Nokea
A patient visits her nurse practitioner (NP) after she has a cold for a week and is now experiencing a severe headache and fever. Her NP diagnoses a sinus infection. Which of the following additional symptoms is the patient likely to exhibit?
- A. Facial tenderness
- B. Photophobia
- C. Chest pain
- D. Ear drainage
Correct Answer: A
Rationale: Sinus infections, also known as sinusitis, are often characterized by symptoms such as congestion, facial pain or pressure, and nasal discharge. Facial tenderness over the affected sinuses, particularly when tapping on the area, is a common symptom associated with sinus infections due to the inflammation and buildup of mucus in the sinuses. This tenderness is often present in the cheeks, forehead, or around the eyes. The other symptoms mentioned in the choices (photophobia, chest pain, ear drainage) are less commonly associated with sinus infections compared to facial tenderness.
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the frontal fontanell is protruding when a child suffering from:
- A. meningitis
- B. hydrocepalus
- C. subdural hematoma
- D. all the answers are correct
Correct Answer: D
Rationale: The protrusion of the frontal fontanelle in a child can be a concerning sign and can be seen in various conditions such as meningitis, hydrocephalus, and subdural hematoma. In meningitis, the inflammation of the meninges can lead to increased intracranial pressure, which may cause the fontanelle to bulge. Hydrocephalus, which is the buildup of fluid in the brain, can also result in the fontanelle being more pronounced. Additionally, a subdural hematoma, which is a collection of blood between the brain and its outermost covering, can lead to pressure on the brain and consequent fontanelle protrusion. Therefore, all the provided choices (A, B, C) are correct as they can lead to the protrusion of the frontal fontanelle in a child.
When is the best time for the neonatal intensive care unit (NICU) nurse to initiate an individualized stimulation program for the preterm newborn?
- A. As soon as possible after newborn is born
- B. As soon as parent is available to provide stimulation
- C. When newborn is over 38 weeks of gestation
- D. When developmental organization and stability are sufficient
Correct Answer: D
Rationale: Initiating an individualized stimulation program for a preterm newborn in the NICU should be based on the readiness of the newborn. The optimal time to start such a program is when the newborn's developmental organization and stability are sufficient to handle the stimulation. Premature newborns often require a period of stabilization and development before they can effectively engage with stimulation activities. Initiating stimulation programs too early may overwhelm the newborn or hinder their progress. Therefore, waiting until the newborn is developmentally ready ensures that the stimulation program is appropriate and beneficial for their individual needs.
Which of the following method if used by Wilma will best assure that the tracheostomy ties are not too tightly placed?
- A. Wilma places 2 fingers between the tie and neck
- B. The tracheotomy can be pulled slightly away from the neck
- C. James' neck veins are not engorged
- D. Wilma measures the tie from the nose to the tip of the earlobe and to the xiphoid process
Correct Answer: A
Rationale: Placing 2 fingers between the tracheostomy tie and the neck is a reliable method to ensure that the tie is not too tight. This technique allows for proper circulation around the neck area and helps prevent skin irritation or pressure ulcers from developing. It strikes a balance between securing the tracheostomy in place and maintaining the patient's comfort and safety. Checking for appropriate tightness by using the finger method is a standard practice in tracheostomy care to prevent complications related to excessive pressure or constriction.
The nurse is preparing a client for magnetic resonance imaging (MRI) to confirm or rule out a spinal cord lesion. During the MRI scan, which of the following would pose a threat to the client?
- A. The client lies still.
- B. The client wears a watch and wedding
- C. The client asks questions. band.
- D. the client hears thumping sounds.
Correct Answer: B
Rationale: The client wearing a watch and wedding band would pose a threat during the MRI scan. MRI machines use strong magnetic fields that can interact with metal objects. The presence of metal objects such as a watch and wedding band can lead to serious safety risks for the client inside the MRI machine. These metal objects can become projectiles or heat up, causing burns or other injuries. Thus, it is crucial for the client to remove all metal objects before undergoing an MRI scan to ensure their safety.
Which of the ff nursing interventions should a nurse perform to relieve tachycardia that may develop in a client with myocarditis from hypoxemia?
- A. Maintain the client on bed rest c.Elevate the clients head
- B. Administer a prescribed anti pyretic
- C. Administer supplemental oxygen
Correct Answer: C
Rationale: Administering supplemental oxygen is the most appropriate nursing intervention to relieve tachycardia that may develop in a client with myocarditis from hypoxemia. Myocarditis can lead to decreased oxygen delivery to the tissues, which may result in tachycardia as the body tries to compensate for the lack of oxygen. Providing supplemental oxygen will help increase oxygen levels in the blood, improving tissue perfusion and thus reducing the tachycardia. This intervention aims to address the underlying cause of the tachycardia in this situation.