Nokea
A patient presents with chest pain that worsens with inspiration and is relieved by sitting forward. There is also evidence of deep vein thrombosis (DVT) in the lower extremity. Which cardiovascular disorder is most likely responsible for these symptoms?
- A. Stable angina
- B. Pulmonary embolism
- C. Pericarditis
- D. Aortic dissection
Correct Answer: B
Rationale: The patient's presenting symptoms of chest pain worsened by inspiration and relieved by sitting forward, with associated DVT in the lower extremity, suggest a high likelihood of pulmonary embolism. Chest pain that worsens with inspiration due to pleuritic involvement is a classic symptom of pulmonary embolism. Additionally, the presence of DVT in the lower extremity represents a risk factor for the development of pulmonary embolism, as clots originating in the deep veins can travel to the pulmonary circulation to cause an obstruction. Patients with pulmonary embolism may also exhibit signs of right heart strain, such as tachycardia, tachypnea, and sometimes hemoptysis.
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A patient with a suspected spinal injury is found unconscious. Which of the following actions should be taken first?
- A. Move the patient to a flat surface.
- B. Perform a jaw thrust maneuver.
- C. Apply a cervical collar.
- D. Check for responsiveness.
Correct Answer: B
Rationale: When a patient with a suspected spinal injury is found unconscious, the priority action is to secure the airway without jeopardizing the cervical spine. A jaw thrust maneuver is the appropriate technique to open the airway in this situation because it allows for the maintenance of neutral alignment of the cervical spine while ensuring proper ventilation. Moving the patient to a flat surface or applying a cervical collar could potentially worsen the spinal injury if not done correctly, and checking for responsiveness should only be done after ensuring a patent airway. Therefore, the safest and most effective initial action is to perform a jaw thrust maneuver to establish a clear airway.
Because Mr. Steve cannot pay for his medical bills, he is referred to the social worker. which of the following rights is applicable in this case the right to_______.
- A. Considerate and respectful care and respectful care irrespective of his socio-economics status.
- B. Expect reasonable continuity of care
- C. Examine and receive an explanation of his medical bills regardless of the source of payment
- D. Know what hospital rules and regulation apply to his conduct as a client.
Correct Answer: A
Rationale: The right to considerate and respectful care irrespective of socio-economic status is applicable in this case because Mr. Steve is facing financial difficulties in paying for his medical bills. This right ensures that all patients receive proper treatment and care regardless of their ability to pay. It emphasizes that every individual deserves to be treated with dignity and respect, regardless of their financial situation. In Mr. Steve's case, being referred to a social worker due to inability to pay should not impact the quality of care and respect he receives from healthcare providers.
In handling all information about the famiilies in the community, which of the following principles should the nurse consider ethical?
- A. Confidentialty
- B. Justice
- C. Fair treatment
- D. Beneficence
Correct Answer: A
Rationale: When handling information about families in the community, the nurse should consider the principle of confidentiality as ethical. Confidentiality refers to the obligation of healthcare providers to safeguard the privacy of patient information. By maintaining confidentiality, the nurse upholds trust and respect in the nurse-family relationship. This principle ensures that sensitive information shared by families is kept secure and not disclosed without permission, thus respecting their autonomy and promoting open communication in healthcare settings.
A postpartum client presents with persistent, severe perineal pain despite analgesic medication. On assessment, the nurse observes ecchymosis and swelling of the perineum. Which nursing action is most appropriate?
- A. Applying ice packs to the perineum for pain relief
- B. Encouraging the client to sit on a donut cushion
- C. Notifying the healthcare provider immediately
- D. Administering additional analgesic medication
Correct Answer: C
Rationale: The presence of persistent, severe perineal pain along with ecchymosis and swelling of the perineum can indicate a complication such as a hematoma. A hematoma is a collection of blood that can occur in the perineal area postpartum, usually as a result of trauma during delivery. It is essential to notify the healthcare provider immediately to assess the situation, provide appropriate treatment, and prevent further complications. Applying ice packs or administering additional analgesic medication may not address the underlying issue of a possible hematoma, so prompt medical evaluation is crucial in this situation.
A patient presents with chronic low back pain and radicular symptoms radiating down the leg. MRI reveals a herniated disc at the L5-S1 level with compression of the adjacent nerve root. Which surgical procedure is commonly performed to decompress the nerve root and alleviate symptoms?
- A. Spinal fusion
- B. Laminectomy
- C. Discectomy
- D. Foraminotomy
Correct Answer: C
Rationale: A discectomy is a surgical procedure commonly performed to decompress the nerve root by removing a portion of the herniated disc that is pressing on the nerve. In cases of herniated discs causing radicular symptoms (such as pain radiating down the leg), a discectomy can help alleviate the compression on the nerve, reduce symptoms, and improve the patient's condition. This procedure involves removing the portion of the disc that is herniated or bulging out to relieve pressure on the nerve root, allowing for improved function and reduced pain. Spinal fusion, laminectomy, and foraminotomy are other surgical procedures that are not typically performed for the direct decompression of the nerve root in cases of herniated discs at a specific level like the L5-S1 level.