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A patient with suspected pulmonary embolism (PE) presents with sudden onset dyspnea, pleuritic chest pain, and hemoptysis. Which of the following diagnostic tests is most appropriate for confirming the diagnosis?
- A. Chest X-ray
- B. Electrocardiography (ECG)
- C. D-dimer assay
- D. Spiral computed tomography (CT) angiography
Correct Answer: D
Rationale: Spiral CT angiography is the most appropriate test for confirming the diagnosis of pulmonary embolism (PE) in a patient with suspected PE. It is a non-invasive imaging modality that can detect filling defects within the pulmonary vasculature indicative of a clot. This diagnostic test has high sensitivity and specificity for diagnosing PE, making it a valuable tool in the management of patients with suspected PE.
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When a patient has pneumothorax, the nurse's assessment findings will likely reveal _______. I. absent breadth sounds on the affected side II. Decreased chest expansion unilaterally III. Sharp chest pain IV. Burning chest pain
- A. I, II, III
- B. I, II, IV
- C. III & IV
- D. I & II
Correct Answer: A
Rationale: Pneumothorax is a condition characterized by the presence of air in the pleural space surrounding the lungs, which can lead to lung collapse. The nurse's assessment findings in a patient with pneumothorax are typically as follows:
In giving health teaching to the mother how to manage the patient at home, which of the following she should emphasize?
- A. Give the patient more time for self
- B. Impose strict discipline
- C. Do traditional parenting style
- D. Need for emotional support
Correct Answer: D
Rationale: When giving health teaching to the mother on how to manage the patient at home, emphasizing the need for emotional support is crucial. Taking care of a patient at home can be emotionally taxing, and the mother needs to be aware of the importance of providing emotional support to the patient. This can greatly impact the patient's overall well-being and recovery. By emphasizing the need for emotional support, the mother can create a conducive and supportive environment for the patient to heal physically, mentally, and emotionally. It also helps foster a sense of connection and positivity, which is beneficial for the patient's overall health outcomes.
A patient presents with a small, painless, well-defined nodule on the lateral aspect of the neck, just above the clavicle. Fine-needle aspiration cytology reveals clusters of polygonal cells with abundant granular cytoplasm. Which of the following conditions is most likely responsible for this presentation?
- A. Thyroglossal duct cyst
- B. Branchial cleft cyst
- C. Lymphadenopathy
- D. Parathyroid adenoma
Correct Answer: D
Rationale: The presentation of a small, painless, well-defined nodule on the lateral aspect of the neck, above the clavicle, along with the cytology showing clusters of polygonal cells with abundant granular cytoplasm is most indicative of a parathyroid adenoma. Parathyroid adenomas are benign tumors derived from the parathyroid gland that can produce excess parathyroid hormone (PTH), leading to hyperparathyroidism. The characteristic histology of parathyroid adenomas includes chief cells with abundant granular cytoplasm.
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 characteristic of acute angle-closure glaucoma. This condition typically presents with sudden-onset severe eye pain, headache, nausea, and vomiting. On examination, the affected eye may appear red due to conjunctival injection, and there may be a steamy cornea due to corneal edema. The mid-dilated, non-reactive pupil is a key finding in angle-closure glaucoma, as the iris bombe (forward movement of the peripheral iris) blocks the drainage angle, leading to increased intraocular pressure. If left untreated, acute angle-closure glaucoma can result in irreversible vision loss. Immediate intervention is crucial to lower the intraocular pressure and prevent further damage to the optic nerve. Prompt referral to an ophthalmologist for definitive treatment is necessary in cases of suspected acute angle-closure glaucoma.
Which of the following actions is appropriate for managing a conscious patient with a dislocated shoulder?
- A. Attempting to reduce the dislocation by pulling on the affected arm.
- B. Applying a splint to immobilize the arm in the dislocated position.
- C. Providing analgesia and applying ice packs to the affected shoulder.
- D. Administering intravenous fluids to prevent dehydration.
Correct Answer: C
Rationale: For managing a conscious patient with a dislocated shoulder, the appropriate action is to provide analgesia to help manage the pain and discomfort associated with the dislocation. Applying ice packs to the affected shoulder can also help reduce swelling and provide some relief. It is important to refrain from attempting to reduce the dislocation by pulling on the affected arm, as this can cause further damage and worsen the injury. Applying a splint to immobilize the arm in the dislocated position is also not recommended, as this can lead to complications and hinder the reduction process. Administering intravenous fluids to prevent dehydration is not directly related to managing a dislocated shoulder in a conscious patient.