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Which of the following conditions is characterized by inflammation of the plantar fascia, resulting in heel pain that is typically worse with the first steps in the morning?
- A. Achilles tendinitis
- B. Plantar fasciitis
- C. Morton's neuroma
- D. Stress fracture of the calcaneus
Correct Answer: B
Rationale: Plantar fasciitis is the correct answer. It is characterized by inflammation of the plantar fascia, leading to heel pain, especially in the morning. The plantar fascia is a band of tissue that connects the heel bone to the toes. The pain is usually worse with the first steps after resting.
Achilles tendinitis involves inflammation of the Achilles tendon, which connects the calf muscles to the heel bone, causing pain at the back of the heel and ankle. Morton's neuroma is a condition involving a thickening of tissue around a nerve in the ball of the foot, leading to sharp, burning pain in the toes.
Stress fracture of the calcaneus refers to a small crack in the heel bone due to repetitive stress or overuse, resulting in heel pain that may worsen with activity, but not specifically with the first steps in the morning.
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A woman in active labor is receiving an epidural analgesic for pain relief. What assessment findings indicate a potential complication of epidural analgesia?
- A. Maternal hypotension
- B. Uterine hyperstimulation
- C. Fetal tachycardia
- D. Respiratory depression
Correct Answer: A
Rationale: One potential complication of epidural analgesia in labor is maternal hypotension. The epidural analgesic can cause vasodilation, leading to a decrease in blood pressure. Maternal hypotension can result in decreased placental perfusion, which may jeopardize fetal well-being. It is important for healthcare providers to monitor the maternal blood pressure closely and intervene promptly if hypotension occurs by providing IV fluids or administering medication to raise blood pressure. Uterine hyperstimulation, fetal tachycardia, and respiratory depression are not typically associated with epidural analgesia as complications.
A postpartum client who delivered via cesarean section expresses discomfort when ambulating and performing activities of daily living. What nursing intervention should be prioritized to promote optimal recovery?
- A. Encouraging early ambulation and progressive activity as tolerated
- B. Administering oral analgesics on a fixed schedule around the clock
- C. Restricting movement to prevent disruption of the incision site
- D. Applying heat packs to the incision site for pain relief
Correct Answer: A
Rationale: Encouraging early ambulation and progressive activity as tolerated is the most appropriate nursing intervention to promote optimal recovery for a postpartum client who delivered via cesarean section. Early ambulation helps prevent complications such as blood clots, pneumonia, and constipation. It also promotes circulation and facilitates healing by reducing the risk of postoperative complications. Progressive activity helps the client regain strength, mobility, and independence, which are essential for a speedy recovery. Restoring normal movement will also help decrease discomfort and improve the client's overall well-being. In contrast, restricting movement may lead to complications and delayed recovery. Administering oral analgesics as needed is important for pain management, but promoting early ambulation is essential for optimal recovery. Heat packs should not be applied to the incision site as they can increase the risk of infection and interfere with proper wound healing.
A patient presents with acute onset of shoulder pain and limited range of motion after a fall onto an outstretched hand. Physical examination reveals tenderness over the greater tuberosity of the humerus and pain with passive abduction and external rotation of the shoulder. Which of the following conditions is most likely?
- A. Rotator cuff tear
- B. Glenohumeral dislocation
- C. Acromioclavicular joint separation
- D. Proximal humerus fracture
Correct Answer: A
Rationale: The correct answer is A: Rotator cuff tear. The presentation of acute shoulder pain and limited range of motion after a fall onto an outstretched hand, along with tenderness over the greater tuberosity and pain with passive abduction and external rotation, is classic for a rotator cuff tear. The mechanism of injury and physical exam findings are consistent with this condition.
B: Glenohumeral dislocation typically presents with a visibly deformed shoulder and loss of normal shoulder contour.
C: Acromioclavicular joint separation would present with tenderness over the AC joint rather than the greater tuberosity, and typically involves a history of direct trauma to the shoulder.
D: Proximal humerus fracture would present with more diffuse shoulder pain and swelling, and not specific tenderness over the greater tuberosity.
Which of the following interventions is the KEY to increasing the survival rates of clients with lung cancer?
- A. High-dose chemotherapy
- B. Smoking cessation
- C. Early bronchoscopy
- D. Early detection
Correct Answer: B
Rationale: The correct answer is B: Smoking cessation. Smoking is the leading cause of lung cancer, so quitting smoking is crucial in preventing and improving survival rates. Smoking cessation reduces the risk of developing lung cancer and improves treatment outcomes. High-dose chemotherapy (A) may be part of the treatment plan, but quitting smoking is more impactful. Early bronchoscopy (C) and early detection (D) are important, but without addressing the root cause (smoking), the survival rates will not significantly increase.
A patient presents with petechiae, ecchymoses, and gingival bleeding. Laboratory tests reveal prolonged bleeding time, normal platelet count, and normal PT and aPTT. Which of the following conditions is most likely to cause these findings?
- A. Glanzmann thrombasthenia
- B. Bernard-Soulier syndrome
- C. Acquired von Willebrand syndrome
- D. Hemophilia A
Correct Answer: C
Rationale: The correct answer is C: Acquired von Willebrand syndrome. This condition is characterized by a defect in von Willebrand factor function, leading to prolonged bleeding time and mucocutaneous bleeding. Normal platelet count rules out Glanzmann thrombasthenia and Bernard-Soulier syndrome which are platelet disorders. Normal PT and aPTT rule out Hemophilia A, a coagulation factor deficiency. Acquired von Willebrand syndrome is the most likely cause based on the clinical presentation and laboratory findings.