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A patient presents with chronic nasal congestion, hyposmia, and anosmia. Nasal endoscopy reveals polypoid masses obstructing the nasal cavity and sinuses. Which of the following conditions is most likely responsible for this presentation?
- A. Allergic rhinitis
- B. Chronic sinusitis
- C. Nasal polyps
- D. Deviated nasal septum
Correct Answer: C
Rationale: The correct answer is C: Nasal polyps. Nasal polyps are benign growths that form in the nasal cavity and sinuses, leading to symptoms such as chronic nasal congestion, hyposmia, and anosmia. The presence of polypoid masses seen on nasal endoscopy is characteristic of nasal polyps.
Rationale:
1. Chronic nasal congestion, hyposmia, and anosmia are common symptoms of nasal polyps.
2. Nasal endoscopy revealing polypoid masses confirms the presence of nasal polyps.
3. Allergic rhinitis may cause nasal congestion but does not typically present with polypoid masses.
4. Chronic sinusitis can cause nasal congestion but is usually associated with inflammation of the sinuses, not just polypoid masses.
5. A deviated nasal septum can lead to nasal congestion but does not typically cause polypoid masses obstructing the nasal cavity and sinuses.
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A patient expresses distrust in the healthcare system due to previous negative experiences. What is the nurse's best approach to rebuild trust?
- A. Dismiss the patient's concerns and assure them that the healthcare team is trustworthy.
- B. Listen actively to the patient's concerns, acknowledge their past experiences, and work to rebuild trust through transparency and reliability.
- C. Ignore the patient's distrust and proceed with providing care.
- D. Tell the patient that their distrust is unfounded and they should trust the healthcare system.
Correct Answer: B
Rationale: The correct answer is B because actively listening, acknowledging the patient's concerns, and working towards rebuilding trust through transparency and reliability are essential steps in addressing distrust. By validating the patient's experiences and actively involving them in the process, the nurse can foster a supportive and trusting relationship.
Choice A is incorrect because dismissing the patient's concerns can further damage trust and undermine the patient's feelings. Choice C is incorrect as ignoring the distrust can lead to a breakdown in communication and trust. Choice D is incorrect because telling the patient to trust the healthcare system without addressing their concerns is dismissive and unhelpful.
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.
The physician inserted a chest tube drainage to Mr. Alda in order to help re-expand the lungs. Which of the following should you prepare FIRST as a nurse in case of emergency when the tube is accidentally disconnected?
- A. sterile clamps
- B. Sterile dressing.
- C. Another chest tube
- D. A bottle of sterile water.
Correct Answer: A
Rationale: Correct Answer: A - sterile clamps
Rationale:
1. **Immediate action**: Sterile clamps are essential to clamp the chest tube to prevent air from entering the pleural space.
2. **Prevent lung collapse**: Clamping the tube will prevent lung collapse and maintain positive pressure in the pleural space.
3. **Buy time**: By clamping the tube, you buy time to properly reattach the tube or secure it with a new connection.
4. **Safety**: Sterile clamps are a quick and effective solution to prevent a potentially life-threatening situation.
Summary of other choices:
B: Sterile dressing - Not the first priority as the immediate concern is preventing air from entering the pleural space.
C: Another chest tube - Not necessary initially as clamping can buy time to reattach the disconnected tube.
D: A bottle of sterile water - Not needed for emergency management of a disconnected chest tube.
Patient Ximena sought referral to an abort ion clinic from the nurse. She reasons out that her pregnancy a burden to her work and daily routines. What should be the BEST RESPONSE of the nurse?
- A. It will cause discrimination from friends and relatives.
- B. Inform her that abortion is morally and legally wrong by virtue of the law .
- C. It will cause infection.
- D. It is against any religion.
Correct Answer: A
Rationale: The correct response is A because it addresses the patient's concerns about potential discrimination. This shows empathy and understanding towards the patient's emotional well-being. Choices B, C, and D are incorrect because they do not directly address the patient's reasons for seeking an abortion. Choice B imposes moral and legal judgments, which can be insensitive. Choice C is not relevant to the patient's stated reason. Choice D imposes religious beliefs, which may not align with the patient's own beliefs.
What type of sampling wills Nurse Sandy adopts 11 when every third (3rd) patients with MI are selected after a random start?
- A. Simple random
- B. Stratified
- C. Systematic
- D. Cluster
Correct Answer: C
Rationale: The correct answer is C: Systematic sampling. Nurse Sandy is adopting systematic sampling by selecting every third patient with MI after a random start. This method ensures equal chance of selection for each patient and maintains randomness. In contrast, simple random sampling (A) entails each patient having an equal chance of being selected independently. Stratified sampling (B) divides patients into groups based on certain characteristics, which is not the case here. Cluster sampling (D) involves grouping patients and selecting entire groups, which is different from the individual selection in this scenario.