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A patient is prescribed an opioid analgesic for the management of acute pain. Which adverse effect should the nurse monitor closely in the patient?
- A. Hypertension
- B. Hypoglycemia
- C. Respiratory depression
- D. Hyperkalemia
Correct Answer: C
Rationale: Opioid analgesics are known to suppress the respiratory centers in the brain, leading to respiratory depression as a side effect. This adverse effect is particularly dangerous and potentially life-threatening, especially in patients who are opioid-naive or when high doses are administered. Therefore, it is crucial for the nurse to closely monitor the patient's respiratory rate, depth, and effort while on opioid analgesic therapy to detect early signs of respiratory depression and intervene promptly to prevent complications. Hypertension, hypoglycemia, and hyperkalemia are not commonly associated with opioid analgesics.
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Nurse Selma is preparing to administer ofloxacin eardrop on Catherine per Doctor's order. She needs to hold the bottle with her hands to warm up the solution to prevent dizziness for
- A. 5-6 minutes
- B. 1 to 2 minutes
- C. 3-4 minutes
- D. 6-7 minutes
Correct Answer: B
Rationale: Warming up ofloxacin eardrops before administering is done to prevent dizziness, which can occur if a cold solution is placed in the ear. Holding the bottle with hands for about 1 to 2 minutes is usually sufficient to warm up the solution to a comfortable temperature for the patient. Warming the solution for too long, such as 5-6 minutes, may not be necessary and could potentially waste time. So, the correct duration for warming up ofloxacin eardrops is 1 to 2 minutes.
A 45-year-old woman presents with heavy menstrual bleeding and iron deficiency anemia. On pelvic examination, the uterus is enlarged, and multiple irregularly shaped masses are palpated. Which condition is most likely to be responsible for these findings?
- A. Leiomyomas (uterine fibroids)
- B. Endometrial hyperplasia
- C. Endometrial polyps
- D. Adenomyosis
Correct Answer: A
Rationale: The clinical presentation of heavy menstrual bleeding, iron deficiency anemia, an enlarged uterus, and irregularly shaped masses palpated on pelvic examination is most indicative of leiomyomas, also known as uterine fibroids. Leiomyomas are benign smooth muscle tumors that commonly occur in women of reproductive age. They can lead to heavy menstrual bleeding and iron deficiency anemia due to their size and location within the uterus. On pelvic examination, leiomyomas can be felt as irregularly shaped masses within the uterine wall. This presentation is classic for leiomyomas and distinguishes them from conditions such as endometrial polyps, endometrial hyperplasia, and adenomyosis.
What is the PRIORITY of care for patient diagnosed with Guillain-Barre Syndrome?
- A. Maintenance of respiratory function
- B. Prevention of decubitus
- C. Control of urinary tract infection
- D. Replacement of fluid and electrolytes
Correct Answer: A
Rationale: The priority of care for a patient diagnosed with Guillain-Barre Syndrome is the maintenance of respiratory function. Guillain-Barre Syndrome can cause paralysis, including respiratory muscles, leading to respiratory failure. Ensuring adequate ventilation and oxygenation is crucial to prevent complications such as respiratory failure and the need for mechanical ventilation. Monitoring for signs of respiratory distress, such as shortness of breath, decreased oxygen saturation, and diminished lung sounds, is essential in providing prompt intervention and support for the patient's respiratory needs. Other aspects of care, such as prevention of decubitus ulcers, control of urinary tract infections, and replacement of fluid and electrolytes, are also important but not as immediate or life-threatening as ensuring adequate respiratory function in these patients.
What is one of the MAJOR challenges that a beginning nurse may encounter in her service delivery in the hospital in terms of an individual client or patient?
- A. Dysfunctional facilities
- B. Poor health seeking behaviour.
- C. Social determinants of health
- D. Stock out of essential commodities
Correct Answer: C
Rationale: In Nadine's case, one major challenge that a beginning nurse may encounter in her service delivery is related to social determinants of health. Social determinants of health refer to the social and economic conditions that influence individual and group differences in health status. In this scenario, Nadine's bruises, bed-wetting, signs of anxiety, and potentially other health issues are likely influenced by factors such as her living environment, family dynamics, and social support systems. As a nurse, addressing social determinants of health requires a holistic approach that considers not only the physical symptoms but also the underlying social, economic, and environmental factors affecting the patient's health and well-being. This can be a complex challenge for beginning nurses who may not have as much experience or training in navigating these social determinants of health to provide comprehensive care to their patients.
A few days later, the patient comes into the emergency department via ambulance stretcher and reveals a work-up of blood sugar level at 800mg/dl, ketones are absent in the urine, she is dehydrated, and has an altered mental status. Based on the data, t he patient is most likely suferring from what specifi medical condition?
- A. Hyperosmolar nonketotic coma (HNKC)
- B. Diabetic retinopathy
- C. Acute renal failure
- D. Diabetic ketoacidosis (DKA)
Correct Answer: A
Rationale: The patient's presentation with a blood sugar level of 800mg/dL, absence of ketones in the urine, dehydration, and altered mental status points towards Hyperosmolar nonketotic coma (HNKC). HNKC typically occurs in patients with Type 2 diabetes and is characterized by extremely high blood glucose levels (hyperglycemia) without significant ketosis. The absence of ketones in the urine distinguishes HNKC from Diabetic ketoacidosis (DKA). Patients with HNKC often present with severe dehydration, altered mental status, and hyperosmolarity. It is crucial to address the underlying cause of the hyperglycemia, correct dehydration, and normalize blood glucose levels promptly in the management of HNKC.