Nokea
If case a patient falls, the nurse FIRST responsibility is to________.
- A. assess the patient's injury
- B. report the incident to the head nurse
- C. write an incident repot
- D. notify the physician at once
Correct Answer: A
Rationale: The first responsibility of a nurse when a patient falls is to assess the patient's injury. Assessing the patient's injury immediately allows the nurse to determine the severity of the fall and provide appropriate care and interventions. It is important to assess for any signs of injury, such as pain, swelling, bruising, or altered mobility, and to address any immediate medical needs. Once the patient's injury has been assessed, the nurse can then proceed to report the incident to the head nurse, write an incident report, and notify the physician if necessary.
You may also like to solve these questions
A patient presents with acute onset of severe headache, visual disturbances, and altered mental status. Imaging reveals a tumor compressing the optic chiasm. Which of the following neurological conditions is most likely responsible for these symptoms?
- A. Meningioma
- B. Glioblastoma multiforme
- C. Pituitary adenoma
- D. Medulloblastoma
Correct Answer: C
Rationale: Pituitary adenoma is the most likely neurological condition responsible for the described symptoms of acute onset severe headache, visual disturbances, and altered mental status when a tumor is found compressing the optic chiasm. Pituitary adenomas are benign tumors arising from the pituitary gland located at the base of the brain. As the tumor grows, it can compress nearby structures such as the optic chiasm, leading to visual disturbances (due to pressure on the optic nerves), severe headache (due to increased intracranial pressure), and altered mental status (due to effects on nearby brain structures).
Which of the following is caused by the markedly distended uterus and intermittent uterine contractions within 2 to 3 days after birth?
- A. Retained placenta
- B. Uterine atony
- C. Afterpains
- D. Boggy uterus
Correct Answer: B
Rationale: Uterine atony is caused by the markedly distended uterus and intermittent uterine contractions within 2 to 3 days after birth. It is characterized by the inability of the uterus to contract after delivery, leading to excessive bleeding postpartum. This condition is a significant risk factor for postpartum hemorrhage. Treatment may involve massage of the uterus, administration of uterotonics, and in severe cases, surgical interventions such as a hysterectomy. Retained placenta refers to incomplete expulsion of the placenta after delivery. Afterpains are the discomfort felt by some women as their uterus contracts and returns to its normal size after childbirth. A boggy uterus is another term for a uterus that feels soft, lax, or lack firm tone, which can be a sign of uterine atony.
A 28-year-old woman presents with lower abdominal pain, dyspareunia, and dysmenorrhea that worsens during menstruation. On pelvic examination, tender nodules are palpated along the uterosacral ligaments. Which condition is most likely to be responsible for these findings?
- A. Polycystic ovary syndrome (PCOS)
- B. Endometriosis
- C. Pelvic inflammatory disease (PID)
- D. Uterine fibroids
Correct Answer: B
Rationale: The clinical presentation of lower abdominal pain, dyspareunia (pain during sexual intercourse), dysmenorrhea (painful periods), and tender nodules along the uterosacral ligaments is highly suggestive of endometriosis. Endometriosis is a condition where the tissue that lines the uterus (endometrium) grows outside the uterus, commonly on the pelvic organs such as the ovaries, fallopian tubes, and the peritoneum. The characteristic tender nodules along the uterosacral ligaments are known as "nodularity" and are a classic finding in endometriosis.
The nurse, as the community organizer, immerses self by joining local folks in their usual everyday activities in ordwwer to ______.
- A. gain trust and rapport of people
- B. make self popular among people
- C. identify and spot leaders
- D. become familiar with the place
Correct Answer: A
Rationale: Immersing oneself in the local community and participating in their everyday activities allows the nurse, as a community organizer, to establish trust and build rapport with the people. By actively engaging with the community members, the nurse can show genuine interest and commitment to their well-being, which fosters a sense of connection and mutual understanding. This approach is crucial for gaining the trust of the community, as it demonstrates that the nurse is invested in listening to their needs and working together to address health concerns effectively.
A patient presents with a painless, gradually enlarging mass in the left neck, anterior to the sternocleidomastoid muscle. Fine-needle aspiration cytology reveals thyroid follicular cells. Which of the following conditions is most likely responsible for this presentation?
- A. Thyroglossal duct cyst
- B. Lymphadenopathy
- C. Thyroid adenoma
- D. Thyroid carcinoma
Correct Answer: C
Rationale: The presentation described is most consistent with a thyroid adenoma. Thyroid adenomas are benign neoplasms of the thyroid gland and can present as painless, gradually enlarging masses in the neck. Fine-needle aspiration cytology revealing thyroid follicular cells further supports the diagnosis of a thyroid adenoma. Thyroglossal duct cysts typically present as midline neck masses that move with swallowing, while lymphadenopathy presents as enlarged lymph nodes and may be associated with infection or malignancy. Thyroid carcinoma may also present as a neck mass but is more likely to be associated with other features such as vocal cord paralysis, hoarseness, or enlarged cervical lymph nodes.