Nokea
A patient presents with muscle weakness and fatigue. Upon further examination, it is revealed that the patient has decreased acetylcholine receptors at the neuromuscular junction. Which of the following conditions is most likely responsible for this presentation?
- A. Myasthenia gravis
- B. Amyotrophic lateral sclerosis (ALS)
- C. Guillain-Barre syndrome
- D. Muscular dystrophy
Correct Answer: A
Rationale: The correct answer is A: Myasthenia gravis. In myasthenia gravis, there is a decrease in acetylcholine receptors at the neuromuscular junction, leading to muscle weakness and fatigue. This occurs due to autoimmune destruction of these receptors. ALS (B) affects motor neurons, not acetylcholine receptors. Guillain-Barre syndrome (C) is an autoimmune disorder affecting peripheral nerves, not neuromuscular junctions. Muscular dystrophy (D) is a genetic disorder causing muscle degeneration, not affecting acetylcholine receptors.
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Which diagnostic procedure is commonly used to establish the diagnosis of lung cancer which provides a detailed description of the tracheobronchial tree and allows for biopsies of suspicious areas?
- A. Computerized Tomography (CT) scan
- B. Bronchoscopy
- C. Sputum cytology
- D. Positron Emission Tomography (PET)
Correct Answer: B
Rationale: The correct answer is B: Bronchoscopy. This procedure involves inserting a thin, flexible tube with a camera through the mouth or nose to examine the tracheobronchial tree. It allows direct visualization of the airways, collection of tissue samples for biopsy, and detection of abnormalities like tumors. A: CT scan provides detailed images of the lungs but does not allow for direct tissue sampling. C: Sputum cytology involves examining sputum for cancer cells but may not provide accurate results. D: PET scan is used to detect metabolic activity in tissues, including tumors, but does not provide detailed visualization of the airways or allow for biopsies.
A patient receiving palliative care for end-stage renal disease is experiencing symptoms of depression. Which intervention should the palliative nurse prioritize?
- A. Encourage the patient to engage in social activities to alleviate depression.
- B. Refer the patient to a psychiatrist for pharmacological management of depression.
- C. Provide emotional support and offer counseling or therapy sessions.
- D. Explore the patient's spiritual beliefs and offer spiritual care interventions.
Correct Answer: C
Rationale: The correct answer is C because providing emotional support and offering counseling or therapy sessions address the root cause of the patient's depression in a holistic manner. This intervention allows the patient to express their emotions, process their feelings, and receive guidance on coping strategies. Encouraging social activities (A) may not directly address the underlying emotional issues. Referring to a psychiatrist for medication (B) should be considered if counseling alone is insufficient. Exploring spiritual beliefs (D) is important but may not be the most immediate priority for addressing depression in this context.
A patient is prescribed a selective serotonin reuptake inhibitor (SSRI) for the treatment of depression. Which adverse effect should the nurse monitor closely in the patient?
- A. Bradycardia
- B. Hyperkalemia
- C. Hyponatremia
- D. Hypertension
Correct Answer: C
Rationale: The correct answer is C: Hyponatremia. SSRI medications can lead to the syndrome of inappropriate antidiuretic hormone secretion (SIADH), causing hyponatremia. This occurs due to increased levels of serotonin affecting the hypothalamus, leading to excessive ADH release. Hyponatremia can result in neurological symptoms and must be closely monitored.
A: Bradycardia is not a common adverse effect of SSRIs.
B: Hyperkalemia is not typically associated with SSRIs.
D: Hypertension is not a common adverse effect of SSRIs; they may actually lower blood pressure.
At the pre-Entry phase, which of the following is the FIRST step in the CO-PAR process
- A. Survey the community
- B. Train technical working group
- C. Hold a community assembly
- D. Create a core group
Correct Answer: D
Rationale: The correct answer is D: Create a core group. In the CO-PAR process, creating a core group is the first step in the pre-Entry phase as it establishes a team of committed individuals who will lead the participatory action research. This core group will provide leadership, coordination, and represent the diversity of the community. Surveying the community (choice A) comes after forming the core group to gather information. Training the technical working group (choice B) and holding a community assembly (choice C) are subsequent steps in the process after the core group is established.
Select the medication that should be discussed by the nurse with the attending physician before administering it to patient with acute angle closure glaucoma
- A. Isoptocarpineeyedrops
- B. Mannitol
- C. Corticosporin ophthalmic
- D. Atropine
Correct Answer: D
Rationale: The correct answer is D: Atropine. Atropine is a mydriatic agent that can exacerbate acute angle closure glaucoma by dilating the pupil and potentially worsening the condition. The nurse should discuss with the attending physician before administering it to avoid worsening the patient's condition.
A: Isopto carpine eye drops are actually used in the treatment of acute angle closure glaucoma as they help in lowering intraocular pressure, so there is no need to discuss this with the physician.
B: Mannitol is used as an osmotic diuretic to reduce intraocular pressure in acute angle closure glaucoma, and it does not directly affect the pupil, so it does not require discussion with the physician before administration.
C: Corticosporin ophthalmic is a combination of an antibiotic and a corticosteroid used to treat eye infections and inflammation, but it does not have a direct effect on worsening acute angle closure glaucoma, so it does