections
- D. Increased blood pressure
Correct Answer: B
Rationale: In an 8-year-old boy with a sex hormone deficiency being treated with testosterone, the appearance of signs of puberty would necessitate stopping the treatment. Testosterone therapy in this case aims to supplement the deficient sex hormones but should not trigger premature puberty. Excessive growth in height (choice A) is not a typical reason to stop testosterone therapy. Recurrent urinary tract infections (choice C) and increased blood pressure (choice D) are not directly related to testosterone therapy in this context.
A patient is administered isoniazid (INH) for tuberculosis. Which of the following adverse effects will result in discontinuation of the medication?
- A. Weight gain
- B. Jaundice
- C. Fever
- D. Arthralgia
Correct Answer: B
Rationale: The correct answer is B: Jaundice. Isoniazid (INH) is known to cause hepatotoxicity, which can manifest as jaundice. Jaundice is a serious adverse effect that warrants immediate discontinuation of the medication to prevent further liver damage. Weight gain, fever, and arthralgia are not typically associated with isoniazid use and would not necessitate discontinuation of the medication.
When starting on oral contraceptives, what should the nurse include in the education regarding the timing of the medication?
- A. Oral contraceptives should be taken at the same time each day to maintain stable hormone levels and prevent pregnancy.
- B. Oral contraceptives can be taken at any time of day, as long as the schedule is consistent.
- C. Oral contraceptives should be taken in the morning to avoid nighttime side effects.
- D. Oral contraceptives are effective immediately upon starting, regardless of timing.
Correct Answer: A
Rationale: When educating a patient starting on oral contraceptives, it is essential to stress the importance of taking the medication at the same time each day. This ensures stable hormone levels, improving the effectiveness of the contraceptives in preventing pregnancy. Choice B is incorrect because consistency in timing is crucial for maintaining hormone levels. Choice C is incorrect as there is no specific requirement to take oral contraceptives in the morning to avoid side effects. Choice D is incorrect as oral contraceptives may take some time to become fully effective, and consistent timing is important for their efficacy.
The parents of a 3-year-old boy have brought him to a pediatrician for assessment of the boy's late ambulation and frequent falls. Subsequent muscle biopsy has confirmed a diagnosis of Duchenne muscular dystrophy. Which teaching point should the physician include when explaining the child's diagnosis to his parents?
- A. Your child may develop breathing difficulties as the disease progresses.
- B. Your child is likely to benefit from physical therapy and exercise.
- C. This condition can be cured with early intervention and treatment.
- D. The disease is caused by inflammation in the muscles, which leads to weakness.
Correct Answer: A
Rationale: The correct teaching point that the physician should include when explaining Duchenne muscular dystrophy to the parents is that 'Your child may develop breathing difficulties as the disease progresses.' Duchenne muscular dystrophy is a progressive condition that affects muscle strength, including respiratory muscles, leading to breathing difficulties as the disease advances. Choice B is incorrect because while physical therapy and exercise can help maintain muscle function and mobility, they do not cure the condition. Choice C is incorrect because Duchenne muscular dystrophy is a genetic disorder with no known cure. Choice D is incorrect as Duchenne muscular dystrophy is primarily characterized by a lack of dystrophin protein due to genetic mutations, not inflammation in the muscles.
A 25-year-old woman who works as an air traffic controller presents with facial pain and severe headache. She reports that she sometimes feels the pain in her neck or ear and that it is particularly bad during very busy times at the airport. What is the most likely diagnosis?
- A. Migraine headache
- B. Cluster headache
- C. Temporomandibular joint syndrome
- D. Sinus headache
Correct Answer: C
Rationale: The most likely diagnosis for the 25-year-old woman who works as an air traffic controller and presents with facial pain and severe headache that sometimes radiates to her neck or ear, aggravated by stress, is Temporomandibular joint syndrome. This syndrome involves pain in the jaw joint and the muscles controlling jaw movement, which can radiate to the surrounding areas like the neck and ear. Stress and clenching of the jaw commonly exacerbate the symptoms. Migraine headache (choice A) typically presents with other symptoms like nausea, sensitivity to light or sound, and can be triggered by various factors, not just stress. Cluster headache (choice B) is characterized by severe, unilateral pain around the eye with associated autonomic symptoms. Sinus headache (choice D) is usually associated with sinus congestion or infection, presenting with facial pressure or pain, often worsened by bending forward.