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A patient is prescribed a proton pump inhibitor (PPI) for the treatment of gastroesophageal reflux disease (GERD). Which instruction should the nurse include in patient education about PPI therapy?
- A. "Take the medication with antacids for enhanced effectiveness."
- B. "Avoid consuming citrus fruits while on PPI therapy."
- C. "Take the medication 30 minutes before meals."
- D. "Report any signs of gastrointestinal bleeding promptly."
Correct Answer: C
Rationale: Patients prescribed proton pump inhibitors (PPIs) for gastroesophageal reflux disease (GERD) should be instructed to take the medication 30 minutes before meals. This is because PPIs work best when taken on an empty stomach, allowing them to inhibit the gastric proton pump effectively and reduce acid production in anticipation of food intake. Taking the medication before meals ensures optimal absorption and effectiveness in controlling symptoms of GERD.
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A patient with terminal illness expresses fear and anxiety about dying alone. What intervention should the palliative nurse prioritize to address the patient's concerns?
- A. Arrange for family members or loved ones to be present at the patient's bedside.
- B. Offer reassurance that dying alone is a common experience in palliative care.
- C. Recommend distracting activities to divert the patient's attention from their fears.
- D. Administer sedative medications to alleviate anxiety and promote relaxation.
Correct Answer: A
Rationale: The most appropriate intervention for the palliative nurse to prioritize in this situation is to arrange for family members or loved ones to be present at the patient's bedside. Having loved ones nearby can provide emotional support, comfort, and reassurance to the patient during their final moments. This can help alleviate the fear and anxiety the patient is experiencing about dying alone. Additionally, it can contribute to a sense of connectedness and peace for both the patient and their loved ones during this challenging time. Offering practical solutions to address the patient's emotional needs is key in providing holistic palliative care.
A patient with a history of multiple myeloma presents with weakness, bone pain, and recurrent infections. Laboratory tests reveal anemia, hypercalcemia, renal insufficiency, and monoclonal spike on serum protein electrophoresis. Which of the following conditions is most likely to cause these findings?
- A. Waldenstrom macroglobulinemia
- B. Hodgkin lymphoma
- C. Chronic lymphocytic leukemia (CLL)
- D. Multiple myeloma
Correct Answer: D
Rationale: Multiple myeloma is a plasma cell neoplasm characterized by the presence of abnormal monoclonal plasma cells in the bone marrow, which produce a monoclonal spike on serum protein electrophoresis. The clinical presentation of weakness, bone pain, and recurrent infections is typical of multiple myeloma. Anemia can result from bone marrow infiltration by the abnormal plasma cells, hypercalcemia is due to bone destruction and release of calcium, renal insufficiency can result from hypercalcemia and protein deposition in the kidneys, and the monoclonal spike in serum protein electrophoresis indicates the presence of a monoclonal protein. Waldenström macroglobulinemia, Hodgkin lymphoma, and chronic lymphocytic leukemia do not typically present with the classic tetrad of findings seen in multiple myeloma.
A patient presents with a small, painless, well-defined nodule on the lateral aspect of the neck, just above the clavicle. Fine-needle aspiration cytology reveals clusters of polygonal cells with abundant granular cytoplasm. Which of the following conditions is most likely responsible for this presentation?
- A. Thyroglossal duct cyst
- B. Branchial cleft cyst
- C. Lymphadenopathy
- D. Parathyroid adenoma
Correct Answer: D
Rationale: The presentation of a small, painless, well-defined nodule on the lateral aspect of the neck, above the clavicle, along with the cytology showing clusters of polygonal cells with abundant granular cytoplasm is most indicative of a parathyroid adenoma. Parathyroid adenomas are benign tumors derived from the parathyroid gland that can produce excess parathyroid hormone (PTH), leading to hyperparathyroidism. The characteristic histology of parathyroid adenomas includes chief cells with abundant granular cytoplasm.
Patient was visited by the anesthesiologist and explained the anesthesia for his surgery. Which of the following type of anesthesia would you expect to be ordered?
- A. Spinal
- B. Local
- C. Caudal
- D. General
Correct Answer: D
Rationale: When the anesthesiologist visits a patient to explain the anesthesia for surgery, the most likely type of anesthesia to be ordered in this scenario would be general anesthesia. General anesthesia is a state of controlled unconsciousness where the patient is completely unaware and unresponsive during the procedure. This type of anesthesia is typically used for surgeries that are more complex, lengthy, or invasive, requiring the patient to be completely still and asleep throughout the operation.
Which of the following dental conditions is characterized by inflammation and bleeding of the gingival tissues, often caused by bacterial plaque accumulation?
- A. Dental caries
- B. Gingivitis
- C. Periodontitis
- D. Dental abscess
Correct Answer: B
Rationale: Gingivitis is a dental condition characterized by inflammation and bleeding of the gingival tissues. It is often caused by poor oral hygiene leading to the accumulation of bacterial plaque along the gumline. The plaque contains bacteria that release toxins, leading to inflammation of the gums. If left untreated, gingivitis can progress to periodontitis, a more serious condition that affects the supporting structures of the teeth. Regular dental cleanings, proper oral hygiene practices, and professional treatment can help manage and prevent gingivitis.