Nokea
A postpartum client presents with sudden, severe chest pain and dyspnea. Which nursing action is most appropriate?
- A. Placing the client in a semi-Fowler's position
- B. Administering supplemental oxygen therapy
- C. Notifying the healthcare provider immediately
- D. Encouraging the client to perform deep breathing exercises
Correct Answer: C
Rationale: Sudden, severe chest pain and dyspnea in a postpartum client could be indicative of a potential serious condition, such as a pulmonary embolism or postpartum cardiomyopathy, which require immediate medical attention. Therefore, the most appropriate nursing action would be to notify the healthcare provider immediately for further evaluation and management. Placing the client in a semi-Fowler's position may provide some comfort but does not address the underlying cause of the symptoms. Administering supplemental oxygen therapy may be necessary once the healthcare provider assesses the client. Encouraging deep breathing exercises may not be appropriate if the client is experiencing severe chest pain and dyspnea, as it could worsen the situation.
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A patient presents with a yellowish-white spot on the cornea, surrounded by a ring of inflammation. Slit-lamp examination reveals branching, filamentous opacities extending from the corneal lesion. Which of the following conditions is most likely responsible for this presentation?
- A. Herpes simplex keratitis
- B. Bacterial keratitis
- C. Fungal keratitis
- D. Acanthamoeba keratitis Dental, Alimentary, and Biliary
Correct Answer: C
Rationale: The presentation described is consistent with fungal keratitis. Fungal keratitis typically presents with a yellowish-white spot on the cornea, surrounded by a ring of inflammation. The filamentous opacities seen on slit-lamp examination are characteristic of fungal hyphae extending from the corneal lesion. This condition is often associated with risk factors such as trauma with vegetable matter, contact lens wear, or topical corticosteroid use. Prompt diagnosis and treatment with antifungal medications are essential to prevent complications and preserve vision.
A patient presents with a thyroid nodule and signs of hyperthyroidism. Fine-needle aspiration biopsy reveals Hurthle cells and cellular atypia. Which endocrine disorder is most likely responsible for these symptoms?
- A. Hashimoto's thyroiditis
- B. Graves' disease
- C. Hurthle cell carcinoma
- D. Papillary thyroid carcinoma
Correct Answer: C
Rationale: Hurthle cell carcinoma is a type of thyroid cancer that arises from the Hurthle cells of the thyroid gland. Patients with Hurthle cell carcinoma may present with a thyroid nodule and signs of hyperthyroidism, which can mimic other thyroid disorders such as Graves' disease. Fine-needle aspiration biopsy revealing Hurthle cells and cellular atypia is suggestive of a Hurthle cell neoplasm, particularly Hurthle cell carcinoma. It is important to differentiate Hurthle cell carcinoma from benign Hurthle cell adenomas or other thyroid conditions to guide appropriate management and treatment.
A patient with a history of peptic ulcer disease is prescribed proton pump inhibitors (PPIs) for ulcer healing. Which information is important for the nurse to include in patient education about PPI therapy?
- A. PPIs should be taken on an empty stomach.
- B. PPIs should be discontinued once symptoms resolve.
- C. PPIs may increase the risk of gastrointestinal bleeding.
- D. PPIs should be taken with antacids for optimal effect.
Correct Answer: C
Rationale: While proton pump inhibitors (PPIs) are commonly prescribed for the treatment of peptic ulcer disease to help heal ulcers and reduce acid production, it is important for the nurse to educate the patient about potential risks associated with PPI therapy. PPIs have been associated with an increased risk of gastrointestinal bleeding, especially in patients with a history of peptic ulcer disease. It is crucial for the patient to be aware of this risk and to take precautions, such as avoiding other medications that can increase bleeding risk and informing healthcare providers about any signs of bleeding, such as black stools or abdominal pain. Educating the patient about this potential adverse effect allows for early recognition and prompt intervention if necessary.
A patient with a history of deep vein thrombosis (DVT) is prescribed warfarin therapy. Which instruction is essential for the nurse to include in patient education about warfarin therapy?
- A. "Limit your intake of green leafy vegetables."
- B. "Avoid activities that may increase your risk of bleeding."
- C. "Take a double dose if you miss a dose to catch up."
- D. "Report any unusual bleeding or bruising to your healthcare provider."
Correct Answer: D
Rationale: It is essential for the nurse to instruct the patient to "Report any unusual bleeding or bruising to your healthcare provider." Warfarin is a medication that works by decreasing the clotting ability of the blood. This can increase the risk of bleeding, so it is important for the patient to be vigilant for any signs of abnormal bleeding. Prompt reporting of any unusual bleeding or bruising allows healthcare providers to adjust the dosage of warfarin to maintain a balance between preventing blood clots and minimizing the risk of bleeding complications. This instruction emphasizes the importance of close monitoring and communication with healthcare providers while on warfarin therapy.
A patient with a history of chronic obstructive pulmonary disease (COPD) is prescribed ipratropium bromide inhaler. Which instruction should the nurse provide to the patient regarding ipratropium inhaler use?
- A. Shake the inhaler before each use.
- B. Inhale deeply and rapidly through the mouthpiece.
- C. Hold breath for 10 seconds after inhalation.
- D. Rinse mouth after each use.
Correct Answer: C
Rationale: The nurse should instruct the patient to hold their breath for at least 10 seconds after inhaling the medication from the ipratropium bromide inhaler. This allows the medication to reach deep into the lungs and be more effective. Holding the breath also helps reduce the risk of side effects such as throat irritation. It is essential for optimal drug delivery and therapeutic effect.