Nokea
When is a fat embolism most likely to occur?
- A. 24 to 48 hours following a fractured tibia
- B. 36 to 72 hours following a skull fracture
- C. 4 to 5 days following a fractured femur
- D. 5 to 6 days following a pelvic fracture
Correct Answer: A
Rationale: Fat embolism is most common after tibial fractures within 24-48 hours.
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Which test evaluates a patient's coordination and balance?
- A. The finger-to-nose and heel-to-shin tests.
- B. The Snellen chart test for visual acuity.
- C. The Rinne and Weber tests for hearing.
- D. The Romberg test for proprioception.
Correct Answer: A
Rationale: The finger-to-nose and heel-to-shin tests assess coordination and balance. The Snellen chart tests vision, the Rinne and Weber tests assess hearing, and the Romberg test evaluates proprioception.
The septum of the nasal cavity is innervated by
- A. Nasopalatine nerve from cranial nerve V2
- B. Posterior ethmoidal nerve from V1
- C. Greater palatine nerve from V2
- D. Lesser palatine nerve from V2
Correct Answer: A
Rationale: The nasopalatine nerve, a branch of the maxillary division (V2) of the trigeminal nerve, supplies sensation to the nasal septum. It is important in nasal surgeries and anesthesia.
A 70-year-old alcoholic patient with acute lethargy, confusion, and incontinence is admitted to the hospital ED. His wife tells you that he fell down the stairs about a month ago, but 'he didn't have a scratch afterward.' She feels that he has become gradually less active and sleepier over the last 10 days or so. Which of the following collaborative interventions will you implement first?
- A. Place on the hospital alcohol withdrawal protocol.
- B. Transfer to radiology for a CT scan.
- C. Insert a retention catheter to straight drainage.
- D. Give phenytoin (Dilantin) 100 mg PO.
Correct Answer: B
Rationale: A CT scan is needed to rule out a subdural hematoma, which could explain the symptoms.
The woman with osteoporosis slipped on the ice and now her wrist hurts. If there is a fracture, what type of fracture is expected?
- A. Dislocation
- B. Open fracture
- C. Colles' fracture
- D. Incomplete fracture
Correct Answer: C
Rationale: Colles' fracture is common in osteoporosis-related wrist injuries.
The nurse practitioner is assessing an adult patient with a seizure disorder that is well controlled on phenytoin (Dilantin). What new finding indicates that a phenytoin drug level assessment is needed?
- A. Hypertrophic gums
- B. Vitamin D supplements
- C. BP 125/78 mmHg and pulse 95 bpm
- D. Flat affect and anxiety
Correct Answer: D
Rationale: The correct answer is D because a flat affect and anxiety can indicate potential phenytoin toxicity, which warrants a drug level assessment. Phenytoin toxicity can manifest as neurological symptoms such as mood changes and cognitive impairment. Options A and B are unrelated to phenytoin levels. Option C indicates normal vital signs and is not a specific indicator of phenytoin toxicity.