Nokea
A patient presents with acute knee pain and swelling following a twisting injury during sports activity. Physical examination reveals joint effusion and tenderness along the joint line. Which structure is most likely injured in this scenario?
- A. Anterior cruciate ligament (ACL)
- B. Medial collateral ligament (MCL)
- C. Meniscus
- D. Patellar tendon
Correct Answer: C
Rationale: The scenario described is suggestive of a meniscus injury. A twisting injury during sports activity leading to acute knee pain and swelling, accompanied by joint effusion and tenderness along the joint line, is commonly associated with meniscus tears. The meniscus is a C-shaped cartilage structure located between the femur and tibia in the knee joint, providing cushioning and stability. The symptoms of a meniscus tear typically include pain, swelling, joint line tenderness, and sometimes mechanical symptoms like locking or clicking. Treatment may involve rest, physical therapy, or in some cases, surgery to repair or remove the torn meniscus.
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The nurse specialist cites a situation. If a patient experiences episodes of severe nausea and vomiting with more than 1,000 ml. of vomitus with in a period of four hours, which of the following is the nurses MOST appropriate action?
- A. Withhold fluids for four hours
- B. Observe the patient for another four hours
- C. Notify the physician
- D. Place the patient on a liquid diet
Correct Answer: C
Rationale: Severe nausea and vomiting with a large volume of vomitus can indicate a serious underlying issue such as gastrointestinal obstruction or other medical emergencies. In this situation, it is crucial for the nurse to notify the physician immediately so that further assessment and appropriate management can be initiated promptly. Delay in seeking medical help can lead to complications and worsen the patient's condition. It is important to act quickly and involve the physician in situations where the patient's health may be at risk.
A patient is prescribed a calcium channel blocker for the management of hypertension. Which adverse effect should the nurse monitor closely in the patient?
- A. Hypoglycemia
- B. Peripheral edema
- C. Hypokalemia
- D. Tachycardia
Correct Answer: D
Rationale: Calcium channel blockers are often prescribed for the management of hypertension because they can help relax blood vessels and slow the heart rate, thus reducing blood pressure. One of the major adverse effects associated with calcium channel blockers is bradycardia (slow heart rate) or even more rarely, tachycardia (fast heart rate). Therefore, in a patient prescribed a calcium channel blocker for hypertension, the nurse should closely monitor for any signs and symptoms of tachycardia as it can be a serious adverse effect that needs prompt evaluation and intervention to prevent complications.
A patient asks the nurse several questions about their diagnosis and treatment options. What is the nurse's primary responsibility in responding to these questions?
- A. Provide brief and vague answers to avoid overwhelming the patient.
- B. Refer the patient to the physician for all medical-related questions.
- C. Listen actively and provide accurate, honest, and comprehensive answers.
- D. Ignore the patient's questions and focus on completing other tasks.
Correct Answer: C
Rationale: The nurse's primary responsibility in responding to a patient's questions about their diagnosis and treatment options is to listen actively and provide accurate, honest, and comprehensive answers. This approach helps build trust between the patient and the healthcare team, allows the patient to make informed decisions about their care, and ensures that the patient understands their condition and the recommended treatment plan. Providing vague answers or ignoring the patient's questions can lead to confusion, anxiety, and mistrust, which can hinder the patient's overall care and recovery. Referring the patient to the physician for all questions may be appropriate for certain medical inquiries, but the nurse plays a crucial role in educating and supporting the patient throughout their healthcare journey.
Which of the following statements is NOT true of Pneumothorax?
- A. Atmospheric air within the pleural space can result to a rise in intra thoracic pressure and reduces vital capacity in the lungs
- B. The loss of positive intra-pleural pressure can produce pneumothorax
- C. The loss of negative intra pleural pressure can result to collapse of the lungs.
- D. A spontaneous pneumothorax can occur with the rupture of pulmonary bleb.
Correct Answer: C
Rationale: In pneumothorax, air enters the normally negative pressure space between the lung and chest wall, leading to loss of negative intra-pleural pressure. However, this loss of negative pressure typically does not directly result in lung collapse. Instead, the accumulation of air in the pleural space can lead to a pressure imbalance, causing the lung to collapse partially or completely, which is known as atelectasis. Therefore, it is more accurate to state that the loss of negative intra-pleural pressure can result in lung collapse due to the presence of air in the pleural space, rather than the loss of negative pressure itself causing the collapse.
A patient admitted to the ICU develops acute gastrointestinal bleeding requiring urgent intervention. What intervention should the healthcare team prioritize to manage the patient's bleeding?
- A. Perform endoscopic hemostasis with mechanical or thermal techniques.
- B. Administer proton pump inhibitors (PPIs) to reduce gastric acid secretion.
- C. Implement strict bed rest to minimize physical exertion and bleeding risk.
- D. Recommend transfusion of fresh frozen plasma to correct coagulopathy.
Correct Answer: A
Rationale: In a patient with acute gastrointestinal bleeding requiring urgent intervention, the healthcare team should prioritize performing endoscopic hemostasis with mechanical or thermal techniques. Endoscopy allows for direct visualization of the source of bleeding in the gastrointestinal tract, enabling targeted interventions such as clipping, cauterization, or injection of epinephrine to achieve hemostasis. This approach is effective in managing acute bleeds and can help stop the bleeding quickly, reducing the need for more invasive procedures or surgeries. Administering proton pump inhibitors (PPIs) may be considered for acid-related bleeding, but it is not the primary intervention for acute bleeding requiring urgent management. Strict bed rest may not be necessary and can increase the risk of complications such as deep vein thrombosis. Transfusion of fresh frozen plasma may be indicated if there is evidence of coagulopathy, but addressing the bleeding source should be the initial priority to