Nokea
After arriving for your shift in the emergency department (ED), you receive change-of-shift report about all of these clients. Which one do you need to assess first?
- A. A 19-year-old client with scrotal swelling and severe pain that has not decreased with elevation of the scrotum.
- B. A 25-year-old client who has a painless indurated lesion on the glans penis.
- C. A 44-year-old client with an elevated temperature, chills, and back pain associated with recurrent prostatitis.
- D. A 77-year-old client with abdominal pain and acute bladder distention.
Correct Answer: A
Rationale: Severe scrotal pain unrelieved by elevation suggests testicular torsion, a urologic emergency.
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While giving a history, the patient reports having herpes genitalis. Based on this information, which finding does the nurse anticipate during the assessment?
- A. Small vesicles on the genitalia
- B. Single, firm, painless, open sore
- C. Pain when palpating the cervix
- D. Malodorous greenish-yellow vaginal discharge
Correct Answer: A
Rationale: The correct answer is A: Small vesicles on the genitalia. Genital herpes typically presents with small vesicles on the genitalia. These vesicles are usually painful and may be accompanied by itching or burning sensations. The presence of vesicles is a hallmark sign of genital herpes.
Summary:
B: Single, firm, painless, open sore is more characteristic of syphilis, not genital herpes.
C: Pain when palpating the cervix is not a typical finding in genital herpes.
D: Malodorous greenish-yellow vaginal discharge is more indicative of a bacterial infection like trichomoniasis, not genital herpes.
Mastoid process is part of which bone?
- A. Temporal
- B. Mandible
- C. Maxilla
- D. Ethmoid
Correct Answer: A
Rationale: The correct answer is A: Temporal. The mastoid process is a bony projection located on the temporal bone, which is situated behind the ear. It serves as an attachment site for various neck muscles. The temporal bone also houses important structures like the middle and inner ear components. The other choices, B: Mandible, C: Maxilla, and D: Ethmoid, are incorrect because the mastoid process is not located on these bones. The mandible is the jawbone, the maxilla forms the upper jaw, and the ethmoid bone is located in the skull's orbit and nasal cavity. Therefore, based on its anatomical location and function, the correct answer is A: Temporal.
How long are the typical ovarian and uterine (menstrual) cycles in a female?
- A. 7 days
- B. 14 days
- C. 28 days
- D. 40 days
Correct Answer: C
Rationale: The correct answer is C (28 days) because the typical ovarian and uterine (menstrual) cycles in a female are both around this duration. The menstrual cycle is typically 28 days, with ovulation occurring around day 14. This cycle is regulated by hormonal fluctuations and prepares the uterus for potential pregnancy. Choices A, B, and D are incorrect because a 7-day cycle is too short for a full menstrual cycle, a 14-day cycle is typically the duration of ovulation, and a 40-day cycle is longer than the average menstrual cycle length.
Within minutes following a normal delivery, flow through the foramen ovale decreases dramatically. What is the cause of this change?
- A. Increased formation of prostaglandin E2 in the endocardium
- B. Increased rate of flow through the pulmonary artery
- C. Increased left atrial pressure
- D. Increased right atrial pressure
Correct Answer: C
Rationale: Step-by-step rationale for the correct answer (C):
1. After delivery, the baby takes its first breath, increasing oxygen levels.
2. This leads to the closure of the foramen ovale to shift blood flow from the right to the left side.
3. Increased left atrial pressure occurs due to increased blood returning from the lungs.
4. This pressure change causes the foramen ovale to close.
Summary of incorrect choices:
A: Increased prostaglandin E2 does not directly affect flow through the foramen ovale.
B: Increased flow through the pulmonary artery is expected after birth, but it does not directly impact the foramen ovale.
D: Increased right atrial pressure would not cause a decrease in flow through the foramen ovale.
Large process on the femur that is present for attachment of muscles is
- A. condyle
- B. tubercle
- C. bone head
- D. trochanter
Correct Answer: B
Rationale: The correct answer is B: tubercle. A tubercle is a small rounded projection on a bone where muscles and ligaments can attach. In this case, the large process on the femur that serves as an attachment site for muscles is a tubercle.
Condyle (choice A) is a rounded prominence at the end of a bone, typically for articulation with another bone. Bone head (choice C) refers to the rounded end of a bone, usually forming a joint. Trochanter (choice D) is a large, blunt process on the femur that serves as an attachment point for muscles, but it is not the specific term for the large process on the femur mentioned in the question.