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A patient presents with redness, pain, and photophobia in the left eye. Slit-lamp examination reveals ciliary injection, corneal edema, and a mid-dilated pupil with fixed reaction to light. Which of the following conditions is most likely responsible for this presentation?
- A. Anterior uveitis
- B. Acute angle-closure glaucoma
- C. Endophthalmitis
- D. Corneal abrasion
Correct Answer: A
Rationale: The presentation described in the question is characteristic of anterior uveitis. Anterior uveitis is inflammation of the iris and ciliary body in the eye. Patients typically present with symptoms such as redness, pain, and photophobia. Slit-lamp examination findings include ciliary injection (redness and engorgement of blood vessels in the ciliary body), corneal edema (swelling of the cornea), and a mid-dilated pupil with a fixed reaction to light due to involvement of the iris muscles. These features differentiate anterior uveitis from other conditions. Treatment of anterior uveitis may involve topical steroids and cycloplegics to reduce inflammation and alleviate symptoms.
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What isotonic electrolyte solutions are COMMONLY used as fluid replacement in hypovolemic shock? I. Dextrose 5 percent in water II. 0.9 percent sodium chloride III. Lactated Ringer's solution IV. Dextrose 10 percent in water
- A. II, III, and IV
- B. II and III
- C. I, III, and IV
- D. I and IV
Correct Answer: B
Rationale: In hypovolemic shock, isotonic electrolyte solutions are commonly used for fluid replacement to restore the circulating blood volume. The commonly used isotonic electrolyte solutions for this purpose are 0.9% sodium chloride (normal saline) and lactated Ringer's solution.
Nurse Merle has to renew her license on or before _____.
- A. 6-Jan-21
- B. 16-Nov-21
- C. 16-Nov-22
- D. 6-Jan-22
Correct Answer: D
Rationale: Nurse Merle has to renew her license on or before January 6, 2022, as that date falls at the end of the standard two-year license renewal cycle for nurses in many jurisdictions. Renewing on or before this date will ensure that Nurse Merle maintains her active licensure status and can continue practicing legally without any interruptions. It is important for healthcare professionals like nurses to stay current with their licensure to uphold professional standards and provide quality care to patients.
A patient with a history of rheumatoid arthritis is prescribed methotrexate. Which laboratory parameter should be monitored closely during methotrexate therapy?
- A. Serum sodium
- B. Serum creatinine
- C. Liver function tests
- D. White blood cell count
Correct Answer: C
Rationale: Methotrexate is a medication commonly used in the treatment of rheumatoid arthritis. It is known to have potential hepatotoxic effects, meaning it can harm the liver. Monitoring liver function tests (such as alanine aminotransferase (ALT), aspartate aminotransferase (AST), and bilirubin levels) is essential to detect any liver damage early on during methotrexate therapy. By closely monitoring liver function tests, healthcare providers can assess the medication's impact on the liver and determine if any dose adjustments or discontinuation of the drug is necessary to prevent further liver damage. Regular monitoring of liver function tests helps ensure the safe and effective use of methotrexate in patients with rheumatoid arthritis.
While preparing the operating room (OR) for a surgical procedure, the nurse notices that the surgical instrument tray is incomplete. What should the nurse do?
- A. Proceed with the procedure using the available instruments
- B. Document the missing instruments in the surgical count log
- C. Inform the sterile processing department and request additional instruments
- D. Borrow the missing instruments from another OR Professionalism and Fundamentals of Nursing
Correct Answer: C
Rationale: It is crucial to have a complete set of surgical instruments for any surgical procedure to ensure patient safety and the success of the surgery. If the nurse notices that the surgical instrument tray is incomplete, the best course of action is to inform the sterile processing department immediately. By doing so, the missing instruments can be promptly provided, ensuring that the surgical team has all the necessary tools for the procedure. Proceeding with the procedure using incomplete instruments can compromise patient safety and the quality of care provided. Documenting the missing instruments in the surgical count log is important for record-keeping purposes but should not delay the immediate action of requesting additional instruments. Borrowing instruments from another OR is not recommended as it can create confusion, potential cross-contamination, and disrupt the workflow of another surgical team.
A patient expresses religious beliefs that conflict with a recommended treatment plan. What is the nurse's best approach?
- A. Disregard the patient's religious beliefs and insist on the recommended treatment.
- B. Listen actively to the patient's religious beliefs, respect their autonomy, and explore alternative options.
- C. Ignore the patient's religious beliefs and proceed with implementing the recommended treatment.
- D. Tell the patient that their religious beliefs are irrelevant to their medical care.
Correct Answer: B
Rationale: The best approach for the nurse in this situation is to listen actively to the patient's religious beliefs, respect their autonomy, and explore alternative treatment options. It is important for the nurse to understand and acknowledge the patient's perspective, even if it conflicts with the recommended treatment plan. By showing respect for the patient's beliefs and involving them in the decision-making process, the nurse can work collaboratively with the patient to find a solution that aligns with their religious beliefs while also addressing their medical needs. This approach promotes patient-centered care and helps build a trusting and therapeutic relationship between the nurse and the patient.