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A patient presents with recurrent episodes of vertigo, nausea, and nystagmus, often triggered by head movements. Dix-Hallpike maneuver elicits positional vertigo and rotary nystagmus. Which of the following conditions is most likely responsible for this presentation?
- A. Ménière's disease
- B. Benign paroxysmal positional vertigo (BPPV)
- C. Vestibular neuritis
- D. Labyrinthitis
Correct Answer: B
Rationale: The patient's presentation with recurrent episodes of vertigo, nausea, and nystagmus triggered by head movements, along with a positive Dix-Hallpike maneuver eliciting positional vertigo and rotary nystagmus, is classic for Benign Paroxysmal Positional Vertigo (BPPV). BPPV is the most common cause of vertigo due to a mechanical problem in the inner ear. In BPPV, brief episodes of vertigo are typically triggered by specific head movements, such as rolling over in bed or looking up. The characteristic rotary nystagmus observed in BPPV is consistent with the brief, intense episodes of vertigo that patients experience. The Dix-Hallpike maneuver, commonly used to diagnose BPPV, involves moving the patient from sitting to a supine head-hanging position and can induce vertigo and nystagmus in affected
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A 28-year-old woman presents with cyclic pelvic pain, dysmenorrhea, and infertility. On pelvic examination, tender nodules are palpated along the uterosacral ligaments. Which of the following conditions is most likely to be responsible for these findings?
- A. Polycystic ovary syndrome (PCOS)
- B. Endometriosis
- C. Adenomyosis
- D. Leiomyomas (uterine fibroids)
Correct Answer: B
Rationale: Endometriosis is a chronic gynecologic condition characterized by the presence of endometrial-like tissue outside the uterus, commonly on structures within the pelvis. The classic symptoms of endometriosis include cyclic pelvic pain, dysmenorrhea (painful periods), and infertility. On pelvic examination, tender nodules or masses may be palpated along the uterosacral ligaments. These nodules are often referred to as "endometriotic implants" or "chocolate cysts." Endometriosis can cause inflammation, scarring, and adhesions in the pelvis, leading to symptoms such as pain and infertility. Polycystic ovary syndrome (PCOS) is characterized by ovarian dysfunction and hormonal imbalances, often leading to irregular periods and symptoms related to excess androgens. Adenomyosis is the presence of endometrial tissue within the myometrium of the uterus, leading
A patient presents with a small, painless, well-defined nodule on the lateral aspect of the neck, just above the clavicle. Fine-needle aspiration cytology reveals clusters of polygonal cells with abundant granular cytoplasm. Which of the following conditions is most likely responsible for this presentation?
- A. Thyroglossal duct cyst
- B. Branchial cleft cyst
- C. Lymphadenopathy
- D. Parathyroid adenoma
Correct Answer: D
Rationale: The presentation described is characteristic of a parathyroid adenoma. Parathyroid adenomas are benign neoplasms that can present as painless, well-defined nodules usually located in the lower pole of the thyroid gland or in close proximity, such as the lateral aspect of the neck above the clavicle. Fine-needle aspiration cytology of a parathyroid adenoma typically reveals polygonal cells with abundant granular cytoplasm, often referred to as chief cells. This is key in differentiating it from other conditions mentioned in the question.
The patient seems indecisive whether to breastfeed her baby or not. Which is the desired nursing action of Nurse Vera to help the pregnant patient make a decision on breastfeeding?
- A. Give pamphlets and books to read.
- B. Provide ample time for the patient to decide.
- C. Refer the patient to the nutrionist.
- D. Assist to identify breastfeeding goal and plan.
Correct Answer: D
Rationale: The desired nursing action to help the pregnant patient make a decision on breastfeeding is to assist in identifying a breastfeeding goal and plan. When patients are indecisive about breastfeeding, it is essential for the nurse to support them in setting specific goals and creating a plan that aligns with their values and circumstances. This approach can help the patient feel empowered and confident in their decision-making process. Providing pamphlets and books (choice A) may be helpful, but personalized assistance in identifying a breastfeeding goal and plan is more likely to address the patient's individual needs and concerns. Providing ample time for the patient to decide (choice B) is important, but guidance and support in setting a clear goal can facilitate the decision-making process. Referring the patient to a nutritionist (choice C) may be beneficial for dietary concerns but may not directly address the decision-making process regarding breastfeeding.
A patient with a history of coronary artery disease is prescribed aspirin for antiplatelet therapy. Which information is important for the nurse to include in patient education about aspirin therapy?
- A. "Take aspirin with a full glass of milk to minimize gastrointestinal upset."
- B. "Avoid using nonsteroidal anti-inflammatory drugs (NSAIDs) while taking aspirin."
- C. "Discontinue aspirin therapy if you develop a fever."
- D. "Take aspirin on an empty stomach for better absorption."
Correct Answer: B
Rationale: The correct information for the nurse to include in patient education about aspirin therapy is to advise the patient to avoid using nonsteroidal anti-inflammatory drugs (NSAIDs) while taking aspirin. NSAIDs can increase the risk of gastrointestinal bleeding when taken along with aspirin, which is already a blood-thinning medication due to its antiplatelet effects. Patients with coronary artery disease are typically prescribed aspirin for its antiplatelet properties to prevent blood clot formation in the arteries. Avoiding NSAIDs will help reduce the risk of gastrointestinal complications and ensure the effectiveness of aspirin therapy in preventing cardiovascular events. Taking aspirin with a full glass of milk (Option A) is not a necessary instruction for aspirin therapy. Discontinuing aspirin therapy if a patient develops a fever (Option C) is not a standard practice unless advised by a healthcare provider. Taking aspir
Which of the following is a common complication associated with prostatectomy for the treatment of benign prostatic hyperplasia (BPH)?
- A. Erectile dysfunction
- B. Urinary incontinence
- C. Retrograde ejaculation
- D. Urethral stricture
Correct Answer: B
Rationale: Urinary incontinence is a common complication associated with prostatectomy for the treatment of benign prostatic hyperplasia (BPH). Prostate surgery, such as a prostatectomy, can disrupt the sphincter muscle that controls the flow of urine from the bladder, leading to temporary or even long-term urinary incontinence in some patients. This usually improves over time with pelvic floor exercises and other treatment options, but it is an important consideration when discussing the potential risks and benefits of prostate surgery with patients. While erectile dysfunction and retrograde ejaculation can also be potential side effects of prostate surgery, urinary incontinence is specifically associated with issues related to bladder control following the procedure. Urethral stricture, although it can occur post prostate surgery, is less common compared to urinary incontinence.