Nokea
A patient presents with redness, pain, and photophobia in the left eye. Slit-lamp examination reveals ciliary injection, corneal edema, and a mid-dilated pupil with fixed reaction to light. Which of the following conditions is most likely responsible for this presentation?
- A. Anterior uveitis
- B. Acute angle-closure glaucoma
- C. Endophthalmitis
- D. Corneal abrasion
Correct Answer: A
Rationale: The presentation described in the question is most consistent with anterior uveitis. Anterior uveitis, also known as iritis, is characterized by redness, pain, and photophobia in the affected eye. Slit-lamp examination typically reveals ciliary injection (reddening of the conjunctiva and episclera), corneal edema, and a mid-dilated pupil with a fixed reaction to light (miosis). This occurs due to inflammation within the anterior chamber of the eye involving the iris and ciliary body.
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Nurse Pat promised to a post- surgical patient, that she would come back to assist in his ambulation after carrying out the physician's order. This follows the principle of
- A. beneficence
- B. justice
- C. autonomy
- D. fidelity
Correct Answer: D
Rationale: Fidelity is a principle of ethics that relates to being faithful or loyal to one's commitments and responsibilities. When Nurse Pat promises to assist the post-surgical patient with ambulation after carrying out the physician's order, she is demonstrating fidelity by honoring her commitment to the patient. This principle highlights the importance of keeping promises, being reliable, and maintaining trust in the nurse-patient relationship.
A postpartum client who delivered preterm expresses concern about breastfeeding her premature infant. What nursing intervention should be prioritized to support successful breastfeeding in this situation?
- A. Providing education on strategies for initiating and maintaining milk supply
- B. Recommending the use of supplemental formula feedings to ensure adequate nutrition
- C. Encouraging the client to postpone breastfeeding until the infant reaches full term
- D. Referring the client to a lactation consultant for specialized support
Correct Answer: A
Rationale: Providing education on strategies for initiating and maintaining milk supply should be prioritized to support successful breastfeeding in this situation. Preterm infants can benefit significantly from breast milk due to its unique composition that supports their growth and development. Educating the client on techniques such as pumping to establish and maintain milk supply, proper latching techniques, and understanding the benefits of breastfeeding for preterm infants can help alleviate her concerns and increase her confidence in breastfeeding her premature infant. Additionally, promoting skin-to-skin contact and frequent feedings can also help stimulate milk production and foster bonding between the mother and infant. Encouraging and supporting the client with evidence-based information will be crucial in promoting successful breastfeeding outcomes for the preterm infant.
Leukemia is a chronic illness and it is expected that the patient will be in and out of the hospital. To maintain communication, the nurse will _________.
- A. ask the patient to call the hospital number listed in the yellow pages
- B. ask for the phone number where the patient can be easily contacted
- C. read the information sheet of the patient in the chart
- D. tell patient to write the number in a piece of paper and give it to the ward clerk
Correct Answer: B
Rationale: It is important for the nurse to have a direct and easily accessible means of communication with the patient who is expected to be in and out of the hospital due to their chronic illness like leukemia. By asking for the patient's phone number, the nurse can quickly reach out to them for updates, clarification, or any urgent matters that may arise. This direct communication line helps in ensuring continuity of care and addressing the patient's needs promptly. This approach is more practical and efficient compared to options such as asking the patient to call the hospital number listed in the yellow pages or relying on chart information which may not always be up to date. Writing down the number and giving it to the ward clerk may cause unnecessary delays in communication.
A patient appears confused and disoriented during a consultation. What is the nurse's priority?
- A. Assume the patient is not capable of understanding and proceed with the consultation.
- B. Provide clear and simple explanations and assess for any underlying causes of confusion.
- C. Ignore the patient's confusion and proceed with the consultation.
- D. Dismiss the patient's confusion as insignificant and focus solely on the medical information.
Correct Answer: B
Rationale: The nurse's priority when a patient appears confused and disoriented during a consultation is to provide clear and simple explanations and assess for any underlying causes of confusion. It is essential to ensure that the patient understands the information being provided and to address any potential reasons for the confusion, such as medication side effects, medical conditions, or cognitive impairment. Ignoring the patient's confusion or assuming they cannot understand can lead to misunderstandings, errors in care, and ultimately jeopardize the patient's well-being. It is crucial to approach the situation with empathy, patience, and a focus on ensuring effective communication and understanding between the nurse and the patient.
What symptom is an INDICATOR of cranial nerve involvement?
- A. Difficulty of speaking and chewing.
- B. Loss of pain sensation
- C. Spastic paralysis of the extremities
- D. Forgetfulness and syncope
Correct Answer: A
Rationale: Difficulty of speaking and chewing is an indicator of cranial nerve involvement. Cranial nerves are responsible for controlling various functions of the head and neck, including speech and mastication. Impairment of cranial nerve function can lead to difficulty in these activities. In the context of the question, with the patient in the stroke unit, cranial nerve involvement can occur due to the stroke affecting the brain regions responsible for cranial nerve function. Loss of pain sensation, spastic paralysis of the extremities, and forgetfulness with syncope are not specific indicators of cranial nerve involvement in this scenario.