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During the surgical procedure, the nurse notices a discrepancy between the patient's identification bracelet and the surgical consent form. What should the nurse do?
- A. Proceed with the procedure as planned
- B. Document the discrepancy in the patient's chart
- C. Inform the surgeon and anesthesia provider immediately
- D. Request clarification from the patient and family members
Correct Answer: C
Rationale: If the nurse notices a discrepancy between the patient's identification bracelet and the surgical consent form, the immediate action should be to inform the surgeon and anesthesia provider. It is crucial to address any discrepancies before proceeding with the surgical procedure to ensure patient safety and prevent any potential errors or complications. The surgical team needs to be made aware of the issue so that they can verify the correct patient information and ensure that all necessary steps are taken to proceed safely. Communication and collaboration among the healthcare team members are essential in such situations to prevent any harm to the patient.
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After washing her hands and gently cleaning any discharge that can be removed easily from the outer ear, Nurse Selma positions the child. Which of the following steps follows?
- A. Gently press the tragus of the ear four times in a pumping motion.
- B. Gently pull the outer ear
- C. Drop the medicine into the ear canal.
- D. Keep the ear up for five minutes.
Correct Answer: C
Rationale: The correct next step after positioning the child is to drop the medicine into the ear canal. This is typically the next step in administering ear drops for a child. The cleaning and positioning steps are to prepare the ear for receiving the medication. Dropping the medicine into the ear canal ensures that the medication can reach the affected area effectively. Once the medicine is dropped into the ear canal, it is important to follow any additional instructions provided by the healthcare provider regarding keeping the ear in a certain position or any other post-administration care steps.
A patient presents with a thyroid nodule and signs of compression such as difficulty swallowing and breathing. Fine-needle aspiration biopsy reveals lymphocytic infiltration and germinal centers. Which endocrine disorder is most likely responsible for these symptoms?
- A. Hashimoto's thyroiditis
- B. Graves' disease
- C. Diabetes mellitus
- D. Thyroid nodules
Correct Answer: A
Rationale: Hashimoto's thyroiditis is an autoimmune disorder characterized by chronic inflammation of the thyroid gland. In this condition, lymphocytic infiltration and germinal centers can be seen in the thyroid tissue. This inflammation can lead to the formation of thyroid nodules and enlargement of the thyroid gland, causing symptoms such as difficulty swallowing and breathing due to compression of surrounding structures. Additionally, Hashimoto's thyroiditis can result in hypothyroidism over time, further contributing to the symptoms. Therefore, the patient in this case is most likely experiencing these symptoms due to Hashimoto's thyroiditis. Graves' disease, on the other hand, typically presents with hyperthyroidism and is less likely to manifest as compressive symptoms of the thyroid gland.
Which of the following medications is commonly used for the management of overactive bladder (OAB) symptoms such as urinary urgency and frequency?
- A. Furosemide
- B. Oxybutynin
- C. Spironolactone
- D. Finasteride
Correct Answer: B
Rationale: Oxybutynin is a medication commonly used for the management of overactive bladder (OAB) symptoms such as urinary urgency and frequency. It belongs to a class of medications known as anticholinergics, which work by relaxing the bladder muscles and reducing bladder spasms. By doing so, it helps to decrease the symptoms of OAB, including frequent urination, sudden urges to urinate, and leakage. Oxybutynin can be taken orally in tablet form, as a transdermal patch, or as a gel, providing various options for patients based on their preferences and needs. Overall, oxybutynin is an effective treatment option for individuals experiencing overactive bladder symptoms.
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
Correct Answer: C
Rationale: The described presentation of a yellowish-white spot on the cornea with a ring of inflammation, along with branching, filamentous opacities extending from the corneal lesion, is characteristic of fungal keratitis. Fungal keratitis typically presents with these specific features on clinical examination.
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.