A patient presents with chest pain at rest, unrelated to exertion, and not relieved by nitroglycerin. An electrocardiogram (ECG) shows ST-segment depression. Which cardiovascular disorder is most likely responsible for these symptoms?
- A. Stable angina
- B. Unstable angina
- C. Acute myocardial infarction
- D. Prinzmetal's angina
Correct Answer: B
Rationale: Unstable angina is characterized by chest pain at rest, which is not relieved by nitroglycerin. The ECG findings in unstable angina typically show ST-segment depression or T-wave inversion. It is considered a medical emergency as it can progress to a myocardial infarction. Stable angina, on the other hand, is chest pain or discomfort that occurs with exertion and is relieved by rest or medications like nitroglycerin. Acute myocardial infarction would typically present with ST-segment elevation on ECG, while Prinzmetal's angina is characterized by transient ST-segment elevation due to coronary artery vasospasm.
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Upon history-taking, the nurse notes that the cough of a patient with lung cancer usually STARTS off to be ___________.
- A. blood-tinged
- B. dark yellow sputum
- C. productive
- D. dry and persistent
Correct Answer: D
Rationale: The cough of a patient with lung cancer typically starts off as dry and persistent. This is because lung cancer can irritate the airways, leading to a persistent dry cough as an early symptom. As the cancer progresses, the cough may become more productive with blood-tinged or dark yellow sputum. However, in the early stages, the cough is often dry and persistent, which can be a warning sign for healthcare providers to further investigate potential underlying issues such as lung cancer.
A patient receiving palliative care for end-stage liver disease develops hepatic encephalopathy, presenting with confusion and altered mental status. What intervention should the palliative nurse prioritize to manage the patient's symptoms?
- A. Administer lactulose or other ammonia-lowering agents to reduce ammonia levels.
- B. Initiate intravenous fluid therapy to correct electrolyte imbalances.
- C. Refer the patient to a neurologist for evaluation and treatment of encephalopathy.
- D. Prescribe sedative medications to promote sleep and reduce agitation.
Correct Answer: A
Rationale: The most appropriate intervention for managing hepatic encephalopathy in this patient receiving palliative care for end-stage liver disease is to administer lactulose or other ammonia-lowering agents to reduce ammonia levels. Hepatic encephalopathy is believed to be primarily caused by the accumulation of ammonia in the bloodstream due to compromised liver function. Lactulose works by acidifying the gut lumen, which facilitates the excretion of ammonia in the form of ammonium ions. By reducing ammonia levels, hepatic encephalopathy symptoms, such as confusion and altered mental status, can be improved. Initiating other supportive measures like managing precipitating factors, maintaining hydration, and addressing nutritional issues should also be part of the holistic approach in managing hepatic encephalopathy in palliative care. However, addressing the underlying cause by reducing ammonia levels with lactulose is the priority intervention in this scenario.
Which of the following clinical manifestations would the nurse expect to find in the client with rhinitis?
- A. Nasal congestion, rhinorrhea and sneezing
- B. Headache, sore throat and sneezing
- C. Nasal congestion, pyrexic and rhinorrhea
- D. Nasal congestion, headache and sore throat
Correct Answer: A
Rationale: Rhinitis is inflammation of the nasal mucosa, and common clinical manifestations include nasal congestion (blockage or stuffiness), rhinorrhea (runny nose), and sneezing. These symptoms are often present in both allergic and non-allergic rhinitis. While headaches, sore throat, and fever can occur in some cases, they are not as specific to rhinitis as nasal congestion, rhinorrhea, and sneezing.
A patient with a history of coronary artery disease is prescribed aspirin for antiplatelet therapy. Which information is important for the nurse to include in patient education about aspirin therapy?
- A. "Take aspirin with a full glass of milk to minimize gastrointestinal upset."
- B. "Avoid using nonsteroidal anti-inflammatory drugs (NSAIDs) while taking aspirin."
- C. "Discontinue aspirin therapy if you develop a fever."
- D. "Take aspirin on an empty stomach for better absorption."
Correct Answer: B
Rationale: The correct information for the nurse to include in patient education about aspirin therapy is to advise the patient to avoid using nonsteroidal anti-inflammatory drugs (NSAIDs) while taking aspirin. NSAIDs can increase the risk of gastrointestinal bleeding when taken along with aspirin, which is already a blood-thinning medication due to its antiplatelet effects. Patients with coronary artery disease are typically prescribed aspirin for its antiplatelet properties to prevent blood clot formation in the arteries. Avoiding NSAIDs will help reduce the risk of gastrointestinal complications and ensure the effectiveness of aspirin therapy in preventing cardiovascular events. Taking aspirin with a full glass of milk (Option A) is not a necessary instruction for aspirin therapy. Discontinuing aspirin therapy if a patient develops a fever (Option C) is not a standard practice unless advised by a healthcare provider. Taking aspir
Cell-mediated immunity is NOT usually associated with what condition:
- A. Rejection of tissue graft
- B. Production of antibodies
- C. Skin hypersensitivity reaction
- D. Surveying for malignant cells
Correct Answer: B
Rationale: Cell-mediated immunity is a type of immune response that involves the activation of cytotoxic T cells and other immune cells to directly target and destroy infected or abnormal cells. It does not involve the production of antibodies, which are the primary component of humoral immunity. Antibodies are produced by B cells and are responsible for targeting extracellular pathogens such as bacteria and viruses. In contrast, cell-mediated immunity is more focused on targeting intracellular pathogens, cancerous cells, and other cells that have been compromised. So, production of antibodies is not usually associated with cell-mediated immunity.