Which of the following medications taken by the patient is least likely to cause urine discoloration?
- A. Sulfasalazine
- B. Levodopa
- C. Phenolphthalein
- D. Aspirin
Correct Answer: D
Rationale: The correct answer is Aspirin. Aspirin is not known to cause urine discoloration. Sulfasalazine is associated with causing orange-yellow discoloration of urine. Levodopa can cause darkening of urine to a brown or black color. Phenolphthalein has been linked to pink or red discoloration of urine. Therefore, among the options provided, Aspirin is the medication least likely to cause urine discoloration.
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A client is brought into the emergency room where the physician suspects that he has cardiac tamponade. Based on this diagnosis, the nurse would expect to see which of the following signs or symptoms in this client?
- A. Fever, fatigue, malaise
- B. Hypotension and distended neck veins
- C. Cough and hemoptysis
- D. Numbness and tingling in the extremities
Correct Answer: B
Rationale: Cardiac tamponade occurs when fluid or blood accumulates in the pericardium, preventing the heart from contracting properly. This leads to decreased cardiac output and is considered a medical emergency. Classic signs of cardiac tamponade include hypotension (low blood pressure) and distended neck veins due to the increased pressure around the heart. These signs result from the compromised ability of the heart to pump effectively. Choices A, C, and D are not typically associated with cardiac tamponade. Fever, fatigue, and malaise are non-specific symptoms that can be seen in various conditions. Cough and hemoptysis are more commonly associated with respiratory conditions, while numbness and tingling in the extremities are neurological symptoms not typically seen in cardiac tamponade.
A patient asks a nurse, "My doctor recommended I increase my intake of folic acid. What type of foods contain the highest concentration of folic acid?'
- A. Green vegetables and liver
- B. Yellow vegetables and red meat
- C. Carrots
- D. Milk
Correct Answer: A
Rationale: Green vegetables and liver are rich sources of folic acid. Green vegetables like spinach, asparagus, and broccoli are high in folic acid content. Liver, especially from chicken or beef, is also a good source of folic acid. Yellow vegetables and red meat (choice B) do not contain as high a concentration of folic acid as green vegetables and liver. Carrots (choice C) are nutritious but do not have the highest concentration of folic acid. Milk (choice D) is not a significant source of folic acid compared to green vegetables and liver.
A nurse prepares to care for a 4-year-old newly admitted for rhabdomyosarcoma. The nurse should alert the staff to pay more attention to the function of which area of the body?
- A. All striated muscles
- B. The cerebellum
- C. The kidneys
- D. The leg bones
Correct Answer: A
Rationale: Rhabdomyosarcoma is the most common soft tissue sarcoma in children, originating in striated (skeletal) muscles and potentially affecting any part of the body. Symptoms vary based on the location of the tumor. In the head or neck area, symptoms may include sudden bulging or swelling of the eyes, conjunctival chemosis, and headache. Rhabdomyosarcoma can also impact organs like the urinary or reproductive system. Common metastatic sites include the lungs. Therefore, the nurse should pay attention to the function of all striated muscles in the child to monitor for any signs or symptoms related to the disease. Choices B, C, and D are incorrect as rhabdomyosarcoma primarily involves striated muscles and does not specifically target the cerebellum, kidneys, or leg bones.
An 85-year-old male has been losing mobility and gaining weight over the last two months. The patient also has the heater running in his house 24 hours a day, even on warm days. Which of the following tests is most likely to be performed?
- A. CBC (complete blood count)
- B. ECG (electrocardiogram)
- C. Thyroid function tests
- D. CT scan
Correct Answer: C
Rationale: The symptoms of weight gain and poor temperature tolerance in an elderly male suggest a potential thyroid dysfunction. Thyroid function tests are crucial in differentiating between hyperthyroidism, hypothyroidism, and a euthyroid state. These tests involve measuring the serum levels of thyroid hormones T3 and T4, also known as thyroxine, to evaluate thyroid function accurately. A complete blood count (Choice A) would not directly address the symptoms presented. An electrocardiogram (Choice B) assesses heart activity and would not be the primary test for these symptoms. A CT scan (Choice D) provides detailed images of internal organs and structures, which would not be the initial investigation for the described symptoms.
A patient is scheduled for a magnetic resonance imaging (MRI) scan for suspected lung cancer. Which of the following is a contraindication to the study for this patient?
- A. The patient is allergic to shellfish.
- B. The patient has a pacemaker.
- C. The patient suffers from claustrophobia.
- D. The patient takes antipsychotic medication.
Correct Answer: B
Rationale: The correct answer is that the patient has a pacemaker. A pacemaker is a contraindication to MRI scanning due to the interference with the magnetic fields of the MRI scanner. This interference can potentially deactivate the pacemaker, putting the patient at risk. Patients with cardiac implantable electronic devices (CIED) are at risk for inappropriate device therapy, device heating/movement, and arrhythmia during MRI. This necessitates special precautions such as scheduling in a CIED blocked slot or having electrophysiology nurse or technician support. It is important to ensure that the patient's pacemaker is MRI conditional before proceeding with the scan. The other choices, such as being allergic to shellfish, suffering from claustrophobia, or taking antipsychotic medication, are not direct contraindications to undergoing an MRI scan for suspected lung cancer.
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