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Which of the following conditions is characterized by excessive menstrual bleeding due to abnormal proliferation of endometrial tissue outside the uterus?
- A. Endometriosis
- B. Endometrial hyperplasia
- C. Leiomyomas (uterine fibroids)
- D. Adenomyosis
Correct Answer: A
Rationale: Endometriosis is a condition characterized by the abnormal growth of endometrial tissue outside the uterus. One common symptom of endometriosis is excessive menstrual bleeding, known as menorrhagia. This excessive bleeding is due to the presence of endometrial tissue in abnormal locations, leading to inflammation, scarring, and blood accumulation. In severe cases, endometriosis can lead to the formation of adhesions, cysts, and scar tissue, causing significant pain and fertility issues for affected individuals. Endometrial hyperplasia, leiomyomas (uterine fibroids), and adenomyosis are other gynecological conditions, but they do not involve the abnormal proliferation of endometrial tissue outside the uterus like endometriosis does.
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A patient presents with a sensation of fullness and pressure in the left ear, along with hearing loss and occasional tinnitus. Otoscopic examination reveals a retracted tympanic membrane with decreased mobility on pneumatic otoscopy. Which of the following conditions is most likely responsible for this presentation?
- A. Acute otitis media
- B. Otitis externa
- C. Serous otitis media (otitis media with effusion)
- D. Cholesteatoma
Correct Answer: C
Rationale: The presentation described with a sensation of fullness and pressure in the left ear, along with hearing loss and occasional tinnitus, and the findings of a retracted tympanic membrane with decreased mobility on pneumatic otoscopy are most consistent with serous otitis media, also known as otitis media with effusion (OME). OME is characterized by the presence of non-infected fluid in the middle ear space, leading to symptoms such as ear fullness, hearing loss, and occasionally tinnitus.
A patient with advanced dementia is no longer able to communicate verbally and displays signs of distress. What should the palliative nurse consider when assessing and managing the patient's distress?
- A. Focus solely on physical comfort measures to alleviate distress.
- B. Assume the patient's distress is solely related to physical discomfort.
- C. Explore non-verbal cues and behaviors to identify the underlying causes of distress.
- D. Administer sedative medications to manage the patient's agitation.
Correct Answer: C
Rationale: When assessing and managing distress in a patient with advanced dementia who is no longer able to communicate verbally, the palliative nurse should consider exploring non-verbal cues and behaviors to identify the underlying causes of distress. Since the patient cannot communicate through words, it is essential to pay close attention to their non-verbal cues such as facial expressions, body language, and changes in behavior. Distress in dementia patients can be caused by a variety of factors including physical discomfort, unmet needs, environmental stressors, emotional distress, or even medication side effects. By carefully observing and interpreting non-verbal cues, the nurse can gain insight into what might be causing the patient's distress and tailor interventions accordingly. Simply focusing on physical comfort measures may not address the root cause of the distress, and administering sedative medications without understanding the underlying cause is not considered best practice in palliative care for dementia patients.
A patient receiving palliative care for end-stage lung disease experiences dyspnea and anxiety. What intervention should the palliative nurse prioritize to address the patient's symptoms?
- A. Administer supplemental oxygen therapy to improve oxygenation.
- B. Teach the patient diaphragmatic breathing exercises for respiratory support.
- C. Prescribe benzodiazepine medications to reduce anxiety and promote relaxation.
- D. Refer the patient to a pulmonologist for evaluation and treatment of dyspnea.
Correct Answer: B
Rationale: Teaching the patient diaphragmatic breathing exercises for respiratory support would be the most appropriate intervention to address the symptoms of dyspnea and anxiety in this scenario. Diaphragmatic breathing, also known as belly breathing, focuses on engaging the diaphragm for deep, slow breaths, which can help improve lung expansion and ventilation. This technique can help the patient manage their breathing difficulty and reduce anxiety by promoting relaxation and improving oxygen exchange in the lungs. It empowers the patient with a coping strategy they can use independently to alleviate distressing symptoms at any time. Administering oxygen therapy may be beneficial, but the priority is to teach the patient a technique they can use proactively and routinely. Prescribing benzodiazepines should be considered as an adjunct if non-pharmacological interventions are ineffective in managing anxiety. Referring to a pulmonologist may be necessary for comprehensive evaluation and treatment but may not directly address the immediate symptoms of dyspnea and anxiety.
Nursing, as a human science, deals with the critical and fundamental differences in attitude toward their respective phenomena. Which of the following is an aim o: human sciences?
- A. Construct prediction.
- B. Sets control
- C. Seeks causal explanation
- D. Makes meaningful interpretation.
Correct Answer: D
Rationale: The aim of human sciences, including nursing as a human science, is to make meaningful interpretations of the phenomena being studied. Unlike natural sciences that may focus on prediction, control, or seeking causal explanations, the human sciences aim to understand and interpret human experiences, behaviors, and relationships in a meaningful way. In nursing, this involves not only understanding the biological aspects of health and illness but also considering the holistic and humanistic aspects of care, such as emotions, values, beliefs, and perceptions. By making meaningful interpretations, nurses can better understand their patients and provide individualized and patient-centered care.
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.