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A patient presents with fatigue, weakness, and jaundice. Laboratory tests reveal elevated indirect bilirubin levels, reticulocytosis, and positive Coombs test. Which of the following conditions is most likely to cause these findings?
- A. Hereditary spherocytosis
- B. Thalassemia
- C. Sickle cell disease
- D. G6PD deficiency
Correct Answer: A
Rationale: The patient's presentation of fatigue, weakness, jaundice, elevated indirect bilirubin levels, reticulocytosis, and positive Coombs test is consistent with hemolytic anemia. Among the options provided, hereditary spherocytosis is the most likely condition to cause these findings.
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The newly hired nurse asks for advice from the supervisor. supervisor notices that the newly hired nurse felt uneasy upon learning that the fetus is on breech presentation. Which of the following is the BEST RESPONSE by the supervisor?
- A. "I understand how you feel. Tell me more."
- B. Is this your first time to witness a breech presentation"
- C. Are you afraid to assist the case"
- D. "Don' t worry. There's always a first time"
Correct Answer: A
Rationale: The best response by the supervisor is to acknowledge the newly hired nurse's emotions by saying, "I understand how you feel. Tell me more." This response shows empathy and validates the nurse's feelings, creating a supportive environment for open communication. It allows the nurse to express their concerns and fears, leading to a constructive discussion and providing an opportunity for guidance and reassurance. This approach fosters a positive mentorship and learning experience for the newly hired nurse.
If a research study involves an intervention and "blinding" which research design is being referred to?
- A. Non-descriptive
- B. Experimental
- C. Phenomenological
- D. Descriptive
Correct Answer: B
Rationale: The research design being referred to in the question is an experimental design. An experimental study involves the manipulation of an independent variable, which is the intervention in this case, to determine its effect on a dependent variable. "Blinding" in research refers to the practice of withholding information about the intervention from certain individuals involved in the study, such as researchers, participants, or outcome assessors. Blinding is commonly used in experimental studies to reduce bias and ensure the integrity of the study results. This combination of intervention and blinding is a hallmark of experimental research designs.
While the nurse is taking yhe blood pressure, the patient suddenly stated."They are talking about me!". She was referring to other patients who were waiting for their consultation. Which of the following should be the APPROPRIATE nursing action?
- A. Present the reality situation
- B. Distract patient's attention
- C. Disagree with the patient
- D. Validate the statement
Correct Answer: B
Rationale: The appropriate nursing action in this situation would be to distract the patient's attention. When a patient perceives that others are talking about them, it may indicate feelings of paranoia or anxiety. It's important to help the patient refocus on something else to alleviate their distress. Distracting the patient's attention can help calm them down and allow the blood pressure measurement to proceed smoothly. This approach respects the patient's feelings and helps manage the situation effectively.
One evening, Sonny complained of dyspnea despite continuous oxygen therapy. What should be the FIRST action of the nurse?
- A. Reassess the client.
- B. Give PRN medication.
- C. Assess the patency of the tubing.
- D. Refer client to the physician.
Correct Answer: A
Rationale: The FIRST action of the nurse should be to reassess the client experiencing dyspnea despite continuous oxygen therapy. Reassessment would involve checking the client's respiratory status, oxygen saturation levels, vital signs, and overall condition to gather more information about the situation. This will help the nurse identify any potential causes of the dyspnea and determine the appropriate next steps for intervention. Assessing the client before proceeding with any other actions is crucial in providing safe and effective care.
A patient with a history of chronic kidney disease presents with pruritus, pale skin, and easy bruising. Laboratory findings reveal anemia, thrombocytopenia, and elevated blood urea nitrogen (BUN) and creatinine levels. Which of the following conditions is most likely?
- A. Uremic encephalopathy
- B. Uremic pericarditis
- C. Uremic bleeding diathesis
- D. Uremic neuropathy
Correct Answer: C
Rationale: The given patient with chronic kidney disease (CKD) is likely experiencing uremic bleeding diathesis. Uremic bleeding diathesis is a complication of CKD characterized by abnormal platelet function, leading to a tendency for bleeding. The presence of anemia, thrombocytopenia (low platelet count), pale skin, easy bruising, and elevated blood urea nitrogen (BUN) and creatinine levels are all consistent with uremic bleeding diathesis.