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A patient is brought to the emergency department experiencing a possible stroke. What initial diagnostic test for a stroke , usually performed in the emergency department would the nurse prepare the patient for?
- A. 12-lead electrocardiogram
- B. Carotid ultrasound study
- C. Noncontrast computed tomography
- D. Transcranial Doppler flow study
Correct Answer: C
Rationale: In the emergency department setting, the initial diagnostic test typically performed for a patient suspected of having a stroke is a noncontrast computed tomography (CT) scan of the head. This imaging study is crucial in evaluating and diagnosing stroke because it can quickly identify whether the person is having a hemorrhagic stroke (bleeding in the brain) or an ischemic stroke (blood clot blocking a blood vessel). The results of the CT scan help guide immediate treatment decisions, such as administering clot-busting medications for ischemic strokes or preparing for surgical interventions for hemorrhagic strokes. Carotid ultrasound studies and transcranial Doppler flow studies may be performed after the initial CT scan to further assess the extent of damage and the underlying cause of the stroke. The 12-lead electrocardiogram is useful in assessing the heart's electrical activity but is not the primary test for diagnosing stroke.
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Which of the following historical data MOST probably led to a post-traumatic stress disorder?
- A. Unstable relationship with ex-fiancee.
- B. No gang-relationship with peers
- C. Suicide of her mother
- D. Dropping out of school.
Correct Answer: C
Rationale: The suicide of her mother is the most probable historical data that led to post-traumatic stress disorder. Experiencing the suicide of a close family member, especially a parent, can be an extremely traumatic event that can have long-lasting psychological effects. Witnessing or dealing with such a tragic loss can lead to feelings of helplessness, depression, guilt, and intense emotional distress, all of which are common in individuals with post-traumatic stress disorder (PTSD). This significant and distressing event could have a profound impact on the individual's mental health and well-being, contributing to the development of PTSD symptoms such as intrusive memories, avoidance behaviors, negative mood alterations, and changes in arousal or reactivity.
A patient with a history of cirrhosis is at risk for developing hepatic encephalopathy. Which nursing intervention is most effective in preventing and managing hepatic encephalopathy?
- A. Administering lactulose as prescribed
- B. Restricting dietary protein intake
- C. Monitoring serum ammonia levels
- D. Encouraging increased fluid intake
Correct Answer: A
Rationale: Lactulose is the most effective nursing intervention in preventing and managing hepatic encephalopathy in patients with cirrhosis. Lactulose works by promoting the elimination of ammonia in the colon through its laxative effect, thereby reducing ammonia levels in the blood. High ammonia levels are associated with the development of hepatic encephalopathy. By administering lactulose as prescribed, nurses can help reduce the risk of encephalopathy and manage symptoms effectively. Monitoring serum ammonia levels is important in assessing the effectiveness of lactulose therapy, but administering lactulose is the primary nursing intervention in this situation. Dietary protein restriction is also commonly recommended; however, lactulose administration is the most vital intervention in this scenario. Additionally, encouraging increased fluid intake is important for overall liver health but is not as specific to preventing and managing hepatic encephalopathy as administering lactulose.
A patient presents with fatigue, weakness, and jaundice. Laboratory tests reveal hemolytic anemia, elevated LDH, decreased haptoglobin, and presence of schistocytes on peripheral blood smear. Which of the following conditions is most likely to cause these findings?
- A. Hereditary spherocytosis
- B. Glucose-6-phosphate dehydrogenase (G6PD) deficiency
- C. Autoimmune hemolytic anemia (AIHA)
- D. Thalassemia
Correct Answer: B
Rationale: Glucose-6-phosphate dehydrogenase (G6PD) deficiency is an X-linked recessive disorder that leads to hemolytic anemia in response to oxidative stress. The patient's presentation of fatigue, weakness, and jaundice along with laboratory findings of hemolytic anemia (evidenced by schistocytes), elevated LDH, and decreased haptoglobin are all characteristic of G6PD deficiency. The oxidative stress causes red blood cell destruction, resulting in the release of LDH and bilirubin, leading to jaundice. Decreased haptoglobin is seen due to its consumption in binding free hemoglobin released from the lysed red blood cells. Additionally, the presence of schistocytes on a peripheral blood smear is indicative of red blood cell fragmentation, a common finding in hemolytic anemias including G6PD deficiency
Which of the following dental conditions is characterized by a localized accumulation of pus within the periodontal tissues, often associated with deep periodontal pockets?
- A. Dental caries
- B. Gingivitis
- C. Periodontitis
- D. Dental abscess
Correct Answer: D
Rationale: A dental abscess is a localized accumulation of pus within the periodontal tissues, often associated with deep periodontal pockets. This condition typically arises from bacterial infection in the tooth pulp (periapical abscess) or in the periodontal tissues (periodontal abscess). The pus accumulation leads to localized swelling, pain, and tenderness in the affected area. Treatment usually involves draining the abscess and addressing the underlying infection through root canal therapy, periodontal treatment, or extraction, depending on the extent of the infection. It is important to seek prompt dental care to prevent potential complications as abscesses can lead to severe pain, systemic infection, and even tooth loss if left untreated.
Nursing, as a human science, deals with the critical and fundamental differences in attitude toward their respective phenomena. Which of the following is an aim o: human sciences?
- A. Construct prediction.
- B. Sets control
- C. Seeks causal explanation
- D. Makes meaningful interpretation.
Correct Answer: D
Rationale: The aim of human sciences, including nursing as a human science, is to make meaningful interpretations of the phenomena being studied. Unlike natural sciences that may focus on prediction, control, or seeking causal explanations, the human sciences aim to understand and interpret human experiences, behaviors, and relationships in a meaningful way. In nursing, this involves not only understanding the biological aspects of health and illness but also considering the holistic and humanistic aspects of care, such as emotions, values, beliefs, and perceptions. By making meaningful interpretations, nurses can better understand their patients and provide individualized and patient-centered care.