Nokea
Which of the following is a common complication associated with long-term corticosteroid use in patients with rheumatoid arthritis?
- A. Osteoporotic fracture
- B. Osteonecrosis of the femoral head
- C. Avascular necrosis of the talus
- D. Septic arthritis
Correct Answer: A
Rationale: Long-term corticosteroid use in patients with rheumatoid arthritis can lead to osteoporosis, which is a common complication. Osteoporosis causes weakening of the bones, increasing the risk of fractures, particularly in weight-bearing bones such as the hip, spine, and wrist. Osteoporotic fractures are a significant concern in patients on long-term corticosteroid therapy, highlighting the importance of monitoring bone health and considering preventive measures such as calcium, Vitamin D supplementation, and regular bone density testing. While osteonecrosis of the femoral head and avascular necrosis of the talus can also occur as complications of corticosteroid use, osteoporotic fractures are more commonly associated with this type of therapy in patients with rheumatoid arthritis. Septic arthritis, on the other hand, is not directly related to corticosteroid use but can occur due to other factors such as joint infections.
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A patient with interstitial lung disease (ILD) develops progressive dyspnea, non-productive cough, and fine inspiratory crackles on auscultation. High-resolution computed tomography (HRCT) of the chest reveals diffuse reticular opacities and traction bronchiectasis. Which of the following ILD subtypes is most likely to present with these clinical and radiographic features?
- A. Idiopathic pulmonary fibrosis (IPF)
- B. Sarcoidosis
- C. Hypersensitivity pneumonitis (HP)
- D. Connective tissue disease-associated ILD
Correct Answer: A
Rationale: The clinical presentation of a patient with progressive dyspnea, non-productive cough, fine inspiratory crackles, and HRCT findings of diffuse reticular opacities and traction bronchiectasis is highly suggestive of idiopathic pulmonary fibrosis (IPF). IPF is a specific subtype of ILD characterized by progressive scarring of the lung tissue, leading to the symptoms mentioned above. The presence of reticular opacities and traction bronchiectasis on HRCT is a typical finding in IPF.
A patient receiving palliative care for end-stage heart failure experiences severe fatigue and limited mobility. What intervention should the palliative nurse prioritize to promote the patient's comfort and quality of life?
- A. Recommend initiating physical therapy to improve mobility and strength.
- B. Encourage the patient to conserve energy and avoid unnecessary activities.
- C. Prescribe stimulant medications to alleviate fatigue and increase energy levels.
- D. Refer the patient to a nutritionist for dietary modifications to boost energy.
Correct Answer: B
Rationale: In this scenario, the palliative nurse should prioritize encouraging the patient to conserve energy and avoid unnecessary activities (Option B). End-stage heart failure can lead to severe fatigue and limited mobility, making it essential for the patient to conserve energy to prevent exacerbating symptoms and improve quality of life. Engaging in physical therapy (Option A) may not be suitable for a patient experiencing severe fatigue, as it can further drain energy reserves. Prescribing stimulant medications (Option C) may have limited effectiveness and potential side effects. Referring the patient to a nutritionist for dietary modifications (Option D) is important for overall health but may not directly address the immediate comfort and quality of life concerns related to fatigue and limited mobility. Helping the patient prioritize energy conservation will allow them to use their limited energy for essential activities, leading to a more comfortable and fulfilling experience while receiving palliative care for end-stage heart failure.
What is the best way for Myra to collect data from these participants?
- A. Focus group discussion
- B. Individual Interview
- C. Survey, questionnaire
- D. Observation
Correct Answer: C
Rationale: The best way for Myra to collect data from these participants is through a survey or questionnaire. Surveys and questionnaires are structured instruments that allow for the systematic collection of data from a large number of participants efficiently. They can be easily distributed and completed by participants, making them a convenient method for gathering information. Surveys and questionnaires also provide a standardized approach to data collection, ensuring consistency in the responses obtained. Additionally, they can be designed to include both closed-ended and open-ended questions, allowing for a comprehensive understanding of the participants' perspectives and experiences. Overall, using a survey or questionnaire would enable Myra to collect data from the participants in a systematic and efficient manner.
A patient presents with sudden-onset, severe eye pain, headache, nausea, and vomiting. On examination, the affected eye appears red, with a steamy cornea and mid-dilated, non-reactive pupil. Which of the following conditions is most likely responsible for this presentation?
- A. Acute angle-closure glaucoma
- B. Central retinal artery occlusion
- C. Optic neuritis
- D. Corneal ulcer
Correct Answer: A
Rationale: The clinical presentation described is highly suggestive of acute angle-closure glaucoma. This condition typically presents with sudden-onset severe eye pain, headache, nausea, and vomiting. The red eye, steamy cornea (due to corneal edema), and mid-dilated, non-reactive pupil (from the unopposed force of the dilator muscle) are classic findings in acute angle-closure glaucoma. The increase in intraocular pressure compromises blood flow to the eye, leading to symptoms of blurred vision and possible visual loss. Immediate management usually involves lowering intraocular pressure with medications or surgical intervention to prevent vision loss. Central retinal artery occlusion, optic neuritis, and corneal ulcer typically present with different clinical features and are not consistent with the described presentation.
Which of the following nursing measures would the nurse LEAST CONSIDERS to Patient Ellie with oxytocin drip?
- A. Know, how to recognize potential adverse reactions:
- B. Administer oxytocin drug with caution
- C. Monitor patient closely when infusing oxytocin
- D. Inform patient about potential complications.
Correct Answer: D
Rationale: While all of the nursing measures listed are important considerations when managing a patient receiving oxytocin drip, the nurse would least consider informing the patient about potential complications. The reason for this is that it is the responsibility of the healthcare provider (such as the physician or advanced practice nurse) to inform the patient about potential complications of a medication or treatment. Nurses are instrumental in providing education and support to patients, but in the case of informing patients about potential complications, this task typically falls under the purview of the prescribing provider. The primary focus of the nurse in this situation would be to assess, administer, monitor, and educate the patient as appropriate, ensuring safe and effective care delivery.