Nokea
A patient presents with sudden-onset, severe eye pain, headache, nausea, and vomiting. On examination, the affected eye appears red, with a steamy cornea and mid-dilated, non-reactive pupil. Which of the following conditions is most likely responsible for this presentation?
- A. Acute angle-closure glaucoma
- B. Central retinal artery occlusion
- C. Optic neuritis
- D. Corneal ulcer
Correct Answer: A
Rationale: The presentation described is consistent with acute angle-closure glaucoma. This condition typically presents with sudden-onset severe eye pain, headache, nausea, and vomiting. On examination, the affected eye appears red, with a steamy cornea due to corneal edema and a mid-dilated, non-reactive pupil due to pupillary block from the forward displacement of the iris. Acute angle-closure glaucoma is considered a medical emergency as it can lead to permanent vision loss if not promptly treated. Prompt management involves reducing intraocular pressure to prevent further damage to the optic nerve.
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A patient with obstructive sleep apnea (OSA) presents with excessive daytime sleepiness, loud snoring, and witnessed apneic episodes during sleep. Which of the following interventions is most appropriate for managing OSA and improving symptoms?
- A. Weight loss and lifestyle modifications
- B. Continuous positive airway pressure (CPAP) therapy
- C. Oral appliance therapy
- D. Surgical uvulopalatopharyngoplasty (UPPP)
Correct Answer: B
Rationale: CPAP therapy is considered the gold standard treatment for obstructive sleep apnea (OSA) and is the most appropriate intervention for managing OSA and improving symptoms. CPAP therapy involves using a machine that delivers a continuous flow of air through a mask worn over the nose or mouth during sleep. This air pressure helps keep the airway open, preventing the collapse that causes apneas and snoring during sleep.
When documenting the procedures done, which of the following should NOT be recorded?
- A. Date
- B. Manufacturer
- C. Lot number
- D. Needle gauge
Correct Answer: B
Rationale: In documenting procedures, it is essential to record information that is relevant to the specific procedure done. Recording the date (A), lot number (C), and needle gauge (D) are critical details that provide important context and traceability for the procedure performed. The date helps to keep track of when the procedure was conducted. The lot number is essential for tracking the specific batch of materials used in the procedure. The needle gauge is important for ensuring the appropriate equipment is used for the procedure. However, recording the manufacturer (B) is not necessary for documenting the procedures as it does not directly impact the quality or traceability of the procedure itself.
Nurse Mary had observedthat most patients with hypertension stop taking their medications and heard them saying "I feel good already" Which is the APPROPRIATE nursing diagnosis?
- A. Impaired gas exchange
- B. Knowledge deficit
- C. Anxiety
- D. Ineffective coping
Correct Answer: D
Rationale: The appropriate nursing diagnosis for this situation is "Ineffective coping" because the patients with hypertension who stop taking their medications despite feeling good may be using this behavior as a maladaptive coping mechanism. It suggests that they might not fully understand the importance of medication adherence or are struggling to accept their diagnosis. By not adhering to their prescribed treatment, they are putting themselves at risk for complications associated with uncontrolled hypertension. Therefore, the nursing diagnosis of "Ineffective coping" addresses the patients' inability to deal with their condition in a healthy manner, leading to noncompliance with their treatment regimen.
Which of the following actions is appropriate for managing a conscious patient with a suspected heat cramp?
- A. Massaging the affected muscles vigorously.
- B. Applying cold packs to the affected area.
- C. Providing oral rehydration with electrolyte solutions.
- D. Encouraging the patient to continue strenuous activity.
Correct Answer: C
Rationale: Providing oral rehydration with electrolyte solutions is the appropriate action for managing a conscious patient with suspected heat cramps. Heat cramps are muscle pains or spasms that often occur during intense exercise in hot environments when a person sweats excessively, losing both fluids and electrolytes. Replenishing lost fluids and electrolytes through oral rehydration helps address the underlying cause of the cramps and provides relief to the patient. Massaging the affected muscles vigorously can potentially worsen the condition, applying cold packs is not usually recommended for heat-related conditions, and encouraging the patient to continue strenuous activity can lead to further complications.
Pelvic ultrasound can detect, which of the following?
- A. Congenital defects in the structure, fetal gender, H-mole
- B. Fetal DM, multiple pregnancies, fetal age of gestation
- C. Fetal sex, number, and lung maturity
- D. Fetal congenital defects, placenta previa, fetal lung maturity
Correct Answer: D
Rationale: Pelvic ultrasound can detect fetal congenital defects, placenta previa, and fetal lung maturity.