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A patient presents with unilateral nasal congestion, facial pain, and purulent nasal discharge. Upon examination, tenderness is noted over the affected sinus. Which of the following conditions is most likely responsible for this presentation?
- A. Allergic rhinitis
- B. Acute sinusitis
- C. Nasal polyps
- D. Deviated nasal septum
Correct Answer: B
Rationale: The patient's symptoms of unilateral nasal congestion, facial pain, and purulent nasal discharge with tenderness over the affected sinus are suggestive of acute sinusitis. Acute sinusitis is typically caused by a viral or bacterial infection leading to inflammation and swelling of the sinus mucosa, resulting in the characteristic symptoms described. The tenderness over the affected sinus indicates inflammation in that area. Allergic rhinitis typically presents with bilateral nasal congestion, clear nasal discharge, and itching, rather than facial pain and purulent discharge. Nasal polyps are associated with chronic conditions and usually lead to more gradual onset of symptoms. A deviated nasal septum may contribute to chronic sinus issues but typically does not present with acute symptoms of infection like purulent discharge and facial pain.
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A postpartum client who experienced a perineal laceration reports pain and discomfort during defecation. What nursing intervention should be prioritized to alleviate symptoms?
- A. Recommending the use of stool softeners or laxatives
- B. Encouraging the client to increase fluid and fiber intake
- C. Providing perineal care using peri-bottles with warm water
- D. Instructing the client on proper positioning for defecation
Correct Answer: A
Rationale: The priority nursing intervention for a postpartum client who experienced a perineal laceration and reports pain and discomfort during defecation is to recommend the use of stool softeners or laxatives. Perineal lacerations can lead to pain and discomfort during bowel movements due to the strain that passing stools may cause on the tender area. Stool softeners or laxatives can help soften the stool, making it easier and less painful for the client to have bowel movements. It is important to alleviate the discomfort and promote bowel regularity to prevent complications such as constipation, which can further exacerbate the pain and delay healing of the perineal laceration.
A patient presents with multiple, flesh-colored, papular lesions with a central dell on the face and trunk. The lesions have a tendency to bleed upon minor trauma and have been increasing in number over time. Which of the following conditions is most likely responsible for this presentation?
- A. Basal cell carcinoma
- B. Squamous cell carcinoma
- C. Seborrheic keratosis
- D. Actinic keratosis
Correct Answer: A
Rationale: The presentation described in the question is classic for basal cell carcinoma (BCC). BCC typically presents as multiple, flesh-colored, papular lesions with a central dell (resembling a pearl-like appearance) on sun-exposed areas such as the face and trunk. These lesions are known to bleed easily upon minor trauma and tend to increase in number over time. BCC is the most common type of skin cancer, often triggered by sun exposure. On the other hand, seborrheic keratosis (choice C) presents as benign, pigmented, stuck-on, waxy, or warty lesions with a rough surface, true bumpy appearance. Squamous cell carcinoma (choice B) usually presents as a scaly, erythematous, rapidly growing nodule, ulcer, or plaque. Actinic keratosis (choice D) presents as rough, scaly patches on sun-exposed areas that can progress to
In planning the care of the elderly, which should be the important consideration that Nurse Gina has to consider _____.
- A. The educational qualification
- B. Family support
- C. Activities of daily liiving
- D. Residence of the elderly
Correct Answer: B
Rationale: Family support is a crucial consideration when planning the care of the elderly. The availability of family members to provide emotional support, assistance with daily activities, and decision-making can greatly impact the overall well-being of the elderly individual. Family support can help reduce feelings of isolation, ensure that the elderly person's needs are being met, and provide a sense of security and comfort. Additionally, involving family members in the care planning process can help create a collaborative and comprehensive care approach that considers the preferences and values of the elderly person. Considering the level of family support is essential for creating a care plan that meets the unique needs and circumstances of each elderly individual.
A patient with interstitial lung disease (ILD) develops progressive dyspnea, non-productive cough, and fine inspiratory crackles on auscultation. High-resolution computed tomography (HRCT) of the chest reveals diffuse reticular opacities and traction bronchiectasis. Which of the following ILD subtypes is most likely to present with these clinical and radiographic features?
- A. Idiopathic pulmonary fibrosis (IPF)
- B. Sarcoidosis
- C. Hypersensitivity pneumonitis (HP)
- D. Connective tissue disease-associated ILD
Correct Answer: A
Rationale: The clinical presentation of a patient with progressive dyspnea, non-productive cough, fine inspiratory crackles, and HRCT findings of diffuse reticular opacities and traction bronchiectasis is highly suggestive of idiopathic pulmonary fibrosis (IPF). IPF is a specific subtype of ILD characterized by progressive scarring of the lung tissue, leading to the symptoms mentioned above. The presence of reticular opacities and traction bronchiectasis on HRCT is a typical finding in IPF.
A nurse doubts that the physician has prescribed an unusually large dosage of a medication. The nurse ask the senior nurse on duty about the order if it is correct or wrong, the senior nurse tells the nurse that the order is correct. The nurse comply with the order and administer it to the patient. The patient eventually died. Who is liable for this situation.
- A. Physician
- B. Nurse
- C. Senior nurse
- D. Physician and nurse
Correct Answer: D
Rationale: The physician is ultimately responsible for prescribing the correct dosage of medication to the patient. However, the nurse also plays a critical role in ensuring patient safety by questioning any orders that appear to be unusual or incorrect. In this scenario, the nurse had doubts about the unusually large dosage but was reassured by the senior nurse that the order was correct. Both the physician and the nurse failed in their responsibilities, leading to the patient's unfortunate death. The senior nurse also shares liability as they provided incorrect guidance to the nurse administering the medication. Ultimately, the situation was a result of a breakdown in communication and adherence to proper procedures by both the physician and the nurse.