Nokea
A patient with a history of chronic kidney disease presents with pruritus, pale skin, and easy bruising. Laboratory findings reveal anemia, thrombocytopenia, and elevated blood urea nitrogen (BUN) and creatinine levels. Which of the following conditions is most likely?
- A. Uremic encephalopathy
- B. Uremic pericarditis
- C. Uremic bleeding diathesis
- D. Uremic neuropathy
Correct Answer: C
Rationale: The given patient with chronic kidney disease (CKD) is likely experiencing uremic bleeding diathesis. Uremic bleeding diathesis is a complication of CKD characterized by abnormal platelet function, leading to a tendency for bleeding. The presence of anemia, thrombocytopenia (low platelet count), pale skin, easy bruising, and elevated blood urea nitrogen (BUN) and creatinine levels are all consistent with uremic bleeding diathesis.
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If Nurse Tarly and her core group decide to formulate a directional hypothesis it will be ________.
- A. There is an increase relationship between the caring staff nurses and degree of satisfaction of ostomized patients.
- B. The caring behaviors of the staff nurses is related to increased satisfaction of ostomized patients.
- C. The staff nurses' behaviors have an effect on the patient's satisfaction with osomized patients.
- D. A significant relationship exists between the caring behaviors of the staff-nurses and degree of satisfaction of ostomized patients.
Correct Answer: D
Rationale: A directional hypothesis predicts the direction of the relationship between variables. In this case, the statement "A significant relationship exists between the caring behaviors of the staff-nurses and degree of satisfaction of ostomized patients" clearly indicates the direction of the expected relationship. This hypothesis suggests that there will be a positive or negative relationship between the caring behaviors of staff nurses and the satisfaction of ostomized patients. The terms "significant relationship" and "degree of satisfaction" indicate that the hypothesis is specific and measurable, making it suitable for testing through research methods.
A patient asks the nurse about alternative treatment options for their condition. What is the nurse's best response?
- A. Dismiss the patient's question and assert that the current treatment plan is the only option.
- B. Provide the patient with information about alternative treatment options, including benefits and risks.
- C. Ignore the patient's question and redirect the conversation to a different topic.
- D. Tell the patient that alternative treatments are ineffective and should be avoided.
Correct Answer: B
Rationale: The nurse's best response when a patient asks about alternative treatment options is to provide the patient with information about those options, including their benefits and risks. It is important for the nurse to support the patient in their exploration of different treatment approaches and empower them to make informed decisions about their care. Dismissing the question, ignoring it, or discouraging alternative treatments are not appropriate responses and may hinder the patient's ability to make choices that align with their values and preferences. Therefore, providing information and facilitating an open discussion about alternative treatments is the most appropriate approach for the patient's best interest.
A patient presents with watery diarrhea, abdominal cramps, and nausea after consuming contaminated water from a stream during a camping trip. Laboratory tests reveal oocysts in the stool sample. Which of the following parasites is most likely responsible for this infection?
- A. Giardia lamblia
- B. Entamoeba histolytica
- C. Cryptosporidium parvum
- D. Cyclospora cayetanensis
Correct Answer: C
Rationale: The patient's symptoms of watery diarrhea, abdominal cramps, and nausea after consuming contaminated water from a stream during a camping trip suggest an infection caused by Cryptosporidium parvum. Cryptosporidium is a protozoan parasite that is commonly transmitted through contaminated water sources. Laboratory tests detecting oocysts in the stool sample are characteristic of Cryptosporidium infection.
A patient is prescribed an anticoagulant for the prevention of venous thromboembolism (VTE). Which laboratory parameter should the nurse monitor closely during anticoagulant therapy?
- A. Platelet count
- B. International normalized ratio (INR)
- C. Serum sodium levels
- D. Blood urea nitrogen (BUN)
Correct Answer: B
Rationale: The nurse should monitor the International Normalized Ratio (INR) closely during anticoagulant therapy for the prevention of VTE. The INR measures the clotting ability of the blood and is used to monitor the effectiveness of anticoagulant therapy, such as warfarin. Maintaining the INR within the target therapeutic range is crucial to prevent both excessive bleeding due to over-anticoagulation and clotting events due to under-anticoagulation. Close monitoring of the INR helps healthcare providers adjust the anticoagulant dosage as needed to ensure optimal therapeutic outcomes and minimize risks. Platelet count, serum sodium levels, and blood urea nitrogen (BUN) are important laboratory parameters to monitor for other medical conditions but are not specific to anticoagulant therapy.
A patient with a spinal cord injury at the level of T6 presents with hypotension, bradycardia, and diaphoresis following a sudden change in position from supine to sitting. Which condition is the patient most likely experiencing?
- A. Autonomic dysreflexia
- B. Neurogenic shock
- C. Spinal shock
- D. Orthostatic hypotension
Correct Answer: A
Rationale: The patient is most likely experiencing autonomic dysreflexia. Autonomic dysreflexia is a potentially life-threatening condition that can occur in individuals with spinal cord injuries at the level of T6 or above. It is characterized by a sudden onset of severe hypertension, bradycardia, diaphoresis, flushing, and headache in response to a noxious stimulus below the level of injury. The sudden change in position from supine to sitting likely triggered autonomic dysreflexia in this patient.