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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The purpose why the head nurse asked Nurse Rosie to submit an IR is to ______.
- A. note patterns of incidences in the same unit
- B. place it in Nurse Rosie's 201 file
- C. document immediately the incident
- D. evaluate Nurse Rosie's performance
Correct Answer: A
Rationale: The purpose of asking Nurse Rosie to submit an Incident Report (IR) is most likely to note patterns of incidences in the same unit. Incident reports are essential tools in healthcare settings to track and analyze unexpected events, errors, or situations that may impact patient care and safety. By collecting and reviewing incident reports, the head nurse can identify trends, patterns, or commonalities in the occurrences within the unit. This information allows for targeted interventions, improvements in practices, and enhanced patient safety. Therefore, asking Nurse Rosie to submit an IR would serve the purpose of noting patterns of incidences in the same unit for proactive and quality care delivery.
A patient presents with gradual-onset memory loss, confusion, and difficulty with complex tasks such as managing finances and planning. Over time, the patient develops disorientation to time and place and requires assistance with activities of daily living. Which of the following neurological conditions is most likely responsible for these symptoms?
- A. Alzheimer's disease
- B. Parkinson's disease
- C. Huntington's disease
- D. Frontotemporal dementia
Correct Answer: A
Rationale: The patient's presentation of gradual-onset memory loss, confusion, difficulty with complex tasks, disorientation, and functional decline are all classic features of Alzheimer's disease. Alzheimer's disease is a progressive neurodegenerative disorder characterized by the accumulation of abnormal protein deposits in the brain, leading to widespread neuronal damage and cognitive decline. As the disease progresses, patients typically experience worsening memory loss, cognitive impairment, and deficits in activities of daily living, ultimately requiring full-time care and assistance. Other neurodegenerative diseases such as Parkinson's disease, Huntington's disease, and frontotemporal dementia may present with cognitive impairment and behavioral changes, but the specific constellation of symptoms described in the case is most indicative of Alzheimer's disease.
The applicant was further asked about an incident report. Which of the following is a PRIORITY Case for an incident report be accomplished?
- A. Patient fell from the bed.
- B. Refusal to go to the physical therapy session.
- C. A visitor encourages a patient on bed rest to ambulate.
- D. Nurse left before his duty ends.
Correct Answer: A
Rationale: A patient falling from the bed is a critical incident that must be prioritized for an incident report. Patient falls can lead to injuries, complications, or even serious consequences. Documenting this incident is crucial for analyzing the cause of the fall, implementing prevention measures, and ensuring patient safety. Additionally, reporting patient falls is a standard practice in healthcare settings to maintain transparency and accountability in patient care.
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.
A patient presents with a displaced fracture of the distal radius and ulna after a fall. What is the preferred initial treatment for this injury?
- A. Closed reduction and splinting
- B. Open reduction and internal fixation (ORIF)
- C. Closed reduction and external fixation (CREF)
- D. Cast immobilization without reduction
Correct Answer: A
Rationale: In the case of a displaced fracture of the distal radius and ulna, the preferred initial treatment is typically closed reduction and splinting. Closed reduction involves manually realigning the fractured bones without the need for surgery. Splinting is then utilized to immobilize the wrist and forearm to allow for proper healing of the fracture. This approach is often effective in realigning the bones and stabilizing the injury, allowing for adequate healing without the need for more invasive interventions like surgery. Following the initial management with closed reduction and splinting, the patient's progress will be monitored, and further interventions may be considered based on the specific characteristics of the fracture and the patient's response to treatment.