Nokea
Korino has been using meperidine and codeine for personal consumption. Which of the following does the nurse understand as the physiologic effect of these drugs?
- A. Increases sexual stimulation.
- B. Relieves pain by increasing pain threshold.
- C. Decrease craving for alcoholic intake.
- D. Heightens concentration and alertness
Correct Answer: B
Rationale: The correct answer is B: Relieves pain by increasing pain threshold. Meperidine and codeine are opioid analgesics that work by binding to opioid receptors in the brain and spinal cord, thus increasing the pain threshold and reducing the perception of pain. This leads to pain relief without necessarily affecting sexual stimulation (choice A), craving for alcohol (choice C), or concentration/alertness (choice D). The primary physiological effect of these drugs is to modulate the perception of pain, making choice B the most appropriate answer in this context.
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A patient with a history of nephrolithiasis presents with sudden-onset severe colicky flank pain radiating to the groin. On physical examination, there is tenderness over the costovertebral angle and hematuria. What is the most likely diagnosis?
- A. Acute pyelonephritis
- B. Renal artery embolism
- C. Renal colic due to ureteral calculus
- D. Renal infarction
Correct Answer: C
Rationale: The correct answer is C: Renal colic due to ureteral calculus. The sudden-onset severe colicky flank pain radiating to the groin along with tenderness over the costovertebral angle and hematuria are classic symptoms of kidney stones (ureteral calculus). The pain results from the obstruction of urine flow by the stone, leading to increased pressure and spasm in the ureter. Acute pyelonephritis (choice A) presents with fever, chills, and systemic symptoms. Renal artery embolism (choice B) typically presents with acute onset severe flank pain but is associated with risk factors like atrial fibrillation. Renal infarction (choice D) presents with sudden-onset severe flank pain but is less likely than ureteral calculus in a patient with a history of nephrolithiasis.
During admission, the nurse needs to take the patient`s obstetric Al data. Which of the following the Most important?
- A. Laboratory results
- B. Prenatal check-up records
- C. Previous pregnancy experience
- D. Diagnostic test results
Correct Answer: C
Rationale: Step 1: Previous pregnancy experience is crucial for understanding the patient's obstetric history and potential risks.
Step 2: It helps in identifying any complications or issues that may arise during the current pregnancy.
Step 3: Laboratory results, prenatal check-up records, and diagnostic test results provide additional information but do not offer insights into the patient's past pregnancy experiences.
Summary: Choice C is the most important as it directly relates to the patient's obstetric history, while the other options focus on current data that may not provide the same level of context.
A patient in the ICU develops acute exacerbation of chronic obstructive pulmonary disease (COPD) characterized by worsening dyspnea and increased sputum production. What intervention should the healthcare team prioritize to manage the patient's exacerbation?
- A. Administer bronchodilator medications via nebulization for bronchodilation.
- B. Initiate non-invasive positive pressure ventilation (NIPPV) for respiratory support.
- C. Perform arterial blood gas analysis to assess oxygenation and ventilation.
- D. Recommend chest physiotherapy to promote airway clearance.
Correct Answer: B
Rationale: The correct answer is B: Initiate non-invasive positive pressure ventilation (NIPPV) for respiratory support. In acute exacerbations of COPD, NIPPV helps improve ventilation and oxygenation, reducing the work of breathing and preventing the need for intubation. This intervention is a priority as it can rapidly stabilize the patient's respiratory status.
A: Administering bronchodilator medications is important in COPD management, but in severe exacerbations, NIPPV takes precedence.
C: Arterial blood gas analysis is important for assessing oxygenation and ventilation status, but it does not directly address the acute respiratory distress.
D: Chest physiotherapy can help with airway clearance in COPD, but in acute exacerbations, respiratory support with NIPPV is more urgent.
A pregnant woman presents with severe abdominal pain and passage of tissue at 12 weeks gestation. On examination, the cervix is partially dilated, and products of conception are protruding through the cervical os. Which of the following conditions is the most likely cause of these symptoms?
- A. Ectopic pregnancy
- B. Incomplete abortion
- C. Placenta previa
- D. Gestational trophoblastic disease
Correct Answer: B
Rationale: In this scenario, the pregnant woman is presenting with severe abdominal pain, passage of tissue, and cervical dilation with products of conception protruding through the cervical os at 12 weeks gestation. These are classic signs and symptoms of an incomplete abortion. Incomplete abortion occurs when not all of the products of conception are expelled from the uterus. It can present with vaginal bleeding, abdominal pain, cervical dilation, and passage of tissue. The management of incomplete abortion may involve expectant, medical, or surgical options depending on the clinical context and the patient's condition.
Nurse Florence was asked by her Headnurse why she requested permission to enroll in the Graduate Program for the second semester. Her reply should be, EXCEPT:
- A. To have an impressive resume to enable her to be competitive
- B. Connect with people professionally
- C. Invest for the future
- D. Pursue her interest in Pediatric Nursing in more depth
Correct Answer: D
Rationale: The correct answer is D because Nurse Florence was asked why she requested permission to enroll in the Graduate Program for the second semester, not about her interest in Pediatric Nursing. A: Having an impressive resume to be competitive aligns with career advancement. B: Connecting with people professionally can lead to networking opportunities. C: Investing for the future implies long-term career growth. Therefore, D is the least relevant response to the question asked.