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A patient presents with gross hematuria, flank pain, and a palpable abdominal mass. Imaging reveals a large heterogeneous renal mass with areas of necrosis and calcifications. Which of the following conditions is most likely?
- A. Renal cell carcinoma
- B. Renal cyst
- C. Renal abscess
- D. Renal angiomyolipoma
Correct Answer: A
Rationale: The clinical presentation of gross hematuria, flank pain, palpable abdominal mass, along with imaging findings of a large heterogeneous renal mass with necrosis and calcifications are highly suggestive of renal cell carcinoma (RCC). RCC is the most common type of kidney cancer in adults. The presence of necrosis and calcifications are characteristic features of RCC. Imaging modalities such as CT scans or MRI can confirm the diagnosis by showing the typical features of RCC, including a solid mass with areas of necrosis and calcifications. It is important to further evaluate this patient, likely with a biopsy, to confirm the diagnosis and determine the extent of the disease for appropriate management.
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When the staff nurses in Pediatric Ward work more than they can handle, thus, losing their enthusiasm in their work, which of the following consequences is referred to/
- A. Lower patient care
- B. Low quality patient care
- C. Medical errors
- D. Burnout
Correct Answer: D
Rationale: Burnout is a state of emotional, physical, and mental exhaustion caused by excessive and prolonged stress. In this scenario, when staff nurses in the Pediatric Ward are working more than they can handle, they may experience burnout. Burnout can lead to a decrease in enthusiasm for work, feelings of depersonalization, and a reduced sense of personal accomplishment. These consequences can ultimately impact the quality of patient care provided by the nurses. Burnout not only affects the well-being of the healthcare workers but can also result in lower patient care quality, medical errors, and decreased overall job performance. Addressing and preventing burnout is crucial in maintaining a high standard of care and ensuring the well-being of healthcare professionals.
Which of the following is the central theme of Sr. Calista Roys theory
- A. Self care deficit
- B. Nursing as caring
- C. Adaptation
- D. Transcultural
Correct Answer: C
Rationale: The central theme of Sr. Callista Roy's theory is adaptation. Roy's Adaptation Model focuses on the individual's ability to adapt to internal and external stimuli in order to maintain health and well-being. The theory emphasizes the interconnectedness of the individual and their environment, highlighting the dynamic process of adaptation in response to stimuli. By focusing on adaptation, Roy's theory guides nursing practice in promoting holistic care that supports individuals in adapting to changes and achieving optimal health outcomes.
What drug should the nurse prepare for administration to reverse all signs of toxicity?
- A. Digibind (Digoxin)
- B. Atropine sulfate
- C. Naloxone (Narcan)
- D. Diazepam (Valium)
Correct Answer: C
Rationale: Naloxone, also known by the brand name Narcan, is used to reverse the effects of opioid overdose. Opioids can cause respiratory depression, sedation, and other signs of toxicity. Administering naloxone can quickly reverse these effects, restoring the patient's breathing and consciousness. This makes it the appropriate choice for reversing all signs of toxicity related to opioids. Digibind (Digoxin) is used to reverse toxicity from digoxin specifically. Atropine sulfate is used for bradycardia. Diazepam (Valium) is a benzodiazepine used for anxiety, seizures, and muscle relaxation, not for reversing toxicity.
A patient is complaining of urinary pain after being diagnosed with a urinary tract infection the previous day. What is the nurse's best action?
- A. Administer ordered phenazopyridine hydrochloride (Pyridium).
- B. Administer ordered trimethoprim (Trimpex).
- C. Administer ordered bethanechol (Urecholine).
- D. Administer ordered acetaminophen (Tylenol) and a warm bath.
Correct Answer: B
Rationale: The nurse's best action in this situation would be to administer the ordered antibiotic trimethoprim (Trimpex). A urinary tract infection (UTI) requires antibiotic treatment to eliminate the bacterial infection causing the symptoms. Phenazopyridine hydrochloride is a urinary tract analgesic that can help relieve urinary pain but does not treat the infection itself. Bethanechol is a cholinergic medication used to treat urinary retention, not a UTI. Acetaminophen and a warm bath may help with some discomfort but do not address the underlying infection causing the urinary pain. Therefore, administering the prescribed antibiotic would be the most appropriate action to target the source of the patient's symptoms.
Which should be emhpasize by the nurse in her health teachings
- A. Jogging a mile a day
- B. Vigourous exercise
- C. No need to diet
- D. Weight reduction
Correct Answer: D
Rationale: Weight reduction is the most important focus in the health teachings provided by the nurse. Maintaining a healthy weight is crucial for overall well-being and can significantly reduce the risk of various health conditions such as heart disease, diabetes, and certain cancers. By emphasizing weight reduction, the nurse can help improve the patient's overall health and quality of life. Jogging a mile a day and vigorous exercise are beneficial for weight management, but it is important to address the root cause of potential health problems which in this case may be excess weight. Moreover, emphasizing the importance of weight reduction does not necessarily mean encouraging extreme dieting; instead, it involves promoting a balanced and healthy approach to eating and physical activity.