Nokea
A patient presents with progressive hearing loss, tinnitus, and vertigo. Audiometric testing reveals sensorineural hearing loss with a "carrot-shaped" configuration. Which of the following conditions is most likely responsible for this presentation?
- A. Presbycusis
- B. Noise-induced hearing loss
- C. Ménière's disease
- D. Acoustic neuroma
Correct Answer: C
Rationale: Ménière's disease is characterized by the triad of symptoms including progressive sensorineural hearing loss, tinnitus, and vertigo. The audiometric testing in Ménière's disease often shows a "carrot-shaped" configuration, which refers to low-frequency hearing loss initially and eventually spreading to involve higher frequencies. This distinctive pattern of hearing loss helps differentiate Ménière's disease from other causes like Presbycusis (age-related hearing loss) or Noise-induced hearing loss. Acoustic neuroma can present with unilateral sensorineural hearing loss but typically does not exhibit the specific "carrot-shaped" configuration seen in Ménière's disease.
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A nurse is preparing to perform a bladder catheterization for a patient with urinary retention. What action should the nurse prioritize to minimize the risk of infection?
- A. Using sterile gloves and a surgical mask during catheterization
- B. Cleansing the perineal area with povidone-iodine solution before catheter insertion
- C. Administering prophylactic antibiotics before the catheterization procedure
- D. Using aseptic technique and sterile equipment during catheter insertion
Correct Answer: D
Rationale: Using aseptic technique and sterile equipment during catheter insertion is crucial for minimizing the risk of infection during bladder catheterization. Aseptic technique involves maintaining a sterile field, washing hands thoroughly, using sterile gloves, and ensuring that all equipment used is sterile. By following these practices, the nurse can prevent introducing bacteria into the urinary tract, reducing the likelihood of infection in the patient. While cleansing the perineal area with antiseptic solutions is important for general hygiene, the priority for infection prevention during catheterization lies in maintaining a sterile environment during the procedure. Administering prophylactic antibiotics is not routinely recommended for catheterization unless there are specific risk factors present.
A patient presents with sudden-onset severe headache, nausea, vomiting, and photophobia. On examination, there is neck stiffness and positive Kernig and Brudzinski signs. Which of the following neurological conditions is most likely responsible for these symptoms?
- A. Meningitis
- B. Subdural hematoma
- C. Intracerebral hemorrhage
- D. Acute angle-closure glaucoma
Correct Answer: A
Rationale: The symptoms described - sudden-onset severe headache, nausea, vomiting, photophobia, neck stiffness, and positive Kernig and Brudzinski signs - are classic manifestations of meningitis. Meningitis is an inflammation of the meninges, the protective membranes covering the brain and spinal cord, often caused by infection. The sudden onset of these symptoms and signs, along with neck stiffness and positive Kernig and Brudzinski signs (indicative of meningeal irritation), strongly suggest meningitis as the most likely diagnosis in this scenario.
A client with end-stage renal disease decides against further treatment and requests a "Do Not Resuscitate" (DNR) order. The DNR status is part of the change-of-shift report. The client stops breathing and a nurse begins cardiopulmonary resuscitation. The family is upset and makes a complaint to the charge nurse. The charge nurse appropriately identifies that nurse has committed:
- A. Defamation
- B. assault
- C. battery .
- D. fraud.
Correct Answer: C
Rationale: Battery occurs when there is an intentional touching of another person without their consent. In this case, the nurse began cardiopulintary resuscitation on a client who had requested a "Do Not Resuscitate" (DNR) order, which means the client did not consent to the resuscitation. This action can be considered as battery because the client's wishes were not respected, and the nurse proceeded with a medical intervention against those wishes, leading to harm and potential legal consequences. This is different from assault, which involves a threat of force, and from defamation and fraud, which are not applicable to this situation.
A patient presents with a thyroid nodule and compressive symptoms such as difficulty swallowing and breathing. Fine-needle aspiration biopsy reveals colloid nodules. Which endocrine disorder is most likely responsible for these symptoms?
- A. Hashimoto's thyroiditis
- B. Graves' disease
- C. Diabetes mellitus
- D. Thyroid nodules
Correct Answer: D
Rationale: Thyroid nodules are abnormal growths of thyroid cells that form a lump within the thyroid gland. When a thyroid nodule becomes large enough, it can cause compressive symptoms such as difficulty swallowing and breathing. The presence of colloid nodules on fine-needle aspiration biopsy indicates a benign and common type of thyroid nodule. In this case, the symptoms are likely due to the physical pressure exerted by the thyroid nodule, rather than an underlying endocrine disorder like Hashimoto's thyroiditis, Graves' disease, or diabetes mellitus. Therefore, the most likely cause of the patient's symptoms is the thyroid nodule itself.
A postpartum client who delivered vaginally reports difficulty emptying the bladder completely and experiences urinary frequency. What nursing intervention should be prioritized to address this issue?
- A. Assessing for signs of urinary retention or bladder distention
- B. Encouraging the client to increase fluid intake to promote urination
- C. Recommending the use of warm compresses to the suprapubic area
- D. Teaching the client pelvic floor exercises to improve bladder control
Correct Answer: A
Rationale: The priority nursing intervention in this situation is to first assess the client for signs of urinary retention or bladder distention. Difficulty in emptying the bladder completely and experiencing urinary frequency can be indications of urinary retention, which can lead to bladder distention and possible complications such as urinary tract infection. By assessing the client, the nurse can determine the cause of the issue and implement appropriate interventions. It is crucial to address potential complications promptly to promote the client's health and well-being postpartum. Once the assessment is completed, further interventions such as recommending appropriate measures, like warm compresses or pelvic floor exercises, can be considered based on the assessment findings.