A patient presents with chest pain that worsens with swallowing and is relieved by leaning forward. An electrocardiogram (ECG) shows diffuse ST-segment elevation. Which cardiovascular disorder is most likely responsible for these symptoms?
- A. Stable angina
- B. Unstable angina
- C. Acute myocardial infarction
- D. Pericarditis
Correct Answer: D
Rationale: The given clinical presentation of chest pain that worsens with swallowing and is relieved by leaning forward along with diffuse ST-segment elevation on an ECG is highly suggestive of pericarditis. Pericarditis is the inflammation of the pericardium, the thin sac surrounding the heart. The symptoms of pericarditis can mimic those of myocardial infarction (heart attack) but can also be differentiated by certain characteristics such as the described positional chest pain, which is worsened by swallowing and relieved by leaning forward.
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Which of the following interventions is most appropriate for managing a patient with acute respiratory failure and hypercapnia due to chronic obstructive pulmonary disease (COPD) exacerbation?
- A. Administration of supplemental oxygen via non-rebreather mask
- B. Initiation of non-invasive positive pressure ventilation (NIPPV)
- C. Placement of an indwelling arterial catheter for continuous monitoring
- D. Titration of inhaled bronchodilators and corticosteroids
Correct Answer: B
Rationale: In a patient with acute respiratory failure and hypercapnia due to a COPD exacerbation, the most appropriate intervention is the initiation of non-invasive positive pressure ventilation (NIPPV). NIPPV helps improve ventilation and oxygenation by providing mechanical support to the patient's breathing without the need for endotracheal intubation. It can reduce the work of breathing, decrease carbon dioxide retention, and improve respiratory muscle function. This intervention is particularly beneficial for COPD exacerbations as it can help alleviate hypercapnia and hypoxemia, leading to improved outcomes and potentially reducing the need for invasive ventilation methods. Therefore, NIPPV is the recommended management strategy in this scenario.
She plans to interview the Psyche Nurse Manager about the patient safety practices of the nurses. What type of sampling includes those who happen to be in the conference room where the activity is scheduled?
- A. Random
- B. convenience
- C. Purposive
- D. Quota
Correct Answer: B
Rationale: Convenience sampling involves selecting participants who are readily available or easy to access. In this scenario, choosing to interview nurses who happen to be in the conference room where the activity is scheduled falls under convenience sampling as they are easily accessible at that moment. While convenience sampling may be convenient, it may introduce bias and may not represent the entire population accurately.
Which of the following is a common complication associated with benign prostatic hyperplasia (BPH)?
- A. Urinary retention
- B. Erectile dysfunction
- C. Urethral stricture
- D. Renal calculi
Correct Answer: A
Rationale: Benign prostatic hyperplasia (BPH) can lead to urinary retention, which is a common complication associated with this condition. As the prostate gland enlarges, it can obstruct the flow of urine from the bladder through the urethra. This obstruction can result in difficulty starting to urinate, weak urine flow, frequent urination, incomplete bladder emptying, and eventually urinary retention. If left untreated, urinary retention can lead to serious complications such as urinary tract infections, bladder damage, kidney damage, and even kidney stones. Therefore, urinary retention is an important complication to be aware of in patients with BPH.
A nurse is preparing to perform a bedside bronchoscopy procedure for a patient. What action should the nurse take to ensure patient safety during the procedure?
- A. Administering sedation to the patient before the bronchoscopy
- B. Obtaining informed consent from the patient or their legal representative
- C. Skipping the use of topical anesthesia to minimize patient discomfort
- D. Allowing the patient to eat or drink up to one hour before the procedure
Correct Answer: B
Rationale: The correct action for the nurse to ensure patient safety during a bedside bronchoscopy procedure is to obtain informed consent from the patient or their legal representative. Informed consent is a vital ethical and legal requirement before any medical procedure. It ensures that the patient understands the risks, benefits, and alternatives of the procedure, as well as gives the patient the authority to make decisions about their healthcare. By obtaining informed consent, the nurse ensures that the patient has been properly informed and agrees to undergo the bronchoscopy, which promotes patient autonomy and safety. Administering sedation, using topical anesthesia, and restricting food intake are also important aspects of bronchoscopy preparation, but obtaining informed consent is the primary action to prioritize patient safety.
As a nurse you are guided that pain is usually described BEST as a phenomenon which is a ________.
- A. Neurologic activation nociceptors
- B. Subjective unpleasant experience
- C. Adaptive mechanism to a stimulus
- D. Creation of one's imagination
Correct Answer: B
Rationale: Pain is best described as a subjective unpleasant experience because it is unique to each individual and is influenced by a variety of factors including emotional, psychological, and cultural elements. Pain cannot be objectively measured or quantified, and therefore it is considered a subjective experience that is reported by the person experiencing it. This is why pain is often assessed using self-report scales and tools to capture the individual's perception of their pain intensity and quality.