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A patient with a history of asthma is prescribed an inhaled corticosteroid. Which adverse effect is associated with long-term use of inhaled corticosteroids?
- A. Oral thrush
- B. Hypertension
- C. Hyperglycemia
- D. Osteoporosis
Correct Answer: D
Rationale: The correct answer is D: Osteoporosis. Long-term use of inhaled corticosteroids can lead to decreased bone density and an increased risk of osteoporosis. Corticosteroids can interfere with calcium absorption and bone formation, resulting in bone weakening. Oral thrush (Choice A) is a common side effect of inhaled corticosteroids, but it is not associated with long-term use. Hypertension (Choice B) and hyperglycemia (Choice C) are more commonly seen with systemic corticosteroid use rather than inhaled corticosteroids.
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A patient admitted to the ICU develops acute delirium with agitation and hallucinations. What intervention should the healthcare team prioritize to manage the patient's delirium?
- A. Implement environmental modifications to promote sleep hygiene.
- B. Administer antipsychotic medications for symptom control.
- C. Perform neurological assessments to rule out focal deficits.
- D. Recommend benzodiazepines for sedation and anxiety relief.
Correct Answer: A
Rationale: The correct answer is A: Implement environmental modifications to promote sleep hygiene. Delirium is often triggered by environmental factors like noise, light, and disruption of sleep. By optimizing the environment for rest and minimizing stimuli, the patient's delirium can improve. This approach focuses on addressing the root cause rather than just managing symptoms.
Choice B is incorrect because antipsychotic medications can worsen delirium and are not recommended as first-line treatment.
Choice C is not the priority as ruling out focal deficits may be important but does not directly address the delirium.
Choice D is incorrect as benzodiazepines can exacerbate delirium and are not recommended due to their potential to worsen cognitive function.
A woman in active labor demonstrates signs of prolonged second stage, characterized by ineffective pushing efforts and slow fetal descent. What maternal condition should the nurse assess for that may contribute to this abnormal labor pattern?
- A. Maternal fatigue
- B. Pelvic floor dysfunction
- C. Fetal macrosomia
- D. Maternal hypotension
Correct Answer: B
Rationale: When a woman in active labor exhibits signs of prolonged second stage, such as ineffective pushing efforts and slow fetal descent, one of the maternal conditions that should be considered is pelvic floor dysfunction. The pelvic floor muscles play a crucial role in supporting the uterus, bladder, and rectum. If these muscles are weak or dysfunctional, it can lead to difficulty in pushing effectively and impede the descent of the fetus through the birth canal. This can result in prolonged labor and increase the risk of complications for both the mother and the baby. Therefore, assessing for pelvic floor dysfunction is important in addressing the abnormal labor pattern and providing appropriate interventions to support the progress of labor.
A patient that had a stroke is experiencing memory loss and impaired learning capacity. In which lobe does the nurse determine that brain damage has MOST likely occurred?
- A. Frontal
- B. Parietal
- C. Occipital
- D. Temporal
Correct Answer: D
Rationale: The correct answer is D: Temporal lobe. Memory and learning are primarily associated with the temporal lobe, specifically the hippocampus. Damage to this area due to stroke can lead to memory loss and impaired learning capacity. Frontal lobe (A) is involved in decision-making and problem-solving. Parietal lobe (B) is responsible for sensory processing. Occipital lobe (C) is related to visual processing. Therefore, the temporal lobe is the most likely site of brain damage in this scenario based on the symptoms presented.
Which of the following conditions is characterized by inflammation of the glomeruli in the kidneys, leading to hematuria, proteinuria, and hypertension?
- A. Acute tubular necrosis
- B. Acute glomerulonephritis
- C. Chronic kidney disease
- D. Nephrotic syndrome
Correct Answer: B
Rationale: The correct answer is B: Acute glomerulonephritis. Glomerulonephritis is characterized by inflammation of the glomeruli in the kidneys, leading to symptoms like hematuria (blood in urine), proteinuria (excess protein in urine), and hypertension (high blood pressure).
Acute tubular necrosis (A) involves damage to the renal tubules, not the glomeruli. Chronic kidney disease (C) refers to long-term kidney damage and may not always present with the classic symptoms mentioned. Nephrotic syndrome (D) involves excessive protein loss in urine but may not always involve inflammation of the glomeruli.
A patient presents with sudden-onset, painless vision loss in the right eye. Fundoscopic examination reveals a cherry-red spot at the macula and attenuated retinal vessels. Which of the following conditions is most likely responsible for this presentation?
- A. Central retinal artery occlusion
- B. Central retinal vein occlusion
- C. Retinal detachment
- D. Acute angle-closure glaucoma
Correct Answer: A
Rationale: The correct answer is A: Central retinal artery occlusion. This condition presents with sudden-onset, painless vision loss, cherry-red spot at the macula due to lack of blood flow, and attenuated retinal vessels. The cherry-red spot is due to the transparency of the fovea when there is ischemia in the surrounding retina. Central retinal vein occlusion (B) presents with sudden vision loss accompanied by retinal hemorrhages and dilated tortuous veins. Retinal detachment (C) typically presents with sudden flashes, floaters, and a curtain-like visual field defect. Acute angle-closure glaucoma (D) presents with severe eye pain, blurred vision, halos around lights, and a fixed mid-dilated pupil.