Nokea
Which of the following conditions is characterized by degenerative changes in the intervertebral discs, leading to narrowing of the disc space and osteophyte formation?
- A. Spondylolisthesis
- B. Spondylosis
- C. Spondylolysis
- D. Spinal stenosis
Correct Answer: B
Rationale: Spondylosis is a condition characterized by degenerative changes in the intervertebral discs, leading to narrowing of the disc space and the formation of osteophytes (bone spurs). This degenerative process commonly occurs with aging and can cause symptoms such as neck or back pain, stiffness, and reduced range of motion. Spondylosis is a common finding on imaging studies like X-rays and MRI scans in individuals over the age of 50 and is a natural part of the aging process of the spine.
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A patient presents with chest pain that occurs at rest and is exacerbated by deep breathing or changes in body position. The pain improves with leaning forward. Which cardiovascular disorder is most likely responsible for these symptoms?
- A. Stable angina
- B. Unstable angina
- C. Pericarditis
- D. Myocarditis
Correct Answer: C
Rationale: Pericarditis is the inflammation of the pericardium, the sac surrounding the heart. Patients with pericarditis typically present with sharp chest pain that worsens with deep breathing, changes in body position, and coughing. The pain tends to improve when the patient leans forward. This characteristic symptom of pericarditis is known as "pleuritic" chest pain. In contrast, stable angina presents as predictable chest pain that occurs with exertion and is relieved by rest or medications. Unstable angina is characterized by chest pain that occurs at rest or with minimal exertion and is considered a medical emergency. Myocarditis involves inflammation of the heart muscle and may present with symptoms such as chest pain, but it does not typically have the characteristic of worsening with deep breathing or changes in body position.
Nurse Ime, is a member of the Quality Assurance team of the hospital and has been always rated as very assertive. Which of the following is NOT a characteristic of an assertive person?
- A. Intervene with the situation calmly and confidently.
- B. She stands up with what she believes & push control on others.
- C. Articulate clearly the importance of nursing perspective.
- D. Use "I" when stating thought and feelings & "YOU" when persuading others.
Correct Answer: B
Rationale: Being assertive means expressing one's thoughts, beliefs, and feelings in a confident and respectful manner while also considering the perspective of others. It does not involve pushing control on others. Assertive individuals do not impose their beliefs on others but express themselves clearly and confidently, respecting the opinions of others. So, standing up for what one believes in can be assertive, but pushing control on others is not a characteristic of assertiveness.
A patient is prescribed a benzodiazepine for the management of anxiety. Which instruction should the nurse include in patient education about benzodiazepine therapy?
- A. "Take the medication with grapefruit juice for enhanced absorption."
- B. "Avoid consuming alcohol while on benzodiazepine therapy."
- C. "Take the medication on an empty stomach for better effectiveness."
- D. "Discontinue the medication abruptly if you experience side effects."
Correct Answer: B
Rationale: Consuming alcohol while on benzodiazepine therapy can increase the central nervous system depressant effects of benzodiazepines, leading to excessive sedation, respiratory depression, and even overdose. It is important for patients to avoid alcohol to prevent these potential dangerous interactions and to ensure the safe and effective use of their medication.
A patient with a displaced femoral neck fracture is scheduled for surgical intervention. Which surgical procedure is most appropriate for this type of fracture?
- A. Closed reduction and internal fixation (CRIF)
- B. Open reduction and internal fixation (ORIF)
- C. Closed reduction and external fixation (CREF)
- D. Closed reduction alone
Correct Answer: B
Rationale: For a displaced femoral neck fracture, the most appropriate surgical procedure is usually an open reduction and internal fixation (ORIF). This procedure involves making an incision to reposition the fractured bone fragments and securing them in place with screws or other fixation devices. ORIF allows for better alignment of the fracture, which is crucial for proper healing and minimizing the risk of complications like avascular necrosis or nonunion. Closed reduction and internal fixation (CRIF) may not be as effective for displaced femoral neck fractures due to the complex nature of the fracture and the need for precise realignment and stability provided by an open surgical approach. External fixation is less commonly used for femoral neck fractures and is typically reserved for certain specific cases where internal fixation is not feasible. Closed reduction alone is unlikely to provide adequate stability for a displaced femoral neck fracture and is generally not recommended as the primary surgical treatment for this type of injury.
A patient is reluctant to undergo a recommended procedure due to fear of pain. What is the nurse's best approach to address this fear?
- A. Dismiss the patient's fear and assure them that the procedure will not be painful.
- B. Provide the patient with accurate information about pain management strategies and options.
- C. Ignore the patient's fear and proceed with scheduling the procedure.
- D. Tell the patient that fear of pain is irrational and unfounded.
Correct Answer: B
Rationale: The nurse's best approach to address the patient's fear of pain is to provide accurate information about pain management strategies and options. In doing so, the nurse can help alleviate the patient's concerns by empowering them with knowledge and potential solutions for managing pain during and after the procedure. By acknowledging the patient's fear and addressing it with practical information, the nurse can build trust, reduce anxiety, and create a more supportive and collaborative environment for the patient. Dismissing, ignoring, or invalidating the patient's fear would not be effective in addressing the underlying concerns and could potentially lead to increased distress and resistance to the recommended procedure.