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Applying multidisciplinary approach of patient care, which among the members of the multidisciplinary team that the nurse would MOST likely collaborate with when the patient is at risk of fall due to an impaired gait?
- A. Podiatrist
- B. Speech therapist
- C. Physica l therapist
- D. Nutritionist
Correct Answer: C
Rationale: When a patient is at risk of falls due to an impaired gait, a physical therapist would be the most appropriate member of the multidisciplinary team for the nurse to collaborate with. Physical therapists specialize in improving mobility, balance, and coordination through exercises, gait training, and other interventions. They can assess the patient's gait pattern, strength, and balance, and develop a personalized plan to address the impairments contributing to the fall risk. By working closely with a physical therapist, the nurse can help the patient improve their gait and reduce the risk of falls, ultimately promoting safety and independence.
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The nurse suspects that a client has multiple myeloma based on the client's major presenting symptom and the analysis of laboratory results. What classic manifestation for multiple myeloma does the nurse assess for?
- A. Debilitating fatigue
- B. Gradual muscle paralysis
- C. Bone pain in the back of the ribs
- D. Severe thrombocytopenia
Correct Answer: C
Rationale: Bone pain in the back of the ribs is a classic manifestation of multiple myeloma. Multiple myeloma is a type of cancer that primarily affects plasma cells in the bone marrow, leading to weakened bones and bone pain. Patients with multiple myeloma often experience bone pain in areas such as the ribs, spine, and pelvis. The bone pain is typically persistent and worsens with movement or pressure. Additionally, other common symptoms of multiple myeloma include anemia, kidney damage, recurrent infections, and elevated calcium levels in the blood.
As a QA nurse, which of the following can Nurse Jen adopts as a concurrent evaluation of patient's outcomes in the unit? I Direct observation of patient's condition. II Patient's interview in the unit. III Face to face interview with nursing staff. IV Nursing audit from the patient's chart.
- A. III & IV
- B. I, II, III, & IV
- C. I, II, & I
- D. I & II
Correct Answer: A
Rationale: As a QA nurse, Nurse Jen can adopt concurrent evaluation methods to assess patient outcomes in the unit. The most appropriate options for concurrent evaluation are Face to face interview with nursing staff (III) and Nursing audit from the patient's chart (IV).
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 consistent with acute angle-closure glaucoma. This condition typically presents with sudden-onset severe eye pain, headache, nausea, and vomiting. On examination, the affected eye appears red, with a steamy cornea due to corneal edema and a mid-dilated, non-reactive pupil due to pupillary block from the forward displacement of the iris. Acute angle-closure glaucoma is considered a medical emergency as it can lead to permanent vision loss if not promptly treated. Prompt management involves reducing intraocular pressure to prevent further damage to the optic nerve.
A patient with chronic kidney disease presents with periorbital edema, hypertension, and proteinuria. Laboratory findings reveal elevated serum creatinine and urea levels, hyperkalemia, and metabolic acidosis. What is the most likely diagnosis?
- A. Nephrotic syndrome
- B. Diabetic nephropathy
- C. Acute glomerulonephritis
- D. Chronic kidney disease (CKD)
Correct Answer: D
Rationale: The constellation of symptoms presented (periorbital edema, hypertension, proteinuria) along with the laboratory findings (elevated creatinine and urea levels, hyperkalemia, metabolic acidosis) are classical signs of chronic kidney disease (CKD). In CKD, the kidneys gradually lose their function over time, leading to impaired filtration of waste products and electrolyte imbalance. The presence of hypertension and proteinuria are common in CKD due to the compromised renal function. Additionally, elevated serum creatinine and urea levels, hyperkalemia, and metabolic acidosis are indicative of kidney dysfunction.
A patient with a history of chronic obstructive pulmonary disease (COPD) is prescribed a metered-dose inhaler (MDI) with a spacer. Which instruction should the nurse include in the demonstration of MDI use?
- A. Inhale slowly and deeply while pressing the canister.
- B. Exhale completely before inhaling the medication.
- C. Shake the inhaler vigorously before each puff.
- D. Hold the breath for 10 seconds after inhaling the medication.
Correct Answer: A
Rationale: The correct instruction for using a metered-dose inhaler (MDI) with a spacer for a patient with COPD is to inhale slowly and deeply while pressing the canister. This technique helps ensure that the medication reaches the lungs effectively. Inhaling slowly and deeply allows the medication to be properly delivered to the airways, maximizing its effectiveness in treating the symptoms of COPD. This instruction helps the patient coordinate pressing the canister with their inhalation, which is crucial for proper medication delivery in COPD management.