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A patient presents with a displaced fracture of the distal radius and ulna after a fall. What is the preferred initial treatment for this injury?
- A. Closed reduction and splinting
- B. Open reduction and internal fixation (ORIF)
- C. Closed reduction and external fixation (CREF)
- D. Cast immobilization without reduction
Correct Answer: A
Rationale: In the case of a displaced fracture of the distal radius and ulna, the preferred initial treatment is typically closed reduction and splinting. Closed reduction involves manually realigning the fractured bones without the need for surgery. Splinting is then utilized to immobilize the wrist and forearm to allow for proper healing of the fracture. This approach is often effective in realigning the bones and stabilizing the injury, allowing for adequate healing without the need for more invasive interventions like surgery. Following the initial management with closed reduction and splinting, the patient's progress will be monitored, and further interventions may be considered based on the specific characteristics of the fracture and the patient's response to treatment.
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A nurse is preparing to assist with a bone marrow biopsy procedure for a patient. What action should the nurse prioritize to ensure patient comfort during the procedure?
- A. Administering intravenous sedation to the patient before the biopsy
- B. Providing distraction techniques such as music or relaxation exercises
- C. Applying a topical anesthetic cream to the biopsy site
- D. Allowing the patient to eat or drink up to one hour before the procedure
Correct Answer: C
Rationale: Prioritizing the application of a topical anesthetic cream to the biopsy site is essential to ensure patient comfort during the bone marrow biopsy procedure. This will help numb the area where the biopsy needle will be inserted, reducing the pain and discomfort experienced by the patient. Administering intravenous sedation may not always be needed for a bone marrow biopsy and should be decided by the healthcare provider based on the patient's individual needs. Providing distraction techniques such as music or relaxation exercises can be helpful, but they may not be as effective at reducing the physical discomfort caused by the procedure. Allowing the patient to eat or drink up to one hour before the procedure is important for other reasons, such as preventing potential complications during sedation or anesthesia, but it is not directly related to ensuring comfort during the biopsy itself.
Disclosure of client information beyond the interdisciplinary team without consent of the client is a breach of ______.
- A. confidentiality
- B. duty
- C. beneficence
- D. veracity
Correct Answer: A
Rationale: Confidentiality is the ethical principle that requires healthcare providers to keep client information private and not disclose it without the client's consent. When client information is shared beyond the interdisciplinary team without the client's consent, it breaches the trust and privacy expected in the nurse-client relationship. This breach not only violates the ethical principle of confidentiality but also undermines the client's autonomy and right to control their own personal information. Maintaining confidentiality is crucial for building trust and ensuring the well-being of the client.
A patient presents with a sudden onset of severe vertigo, nausea, vomiting, and nystagmus. The patient reports a recent upper respiratory tract infection. Which of the following conditions is most likely responsible for this presentation?
- A. Vestibular neuritis
- B. Benign paroxysmal positional vertigo (BPPV)
- C. Ménière's disease
- D. Acoustic neuroma
Correct Answer: A
Rationale: The patient's sudden onset of severe vertigo, nausea, vomiting, and nystagmus following a recent upper respiratory tract infection is consistent with vestibular neuritis. Vestibular neuritis is characterized by acute onset vertigo, often severe, which is typically associated with nausea, vomiting, and nystagmus. The condition is thought to be caused by inflammation of the vestibular nerve, often viral in nature, which can occur following an upper respiratory tract infection. This inflammation leads to dysfunction of the vestibular system in the inner ear, resulting in the symptoms described. Benign paroxysmal positional vertigo (BPPV), characterized by brief episodes of vertigo triggered by specific head movements, is less likely in this case given the sudden onset of symptoms not triggered by head movements. Meniere's disease is characterized by recurrent episodes of vertigo accompanied by hearing loss, tinnitus, and a feeling of fullness
A patient presents with gradual-onset memory loss, confusion, and difficulty with complex tasks such as managing finances and planning. Over time, the patient develops disorientation to time and place and requires assistance with activities of daily living. Which of the following neurological conditions is most likely responsible for these symptoms?
- A. Alzheimer's disease
- B. Parkinson's disease
- C. Huntington's disease
- D. Frontotemporal dementia
Correct Answer: A
Rationale: The patient's presentation of gradual-onset memory loss, confusion, difficulty with complex tasks, disorientation, and functional decline are all classic features of Alzheimer's disease. Alzheimer's disease is a progressive neurodegenerative disorder characterized by the accumulation of abnormal protein deposits in the brain, leading to widespread neuronal damage and cognitive decline. As the disease progresses, patients typically experience worsening memory loss, cognitive impairment, and deficits in activities of daily living, ultimately requiring full-time care and assistance. Other neurodegenerative diseases such as Parkinson's disease, Huntington's disease, and frontotemporal dementia may present with cognitive impairment and behavioral changes, but the specific constellation of symptoms described in the case is most indicative of Alzheimer's disease.
Which of the following clinical findings is most consistent with a diagnosis of pneumonia?
- A. Inspiratory crackles and dullness to percussion
- B. Hemoptysis and pleuritic chest pain
- C. Clubbing of the fingers and cyanosis
- D. Decreased breath sounds and tracheal deviation
Correct Answer: A
Rationale: The clinical findings of inspiratory crackles (also known as rales) and dullness to percussion are most consistent with a diagnosis of pneumonia. Inspiratory crackles are abnormal lung sounds heard on auscultation and are typically due to the presence of fluid or mucus in the alveoli. Dullness to percussion can indicate consolidation of lung tissue, which is a common finding in pneumonia where the alveolar spaces are filled with inflammatory exudate. These findings suggest localized lung pathology and are commonly observed in patients with pneumonia. Hemoptysis and pleuritic chest pain (Choice B) are more suggestive of pulmonary embolism or pleurisy. Clubbing of the fingers and cyanosis (Choice C) are signs of chronic hypoxemia and are not specific to pneumonia. Decreased breath sounds and tracheal deviation (Choice D) are more indicative of conditions such as a pneumoth