A patient with a history of nephrolithiasis presents with sudden-onset severe colicky flank pain radiating to the groin. On physical examination, there is tenderness over the costovertebral angle and hematuria. What is the most likely diagnosis?
- A. Acute pyelonephritis
- B. Renal artery embolism
- C. Renal colic due to ureteral calculus
- D. Renal infarction
Correct Answer: C
Rationale: The correct answer is C: Renal colic due to ureteral calculus. The sudden-onset severe colicky flank pain radiating to the groin along with tenderness over the costovertebral angle and hematuria are classic symptoms of kidney stones (ureteral calculus). The pain results from the obstruction of urine flow by the stone, leading to increased pressure and spasm in the ureter. Acute pyelonephritis (choice A) presents with fever, chills, and systemic symptoms. Renal artery embolism (choice B) typically presents with acute onset severe flank pain but is associated with risk factors like atrial fibrillation. Renal infarction (choice D) presents with sudden-onset severe flank pain but is less likely than ureteral calculus in a patient with a history of nephrolithiasis.
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Which of the following is an example of a PRIMARY) source in a research study?
- A. A textbook of medical-surgical nursing
- B. A doctoral dissertation that critiques all research in the area of attention deficit disorder
- C. A published commentary on the findings of another study
- D. A journal article about a study that used large, previously unpublished databases generated
Correct Answer: D
Rationale: The correct answer is D because a journal article about a study using large, previously unpublished databases is a primary source as it presents original research findings firsthand. It contributes new knowledge to the field. A textbook (A) compiles existing information, not original research. A doctoral dissertation (B) critiques research but is not a primary source. A published commentary (C) interprets others' findings, making it a secondary source.
A nurse is preparing to assist with a lumbar epidural steroid injection (LESI) procedure for a patient with chronic back pain. What action should the nurse prioritize to ensure procedural accuracy?
- A. Confirming the patient's identity and procedure site using two identifiers
- B. Positioning the patient in a prone position with a pillow under the abdomen
- C. Providing conscious sedation to the patient to minimize discomfort
- D. Administering local anesthesia to the skin before needle insertion
Correct Answer: A
Rationale: Correct Answer: A
Rationale:
1. Confirming the patient's identity ensures the right patient is receiving the intended procedure.
2. Verifying the procedure site using two identifiers prevents errors in site selection.
3. This step aligns with the World Health Organization's Surgical Safety Checklist, reducing the risk of wrong-site procedures.
4. Positioning, sedation, and local anesthesia are important but secondary to ensuring the correct patient and site.
Summary:
- Option B: Positioning is essential but not the top priority for procedural accuracy.
- Option C: Sedation aims to minimize discomfort but does not guarantee procedural accuracy.
- Option D: Administering local anesthesia is crucial but not as critical as confirming patient identity and procedure site.
Select the medication that should be discussed by the nurse with the attending physician before administering it to patient with acute angle closure glaucoma
- A. Isoptocarpineeyedrops
- B. Mannitol
- C. Corticosporin ophthalmic
- D. Atropine
Correct Answer: D
Rationale: The correct answer is D: Atropine. Atropine is a mydriatic agent that can exacerbate acute angle closure glaucoma by dilating the pupil and potentially worsening the condition. The nurse should discuss with the attending physician before administering it to avoid worsening the patient's condition.
A: Isopto carpine eye drops are actually used in the treatment of acute angle closure glaucoma as they help in lowering intraocular pressure, so there is no need to discuss this with the physician.
B: Mannitol is used as an osmotic diuretic to reduce intraocular pressure in acute angle closure glaucoma, and it does not directly affect the pupil, so it does not require discussion with the physician before administration.
C: Corticosporin ophthalmic is a combination of an antibiotic and a corticosteroid used to treat eye infections and inflammation, but it does not have a direct effect on worsening acute angle closure glaucoma, so it does
At the pre-Entry phase, which of the following is the FIRST step in the CO-PAR process
- A. Survey the community
- B. Train technical working group
- C. Hold a community assembly
- D. Create a core group
Correct Answer: D
Rationale: The correct answer is D: Create a core group. In the CO-PAR process, creating a core group is the first step in the pre-Entry phase as it establishes a team of committed individuals who will lead the participatory action research. This core group will provide leadership, coordination, and represent the diversity of the community. Surveying the community (choice A) comes after forming the core group to gather information. Training the technical working group (choice B) and holding a community assembly (choice C) are subsequent steps in the process after the core group is established.
Bel1le has a difficulty tolerating frustration The GOAL Of the nurse is to assist Belle to ________.
- A. increase her self-esteem
- B. recognize her need
- C. cope with anxiety
- D. mobilize her resources
Correct Answer: C
Rationale: The correct answer is C: cope with anxiety. The nurse's goal is to address Belle's difficulty tolerating frustration, which likely leads to anxiety. By helping Belle develop coping strategies for managing her anxiety, the nurse can assist her in handling frustration more effectively. Options A, B, and D are incorrect because increasing self-esteem, recognizing needs, and mobilizing resources may be important aspects of Belle's overall care but are not directly related to addressing her difficulty with frustration and anxiety. Focusing on coping with anxiety directly targets the root issue and is the most appropriate goal in this context.