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A patient presents with a sensation of fullness and pressure in the left ear, along with hearing loss and occasional tinnitus. Otoscopic examination reveals a retracted tympanic membrane with decreased mobility on pneumatic otoscopy. Which of the following conditions is most likely responsible for this presentation?
- A. Acute otitis media
- B. Otitis externa
- C. Serous otitis media (otitis media with effusion)
- D. Cholesteatoma
Correct Answer: C
Rationale: The presentation described in the question (sensation of fullness and pressure in the left ear, hearing loss, occasional tinnitus, retracted tympanic membrane with decreased mobility on pneumatic otoscopy) is suggestive of serous otitis media, also known as otitis media with effusion. Serous otitis media occurs when fluid accumulates in the middle ear without signs of infection. This buildup of fluid in the middle ear space can cause the tympanic membrane to retract and reduce its mobility on pneumatic otoscopy.
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A patient is admitted with a suspected myocardial infarction. Which cardiac biomarker is most specific for myocardial injury?
- A. Troponin
- B. Creatine kinase-MB (CK-MB)
- C. Myoglobin
- D. Brain natriuretic peptide (BNP)
Correct Answer: A
Rationale: Troponin is the most specific cardiac biomarker for myocardial injury. Troponin I and Troponin T are proteins released into the bloodstream when there is damage to the heart muscle, making them highly indicative of myocardial infarction. Troponin levels rise within a few hours of cardiac injury, peak within 24-48 hours, and can remain elevated for up to 2 weeks. Troponin is considered the gold standard biomarker for the diagnosis of acute myocardial infarction due to its high specificity and sensitivity for cardiac injury. In contrast, Creatine kinase-MB (CK-MB) and myoglobin are also used in diagnosing myocardial infarction but are less specific than troponin. Brain natriuretic peptide (BNP) is primarily used in heart failure diagnosis and management, and its levels are not specific to myocardial injury.
Kris is a hospitalized movie star. A nursing assistant takes her picture without permission and sells it to a local newspaper. The nursing assistant could be quilts of:
- A. Invasion of privacy
- B. Defamation
- C. Abuse
- D. Assault and battery
Correct Answer: A
Rationale: This scenario falls under the category of invasion of privacy. Invasion of privacy occurs when a person's private information or images are shared or used without their consent, leading to an intrusion of their private life. In this case, Kris, as a hospitalized movie star, had her picture taken without permission by the nursing assistant, which was later sold to a local newspaper. Kris has a right to privacy, especially during a vulnerable time like being hospitalized, and the nursing assistant violated that right by taking and selling her picture without consent. This action constitutes an invasion of privacy.
The incoming nurse on duty reported, the nurse is administering a medication, the patient says, "This pill looks different from the one I had taken before. " What is the APPROPRIATE action of the nurse?
- A. Explain the purpose of the medication.
- B. Encourage the patient to take the medication.
- C. Check the original medication pre scription.
- D. Ask what the other pill looked 1ike.
Correct Answer: C
Rationale: When a patient expresses concern about a medication looking different from what they had taken before, it is crucial for the nurse to verify the original prescription to ensure that the correct medication is being administered. Checking the original medication prescription will help the nurse confirm if there have been any changes or errors in the medication orders. This step is essential for patient safety and to prevent any potential medication errors. It is important to prioritize patient safety and well-being in such situations, and verifying the prescription is the appropriate action to take in this case.
Which procedure has to be done to the patient to establish a definitive diagnosis of lung cancer?
- A. Chest x-ray followed by a CT scan
- B. Cytological study of the sputum
- C. Bronchoscopy
- D. Magnetic resonance imaging
Correct Answer: C
Rationale: Bronchoscopy is a procedure that allows direct visualization of the inside of the airways in the lungs. It is considered the most definitive method to establish a diagnosis of lung cancer as it can directly visualize any abnormal growths or tumors in the bronchial tubes. During bronchoscopy, tissue samples can be collected for biopsy to confirm the presence of cancer cells. This procedure is more accurate compared to other diagnostic methods such as chest x-ray, CT scan, cytological study of sputum, or magnetic resonance imaging in confirming a diagnosis of lung cancer.
Nurse Ime, is a member of the Quality Assurance team of the hospital and has been always rated as very assertive. Which of the following is NOT a characteristic of an assertive person?
- A. Intervene with the situation calmly and confidently.
- B. She stands up with what she believes & push control on others.
- C. Articulate clearly the importance of nursing perspective.
- D. Use "I" when stating thought and feelings & "YOU" when persuading others.
Correct Answer: B
Rationale: Being assertive means expressing one's thoughts, beliefs, and feelings in a confident and respectful manner while also considering the perspective of others. It does not involve pushing control on others. Assertive individuals do not impose their beliefs on others but express themselves clearly and confidently, respecting the opinions of others. So, standing up for what one believes in can be assertive, but pushing control on others is not a characteristic of assertiveness.