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A patient presents with chest pain that occurs at rest and is exacerbated by deep breathing or changes in body position. The pain improves with leaning forward. Which cardiovascular disorder is most likely responsible for these symptoms?
- A. Stable angina
- B. Unstable angina
- C. Pericarditis
- D. Myocarditis
Correct Answer: C
Rationale: Pericarditis is the inflammation of the pericardium, the sac surrounding the heart. Patients with pericarditis typically present with sharp chest pain that worsens with deep breathing, changes in body position, and coughing. The pain tends to improve when the patient leans forward. This characteristic symptom of pericarditis is known as "pleuritic" chest pain. In contrast, stable angina presents as predictable chest pain that occurs with exertion and is relieved by rest or medications. Unstable angina is characterized by chest pain that occurs at rest or with minimal exertion and is considered a medical emergency. Myocarditis involves inflammation of the heart muscle and may present with symptoms such as chest pain, but it does not typically have the characteristic of worsening with deep breathing or changes in body position.
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While positioning the patient for surgery, the nurse notices that the patient's skin is not adequately protected from pressure injuries. What should the nurse do?
- A. Apply a pressure-relieving device to the bony prominences
- B. Document the observation in the preoperative checklist
- C. Reposition the patient to alleviate pressure on vulnerable areas
- D. Continue with the positioning as planned
Correct Answer: C
Rationale: The nurse should reposition the patient to alleviate pressure on vulnerable areas. Pressure injuries can develop when there is prolonged pressure on specific areas of the skin, leading to reduced blood flow and tissue damage. Repositioning the patient helps to relieve the pressure and prevent the development of pressure injuries. Applying a pressure-relieving device may also be helpful, but the immediate action should be to reposition the patient to address the issue. Documenting the observation is important for documentation purposes, but the priority is to take action to prevent harm to the patient. Continuing with the positioning as planned without addressing the inadequate skin protection could lead to the development of pressure injuries, which should be avoided.
Doing year end performance evaluation of the staff is an example of
- A. Planning
- B. Organizing
- C. Controlling
- D. Staffing
Correct Answer: C
Rationale: Conducting a year-end performance evaluation of the staff is an example of a controlling function in management. Controlling involves monitoring and evaluating the performance of employees to ensure that they are working effectively and meeting the set goals and standards. By assessing the staff's performance at the end of the year, managers can identify areas of improvement, provide feedback, and make necessary adjustments to ensure the overall success of the organization. Hence, the process of evaluating staff performance falls under the controlling function of management.
In conducting a study on sleep, Nurse Trining was asked which of the types of research will be used should it involve collecting numerical data which is most often under considerable control. Her answer should be _________.
- A. Ichnographic
- B. Qualitative
- C. Phenomenological
- D. Quantitative
Correct Answer: D
Rationale: Quantitative research is the type of research that involves collecting numerical data, which can be easily quantified and analyzed statistically. It is characterized by its structured methodology, objectivity, and the ability to control variables to a considerable extent. In the context of a study on sleep, where data related to sleep patterns, duration, quality, etc., need to be measured and analyzed in a systematic manner, quantitative research would be the most appropriate choice. This type of research allows for a more precise understanding of the relationships and patterns within the data, providing valuable insights into the sleep-related factors being studied.
A patient presents with fatigue, weakness, and jaundice. Laboratory tests reveal hemolytic anemia, elevated LDH, decreased haptoglobin, and presence of schistocytes on peripheral blood smear. Which of the following conditions is most likely to cause these findings?
- A. Hereditary spherocytosis
- B. Glucose-6-phosphate dehydrogenase (G6PD) deficiency
- C. Autoimmune hemolytic anemia (AIHA)
- D. Thalassemia
Correct Answer: B
Rationale: Glucose-6-phosphate dehydrogenase (G6PD) deficiency is an X-linked recessive disorder that leads to hemolytic anemia in response to oxidative stress. The patient's presentation of fatigue, weakness, and jaundice along with laboratory findings of hemolytic anemia (evidenced by schistocytes), elevated LDH, and decreased haptoglobin are all characteristic of G6PD deficiency. The oxidative stress causes red blood cell destruction, resulting in the release of LDH and bilirubin, leading to jaundice. Decreased haptoglobin is seen due to its consumption in binding free hemoglobin released from the lysed red blood cells. Additionally, the presence of schistocytes on a peripheral blood smear is indicative of red blood cell fragmentation, a common finding in hemolytic anemias including G6PD deficiency
A patient presents with sudden onset of severe, unilateral ear pain, diminished hearing, and purulent otorrhea. Otoscopic examination reveals a bulging, erythematous tympanic membrane with obscured landmarks. Which of the following conditions is most likely responsible for this presentation?
- A. Otitis externa
- B. Acute otitis media
- C. Mastoiditis
- D. Chronic suppurative otitis media
Correct Answer: B
Rationale: Acute otitis media is the most likely condition responsible for this presentation. The sudden onset of severe, unilateral ear pain, diminished hearing, and purulent otorrhea are classic symptoms of acute otitis media. Otoscopic examination revealing a bulging, erythematous tympanic membrane with obscured landmarks further supports the diagnosis. The bulging of the tympanic membrane is due to the accumulation of fluid and pus behind it, causing the characteristic appearance. Treatment typically involves antibiotics to help clear the infection and relieve symptoms. If left untreated, acute otitis media can lead to complications such as perforation of the eardrum or mastoiditis.