Nokea
The nurse suspects that a client has multiple myeloma based on the client's major presenting symptom and the analysis of laboratory results. What classic manifestation for multiple myeloma does the nurse assess for?
- A. Debilitating fatigue
- B. Gradual muscle paralysis
- C. Bone pain in the back of the ribs
- D. Severe thrombocytopenia
Correct Answer: C
Rationale: Bone pain in the back of the ribs is a classic manifestation of multiple myeloma. Multiple myeloma is a type of cancer that primarily affects plasma cells in the bone marrow, leading to weakened bones and bone pain. Patients with multiple myeloma often experience bone pain in areas such as the ribs, spine, and pelvis. The bone pain is typically persistent and worsens with movement or pressure. Additionally, other common symptoms of multiple myeloma include anemia, kidney damage, recurrent infections, and elevated calcium levels in the blood.
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Nurse Selma conducts her INITIAL assessment on Catherine. patient keeps on crying and constantly pulls her right ear. What is her MOST APPROPRIATE action?
- A. Request parent to carry the child
- B. Take Catherine's vital signs.
- C. Refer to the attending physician.
- D. Assess the description and frequency of pain.
Correct Answer: D
Rationale: When a patient is crying and continuously pulling at a specific body part, such as Catherine pulling her right ear, it indicates discomfort or pain in that area. Nurse Selma's most appropriate action would be to further assess the description and frequency of the pain. This will help her identify the possible cause of the pain, whether it is due to an ear infection, injury, or any other underlying issue. Understanding the nature and intensity of the pain will guide Nurse Selma in providing appropriate care and intervention for Catherine. It is crucial to address the patient's pain promptly to ensure their comfort and well-being. Referring to the attending physician may be necessary after this initial assessment but assessing the pain should be the immediate priority.
A patient with terminal cancer experiences dyspnea and anxiety. Which intervention should the palliative nurse prioritize to address the patient's symptoms?
- A. Administer oxygen therapy to relieve dyspnea.
- B. Encourage the patient to practice relaxation techniques.
- C. Prescribe opioid medications for symptom management.
- D. Refer the patient to a respiratory therapist for breathing exercises.
Correct Answer: C
Rationale: When a patient with terminal cancer experiences dyspnea (difficulty breathing) and anxiety, opioid medications are often prioritized by palliative care providers for symptom management. Opioids are effective in relieving dyspnea by acting as respiratory depressants and reducing the feeling of air hunger. Additionally, opioids have sedative effects that can help alleviate anxiety and promote relaxation. Therefore, in this situation, prescribing opioid medications would be the most appropriate intervention to address both the dyspnea and anxiety symptoms simultaneously. Oxygen therapy, relaxation techniques, and breathing exercises may also be useful adjunctive interventions, but opioid medications are typically prioritized for immediate symptom relief in this context.
A patient is having elective surgery under general anesthesia. Who is responsible for obtaining the informed-consent?
- A. Surgeon
- B. Nurse anesthetist
- C. Nurse
- D. Anesthesiologist
Correct Answer: A
Rationale: The primary responsibility for obtaining informed consent lies with the surgeon who will be performing the procedure. Informed consent is a process where the healthcare provider explains the procedure, benefits, risks, and alternatives to the patient, allowing them to make an informed decision about their care. While other healthcare team members may also participate in this process, the ultimate responsibility typically rests with the surgeon as they are the one performing the surgery.
A patient presents with symptoms of severe allergies, including difficulty breathing, hives, and swelling. Which of the following cells is primarily responsible for mediating these allergic responses?
- A. Eosinophils
- B. Basophils
- C. Mast cells
- D. Neutrophils
Correct Answer: C
Rationale: Mast cells are primarily responsible for mediating allergic responses such as severe allergies. When an allergen triggers the immune response, mast cells release histamine, leukotrienes, and other inflammatory mediators. These substances cause symptoms such as difficulty breathing, hives, and swelling. Basophils also release histamine, but mast cells are more abundant in tissues and play a significant role in allergic reactions. Eosinophils are involved in allergic reactions but are more focused on combating parasitic infections. Neutrophils are not typically involved in allergic responses but play a key role in combating bacterial infections.
A patient presents with unilateral facial paralysis, inability to close the eye on the affected side, and loss of taste sensation on the anterior two-thirds of the tongue. Which of the following conditions is most likely responsible for this presentation?
- A. Bell's palsy
- B. Ramsay Hunt syndrome
- C. Glossopharyngeal neuralgia
- D. Acoustic neuroma
Correct Answer: B
Rationale: Ramsay Hunt syndrome is caused by the varicella-zoster virus affecting the geniculate ganglion, leading to a triad of symptoms known as the Hunt syndrome: facial paralysis, ear pain, and a vesicular rash in the ear or palate. The facial paralysis in Ramsay Hunt syndrome is usually peripheral, similar to Bell's palsy, but may be more severe. In addition to facial paralysis, the patient may have the inability to close the eye on the affected side (lagophthalmos) and loss of taste sensation on the anterior two-thirds of the tongue due to involvement of the chorda tympani nerve. This differentiation is important to consider in the context of our patient's presentation.