Nokea
A patient presents with petechiae, purpura, and mucosal bleeding. Laboratory tests reveal thrombocytopenia, elevated serum creatinine, and schistocytes on peripheral blood smear. Which of the following conditions is most likely to cause these findings?
- A. Thrombotic thrombocytopenic purpura (TTP)
- B. Idiopathic thrombocytopenic purpura (ITP)
- C. Hemolytic uremic syndrome (HUS)
- D. Disseminated intravascular coagulation (DIC)
Correct Answer: A
Rationale: Thrombotic thrombocytopenic purpura (TTP) is a rare but serious condition characterized by microangiopathic hemolytic anemia, thrombocytopenia, neurological abnormalities, fever, and renal dysfunction. The classic pentad of symptoms includes fever, neurologic changes, renal impairment, thrombocytopenia, and microangiopathic hemolytic anemia. The presence of petechiae, purpura, and mucosal bleeding along with thrombocytopenia, elevated serum creatinine, and schistocytes on peripheral blood smear are consistent with TTP. In TTP, there is usually a deficiency of ADAMTS13 (a von Willebrand factor-cleaving protease) leading to excessive platelet adhesion, aggregation, and microthrombi formation within small blood vessels. Treatment typically
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A patient with terminal cancer is experiencing dyspnea due to pleural effusion. What intervention should the palliative nurse prioritize to manage the patient's symptoms?
- A. Administer bronchodilator medications to improve airway clearance.
- B. Perform thoracentesis to drain the pleural fluid and relieve dyspnea.
- C. Recommend non-invasive positive pressure ventilation for respiratory support.
- D. Encourage the patient to practice relaxation techniques to reduce anxiety.
Correct Answer: B
Rationale: The palliative nurse should prioritize performing thoracentesis to drain the pleural fluid and relieve dyspnea in a patient with terminal cancer experiencing pleural effusion. Pleural effusion is a common complication in patients with advanced cancer and can cause significant respiratory distress. Drainage of the pleural fluid through thoracentesis can provide immediate relief by easing the pressure on the lungs and improving the patient's ability to breathe. This intervention is essential in managing dyspnea for comfort and quality of life in palliative care settings. Administering bronchodilator medications (option A) or recommending non-invasive positive pressure ventilation (option C) may not directly address the underlying cause of dyspnea in this case. While relaxation techniques (option D) can help with anxiety and overall well-being, they may not be sufficient in managing the physical symptom of dyspnea caused by pleural effusion.
On which occasion would a nurse can be charged with negligence?
- A. Giving the patient the wrong medication.
- B. Giving competent care.
- C. Following standards of care.
- D. Communicating with another health team.
Correct Answer: A
Rationale: A nurse can be charged with negligence when they give the patient the wrong medication. Negligence in healthcare typically refers to a situation where a healthcare provider fails to provide a standard level of care, resulting in harm to the patient. Giving the wrong medication can lead to serious consequences for the patient, including adverse reactions, worsening of the condition, or even death. It is a clear violation of the duty of care that a nurse owes to their patients, and such a mistake can have legal and professional repercussions for the nurse.
Ms. Ruby 28 year old also a patient of Nurse Gladys is suffering from Rheumatic fever due to a previous streptococcal infection. In monitoring patient's status, the nurse should document which of the following TYPICAL manifestation EXCEPT ______.
- A. Increase body temperature
- B. Voluntary muscle spasm
- C. Non-pruritic rashes
- D. Migratory joint pains
Correct Answer: B
Rationale: In patients with Rheumatic fever, typical manifestations include an increase in body temperature, non-pruritic rashes, and migratory joint pains. Voluntary muscle spasm is not a typical manifestation of Rheumatic fever. The main clinical features of Rheumatic fever are related to the inflammation of the heart, joints, skin, and central nervous system. Muscle spasms are not a prominent feature of this condition. It is important for the nurse to be aware of these typical manifestations to effectively monitor and manage the patient's condition.
A postpartum client with a history of gestational diabetes expresses concern about managing blood sugar levels while breastfeeding. What nursing intervention should be prioritized to address the client's concerns?
- A. Educating the client about the importance of balanced nutrition and frequent monitoring of blood glucose levels
- B. Recommending insulin supplementation to maintain target blood sugar levels
- C. Encouraging the client to avoid breastfeeding to prevent fluctuations in blood sugar levels
- D. Referring the client to a dietitian for a specialized postpartum meal plan
Correct Answer: A
Rationale: Educating the client about the importance of balanced nutrition and frequent monitoring of blood glucose levels should be prioritized to address the client's concerns about managing blood sugar levels while breastfeeding. This intervention helps empower the client to make informed choices about her diet and monitor her blood sugar levels effectively. By focusing on balanced nutrition and regular blood glucose monitoring, the client can better manage her blood sugar levels during the postpartum period and while breastfeeding, reducing the risk of complications associated with gestational diabetes. It also promotes overall health and well-being for both the mother and the baby.
A patient is prescribed an antipsychotic medication for the management of schizophrenia. Which adverse effect should the nurse monitor closely in the patient?
- A. Hypertension
- B. Hypoglycemia
- C. Extrapyramidal symptoms
- D. Hypercalcemia
Correct Answer: C
Rationale: Antipsychotic medications, especially first-generation antipsychotics, can cause extrapyramidal symptoms (EPS) as an adverse effect. EPS include symptoms such as muscle rigidity, tremors, akathisia (restlessness), and tardive dyskinesia (involuntary movements of the face and body). These symptoms are due to the medications' effects on the dopamine system in the brain. It is crucial for the nurse to monitor the patient closely for EPS because they can be uncomfortable, distressing, and may impact the patient's quality of life and medication adherence. Early recognition and management of EPS are essential to prevent further complications and improve the patient's overall well-being.