Nokea
A patient with a history of multiple myeloma presents with weakness, bone pain, and recurrent infections. Laboratory tests reveal anemia, hypercalcemia, renal insufficiency, and monoclonal spike on serum protein electrophoresis. Which of the following conditions is most likely to cause these findings?
- A. Waldenstrom macroglobulinemia
- B. Hodgkin lymphoma
- C. Chronic lymphocytic leukemia (CLL)
- D. Multiple myeloma
Correct Answer: D
Rationale: Multiple myeloma is a plasma cell neoplasm characterized by the presence of abnormal monoclonal plasma cells in the bone marrow, which produce a monoclonal spike on serum protein electrophoresis. The clinical presentation of weakness, bone pain, and recurrent infections is typical of multiple myeloma. Anemia can result from bone marrow infiltration by the abnormal plasma cells, hypercalcemia is due to bone destruction and release of calcium, renal insufficiency can result from hypercalcemia and protein deposition in the kidneys, and the monoclonal spike in serum protein electrophoresis indicates the presence of a monoclonal protein. Waldenström macroglobulinemia, Hodgkin lymphoma, and chronic lymphocytic leukemia do not typically present with the classic tetrad of findings seen in multiple myeloma.
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A nurse involves well-being in her definition of health. What will the primary concern or focus of the nurse when she provides care to a family confronting the imminent death of a family member?
- A. Reinforcing the need for the whole family to adapt to the impending death.
- B. Sharing the nurse's knowledge on the client's symptoms of grief
- C. Discussing the perceived meaning of life with the family
- D. Administering pain medication so that the client can be kept comfortable
Correct Answer: A
Rationale: When a nurse involves well-being in her definition of health, it indicates a holistic approach that considers not only physical health but also emotional, mental, and social aspects of well-being. In the context of a family confronting the imminent death of a family member, the primary concern of the nurse would be to focus on reinforcing the need for the whole family to adapt to the impending death. This involves providing emotional support, facilitating communication, addressing coping mechanisms, and assisting the family in coming to terms with the situation. By emphasizing the importance of the whole family adapting to the imminent death, the nurse can help promote holistic well-being for the family during this challenging time.
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 characteristic of acute angle-closure glaucoma. This condition typically presents with sudden-onset severe eye pain, headache, nausea, and vomiting. On examination, the affected eye may appear red due to conjunctival injection, and there may be a steamy cornea due to corneal edema. The mid-dilated, non-reactive pupil is a key finding in angle-closure glaucoma, as the iris bombe (forward movement of the peripheral iris) blocks the drainage angle, leading to increased intraocular pressure. If left untreated, acute angle-closure glaucoma can result in irreversible vision loss. Immediate intervention is crucial to lower the intraocular pressure and prevent further damage to the optic nerve. Prompt referral to an ophthalmologist for definitive treatment is necessary in cases of suspected acute angle-closure glaucoma.
In giving health teaching to the mother how to manage the patient at home, which of the following she should emphasize?
- A. Give the patient more time for self
- B. Impose strict discipline
- C. Do traditional parenting style
- D. Need for emotional support
Correct Answer: D
Rationale: When giving health teaching to the mother on how to manage the patient at home, emphasizing the need for emotional support is crucial. Taking care of a patient at home can be emotionally taxing, and the mother needs to be aware of the importance of providing emotional support to the patient. This can greatly impact the patient's overall well-being and recovery. By emphasizing the need for emotional support, the mother can create a conducive and supportive environment for the patient to heal physically, mentally, and emotionally. It also helps foster a sense of connection and positivity, which is beneficial for the patient's overall health outcomes.
Upon interview, the patient reported the she often felt nauseated, restless, perspired a lot, felt fatigued, and was often hungry when she was younger. What do these signs indicate?
- A. Diabetic Nephropathy
- B. Hypoglycemia
- C. Hyperglycemia
- D. Diabetic retinopathy
Correct Answer: B
Rationale: The signs reported by the patient, such as feeling nauseated, restless, sweating excessively, fatigue, and increased hunger, are indicative of hypoglycemia, which is characterized by low blood sugar levels. In individuals with hypoglycemia, these symptoms can occur when the blood glucose levels drop too low, leading to disturbances in the body's energy supply. This is common in individuals who may have experienced episodes of low blood sugar, especially if they have a history of diabetes or are taking medications that lower blood sugar levels. Diabetic nephropathy, hyperglycemia, and diabetic retinopathy are conditions associated with high blood sugar levels and are not consistent with the symptoms described by the patient.
Nurse Myrna is taking care of a family chose there young children are sick with malnutrition particularly protein deficiency, which of the following behaviors is indicative of the family's positive coping index
- A. Observing erratic mealtime due to work schedule of parents
- B. Bringing children to health enter for consult only when needed.
- C. Serving foods that children like but with high in carbohydrates
- D. Cooking foods in variety that include meat, dairy products and beans.
Correct Answer: D
Rationale: Cooking foods in a variety that includes meat, dairy products, and beans demonstrates a positive coping index for the family in addressing the protein deficiency and malnutrition in their children. This behavior shows the family's understanding and effort to provide diverse sources of protein, which is essential for addressing protein deficiency. By including different protein-rich foods in their meals, the family is actively working towards improving the nutritional status of their children. This approach aligns with the goal of health education to change knowledge, attitudes, and practices to enhance individual, family, and community health.