Nokea
The majority of lumbar disc herniations occur at the level of:
- A. L1 - L2
- B. L4-L5
- C. L3-L4
- D. S1-S2
Correct Answer: B
Rationale: The majority of lumbar disc herniations occur at the level of L4-L5. This is because the L4-L5 disc segment bears the highest amount of stress and load in the lumbar spine due to its location and mechanics. The intervertebral disc between the fourth (L4) and fifth (L5) lumbar vertebrae is subject to repetitive movements and mechanical stress, making it more susceptible to herniation compared to other levels in the lumbar spine. Additionally, the anatomy of the L4-L5 disc makes it more prone to degeneration and herniation, leading to a higher prevalence of herniated discs at this level.
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The effectiveness of Levodopa can be reduced when taking:
- A. Pyridoxine
- B. Bromocriptine
- C. Amantadine
- D. Amantadine
Correct Answer: A
Rationale: The correct choice is Pyridoxine. Levodopa is a precursor to dopamine and is commonly used in the treatment of Parkinson's disease. Pyridoxine, also known as vitamin B6, has been shown to reduce the effectiveness of Levodopa by accelerating its conversion to dopamine in the bloodstream before it reaches the brain. This reduces the amount of Levodopa available to provide therapeutic benefit in Parkinson's disease. It is important for patients taking Levodopa to be cautious about taking vitamin B6 supplements to avoid diminishing the efficacy of their medication.
A nurse caring for a patient with a herniated lumbar disk develops a plan of care for impaired mobility related to nerve compression. Which patient outcome indicates that the plan has been successful?
- A. The patient rates the pain at 3 to 4 on a 0 to 10 scale
- B. The patient has full ROM of the upper extremities
- C. The patient demonstrates correct self-administration of analgesics
- D. The patient is able to ambulate 25 feet without pain
Correct Answer: D
Rationale: The patient being able to ambulate 25 feet without pain is the most appropriate outcome to indicate the success of the plan for impaired mobility related to nerve compression due to a herniated lumbar disk. This outcome directly reflects an improvement in mobility, which is the primary goal when addressing impaired mobility caused by nerve compression. A reduction in pain intensity (choice A) is important but not as specific to mobility impairment. Having full range of motion (choice B) in the upper extremities is not directly related to the issue of lumbar disk herniation. Correct self-administration of analgesics (choice C) is important for pain management but does not directly reflect improvement in mobility.
When caring for a client, whose being treated for hyperthyroidism, it's important to:
- A. Provide extra blankets and clothing to keep the client warm.
- B. Monitor the client for signs of restlessness, sweating and excessive weight loss during thyroid replacement therapy.
- C. Balance the client's periods of activity and rest.
- D. Encourage the client to be active to prevent constipation.
Correct Answer: B
Rationale: When caring for a client with hyperthyroidism, it is important to monitor the client for signs of restlessness, sweating, and excessive weight loss during thyroid replacement therapy. Treatment for hyperthyroidism often involves thyroid replacement therapy to restore the balance of thyroid hormones in the body. Monitoring for signs and symptoms of overmedication or undermedication is crucial to ensure the client's health and well-being. Restlessness, sweating, and weight loss can be indicators of an imbalance in thyroid hormone levels and may require adjustments in medication dosage. Regular monitoring and communication with healthcare providers are essential in managing the client's condition effectively.
While caring for a patient who is hospitalized for acute gastroenteritis and dehydration, the pediatric nurse notes that the patient's parent keeps packets of herbs by the patient's bedside. Suspecting that the parent may be administering the herbs to the patient, the nurse's first action is to:
- A. ask the parent in a nonjudgmental manner about the herbs.
- B. coordinate a nursing care conference to discuss the patient's plan of care.
- C. discuss the risks of using alternative therapies with the parent.
- D. refer the family to a social worker for possible nonadherence with the healthcare regimen.
Correct Answer: A
Rationale: A nonjudgmental approach encourages open communication and allows the nurse to assess the situation appropriately.
The nurse is teaching a patient newly diagnosed with AIDS about complications of the disease. Which of the following is the most common opportunistic infection in AIDS?
- A. Pneumocystis carinii pneumonia
- B. Toxoplasmosis
- C. Candidiasis
- D. Mycoplasma pneumoniae
Correct Answer: A
Rationale: Pneumocystis carinii pneumonia (PCP) is the most common opportunistic infection in individuals with AIDS. PCP is caused by a fungus called Pneumocystis jirovecii (formerly known as Pneumocystis carinii). Patients with AIDS have compromised immune systems, making them susceptible to opportunistic infections like PCP. This infection can be life-threatening if not treated promptly with appropriate antibiotics. Symptoms of PCP include fever, cough, and difficulty breathing. Early recognition and treatment of PCP are crucial in patients with AIDS to prevent severe complications.