Nokea
Which intrapartal assessment should be avoided when caring for a patient with HELLP syndrome?
- A. Abdominal palpation
- B. Venous sample of blood
- C. Checking deep tendon reflexes
- D. Auscultation of the heart and lungs
Correct Answer: A
Rationale: The correct answer is A: Abdominal palpation. Palpating the abdomen can potentially cause rupture of the liver in patients with HELLP syndrome due to increased risk of liver hematoma. This can lead to severe bleeding and compromise the patient's condition. Checking deep tendon reflexes (C), auscultation of the heart and lungs (D), and venous sample of blood (B) are safe assessments that do not pose a risk of exacerbating the patient's condition. It is crucial to prioritize patient safety and avoid interventions that can harm the patient, making avoiding abdominal palpation the correct choice in caring for a patient with HELLP syndrome.
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A patient who was diagnosed with Parkinsons disease several months ago recently began treatment with levodopa-carbidopa. The patient and his family are excited that he has experienced significant symptom relief. The nurse should be aware of what implication of the patients medication regimen?
- A. The patient is in a honeymoon period when adverse effects of levodopa-carbidopa are not yet evident.
- B. Benefits of levodopa-carbidopa do not peak until 6 to 9 months after the initiation of treatment.
- C. The patients temporary improvement in status is likely unrelated to levodopa-carbidopa.
- D. Benefits of levodopa-carbidopa often diminish after 1 or 2 years of treatment.
Correct Answer: A
Rationale: The correct answer is A. The patient is in a honeymoon period when adverse effects of levodopa-carbidopa are not yet evident. This is because the initial response to levodopa-carbidopa in Parkinson's disease can be very positive, leading to significant symptom relief. However, over time, as the disease progresses and the body adjusts to the medication, adverse effects such as dyskinesias may become more prominent.
Choice B is incorrect because the benefits of levodopa-carbidopa can be seen relatively soon after initiation of treatment and do not necessarily take 6 to 9 months to peak. Choice C is incorrect as the temporary improvement is likely related to the medication, given the significant symptom relief experienced. Choice D is incorrect because while benefits may diminish over time, it is not necessarily after 1 or 2 years of treatment, and some patients may continue to benefit from the medication long-term.
A nurse is preparing to document a patient whohas chest pain. Which information is critical for the nurse to include?
- A. The family is a “pain.”
- B. Pupils equal and reactive to light
- C. Had poor results from the pain medication
- D. Sharp pain of 8 on a scale of 1 to 10
Correct Answer: D
Rationale: The correct answer is D because documenting the patient's pain intensity using a pain scale (8 out of 10) is crucial for assessing the severity of the chest pain. This information helps in determining the appropriate intervention and monitoring the effectiveness of treatment. Choice A is irrelevant as it does not provide any useful information about the patient's condition. Choice B is important for neurological assessment but not specifically related to chest pain. Choice C is not as critical as knowing the current pain level.
A man comes to the clinic complaining that he is having difficulty obtaining an erection. When reviewing the patients history, what might the nurse note that contributes to erectile dysfunction?
- A. The patient has been treated for a UTI twice in the past year.
- B. The patient has a history of hypertension.
- C. The patient is 66 years old.
- D. The patient leads a sedentary lifestyle.
Correct Answer: B
Rationale: The correct answer is B: The patient has a history of hypertension. Hypertension is a risk factor for erectile dysfunction as it can lead to reduced blood flow to the penis, impacting the ability to achieve and maintain an erection. High blood pressure can damage blood vessels and affect the circulation necessary for an erection. Other choices are less likely to directly contribute to erectile dysfunction. A: UTI treatment is not typically associated with erectile dysfunction. C: Age alone is not a direct cause of erectile dysfunction, although it can increase the risk. D: While a sedentary lifestyle can impact overall health, it is less likely to directly cause erectile dysfunction compared to hypertension.
The nurse is caring for a patient who is scheduled for a cervical discectomy the following day. During health education, the patient should be made aware of what potential complications?
- A. Vertebral fracture
- B. Hematoma at the surgical site
- C. Scoliosis
- D. Renal trauma
Correct Answer: B
Rationale: The correct answer is B: Hematoma at the surgical site. This is a potential complication of cervical discectomy due to the risk of bleeding post-surgery. Hematoma can compress nearby structures and lead to increased pain and swelling.
A: Vertebral fracture is not a typical complication of cervical discectomy, as the surgery aims to relieve pressure on the spinal cord caused by a herniated disc, not to cause fractures.
C: Scoliosis is a condition characterized by abnormal lateral curvature of the spine, and it is not directly related to cervical discectomy.
D: Renal trauma is not a common complication of cervical discectomy, as the surgery focuses on the cervical spine and does not involve the kidneys or renal system.
A 45-year-old woman has just undergone a radical hysterectomy for invasive cervical cancer. Prior to the surgery the physician explained to the patient that after the surgery a source of radiation would be placed near the tumor site to aid in reducing recurrence. What is the placement of the source of radiation called?
- A. Internal beam radiation
- B. Trachelectomy
- C. Brachytherapy
- D. External radiation
Correct Answer: C
Rationale: The correct answer is C: Brachytherapy. Brachytherapy involves placing a radiation source near or directly into the tumor site. In this case, after the hysterectomy, the source of radiation is placed near the cervical cancer site to deliver targeted radiation therapy. This method helps reduce the risk of cancer recurrence by delivering high doses of radiation to the tumor while minimizing exposure to surrounding healthy tissues.
Choice A (Internal beam radiation) typically refers to a type of external radiation therapy where radiation beams are directed at the tumor from outside the body, not placed internally like brachytherapy.
Choice B (Trachelectomy) is a surgical procedure that involves removal of the cervix while preserving the uterus, not related to radiation therapy.
Choice D (External radiation) involves delivering radiation from outside the body using a machine, unlike brachytherapy where the radiation source is placed internally near the tumor site.