Nokea
A patient presents with sudden-onset, painless vision loss in the right eye. Fundoscopic examination reveals a cherry-red spot at the macula and attenuated retinal vessels. Which of the following conditions is most likely responsible for this presentation?
- A. Central retinal artery occlusion
- B. Central retinal vein occlusion
- C. Retinal detachment
- D. Acute angle-closure glaucoma
Correct Answer: A
Rationale: The correct answer is A: Central retinal artery occlusion. This condition presents with sudden-onset, painless vision loss, cherry-red spot at the macula due to lack of blood flow, and attenuated retinal vessels. The cherry-red spot is due to the transparency of the fovea when there is ischemia in the surrounding retina. Central retinal vein occlusion (B) presents with sudden vision loss accompanied by retinal hemorrhages and dilated tortuous veins. Retinal detachment (C) typically presents with sudden flashes, floaters, and a curtain-like visual field defect. Acute angle-closure glaucoma (D) presents with severe eye pain, blurred vision, halos around lights, and a fixed mid-dilated pupil.
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Nurse Pedrito is teaching a client with Parkinson's disease on ways to prevent curvatures of the spine associated with the disease. To prevent spinal flexion, the nurse should tell the client to _________.
- A. Rest in supine position with his head elevated.
- B. Sleep only in dorsal recumbent position.
- C. Periodically lie in prone position without a neck pillow.
- D. Sleep on either side, but keep his back straight.
Correct Answer: C
Rationale: The correct answer is C: Periodically lie in prone position without a neck pillow. This position helps to prevent spinal flexion by promoting extension of the spine and stretching of the hip flexors. Prone positioning also helps maintain alignment of the spine and prevents contractures. Resting in supine position (choice A) with the head elevated does not promote spinal extension. Sleeping only in dorsal recumbent position (choice B) may lead to spinal flexion. Sleeping on either side (choice D) does not specifically address spinal flexion prevention.
Which of the following conditions is characterized by inflammation of the glomeruli in the kidneys, leading to hematuria, proteinuria, and hypertension?
- A. Acute tubular necrosis
- B. Acute glomerulonephritis
- C. Chronic kidney disease
- D. Nephrotic syndrome
Correct Answer: B
Rationale: The correct answer is B: Acute glomerulonephritis. Glomerulonephritis is characterized by inflammation of the glomeruli in the kidneys, leading to symptoms like hematuria (blood in urine), proteinuria (excess protein in urine), and hypertension (high blood pressure).
Acute tubular necrosis (A) involves damage to the renal tubules, not the glomeruli. Chronic kidney disease (C) refers to long-term kidney damage and may not always present with the classic symptoms mentioned. Nephrotic syndrome (D) involves excessive protein loss in urine but may not always involve inflammation of the glomeruli.
A patient with a history of stroke is prescribed clopidogrel (Plavix) for secondary prevention of thrombotic events. Which laboratory test should the nurse monitor closely during clopidogrel therapy?
- A. Prothrombin time (PT)
- B. Activated partial thromboplastin time (aPTT)
- C. Platelet count
- D. International normalized ratio (INR)
Correct Answer: C
Rationale: The correct answer is C: Platelet count. Platelet count should be monitored closely during clopidogrel therapy because it works by inhibiting platelet aggregation, reducing the risk of clot formation. Monitoring platelet count helps assess the drug's effectiveness and prevent potential complications like bleeding or clotting events. Prothrombin time (A), activated partial thromboplastin time (B), and international normalized ratio (D) are tests that primarily assess the coagulation factors and are not directly affected by clopidogrel therapy, making them less relevant for monitoring this specific medication.
A woman in active labor demonstrates signs of prolonged second stage, characterized by ineffective pushing efforts and slow fetal descent. What maternal condition should the nurse assess for that may contribute to this abnormal labor pattern?
- A. Maternal fatigue
- B. Pelvic floor dysfunction
- C. Fetal macrosomia
- D. Maternal hypotension
Correct Answer: B
Rationale: When a woman in active labor exhibits signs of prolonged second stage, such as ineffective pushing efforts and slow fetal descent, one of the maternal conditions that should be considered is pelvic floor dysfunction. The pelvic floor muscles play a crucial role in supporting the uterus, bladder, and rectum. If these muscles are weak or dysfunctional, it can lead to difficulty in pushing effectively and impede the descent of the fetus through the birth canal. This can result in prolonged labor and increase the risk of complications for both the mother and the baby. Therefore, assessing for pelvic floor dysfunction is important in addressing the abnormal labor pattern and providing appropriate interventions to support the progress of labor.
Which of the following directly VIOLATES the Patient's Bill of Rights?
- A. Informing patients about the billing policies of the hospital.
- B. Disclosing the HIV result to members of the patient's family.
- C. Honestly telling the patient about his current condition.
- D. Immediately referring results of laboratory to the physician.
Correct Answer: B
Rationale: The correct answer is B because disclosing a patient's HIV status to family members violates the patient's right to privacy and confidentiality. Patient confidentiality is a fundamental aspect of the Patient's Bill of Rights, ensuring that personal health information is protected. The other choices (A, C, D) do not directly violate the Patient's Bill of Rights. Choice A relates to transparency in billing, choice C is about honesty in communication, and choice D is about timely communication with the physician, all of which are in line with patient rights and quality care.