RN exams medical-surgical practice questions set 34

Correct answer:

The correct answer is to administer sublingual nitroglycerin. This medication helps dilate the blood vessels, reducing the workload of the heart and improving blood flow to the heart muscle, which is crucial in the management of acute coronary syndrome. Checking cardiac enzymes (choice B) is important for diagnosing a heart attack but is not the priority over providing immediate relief to the patient's chest pain. Administering aspirin (choice C) is also important in acute coronary syndrome to prevent further clot formation, but it is not the priority action for immediate pain relief. Obtaining IV access (choice D) is necessary for administering medications or fluids; however, in this scenario, providing sublingual nitroglycerin for prompt pain relief takes precedence.

Correct answer:

The correct answer is D because vertebrate eyes have single-lens eyes where light is focused by the curved cornea and lens (A), and changing the shape of the lens allows for focusing at different distances (B). Additionally, photoreceptor cells in the retina detect light (C). Therefore, all of the above statements are true, making D the correct choice. Choice A is incorrect because it does not encompass the entire process of vision in vertebrate eyes, missing the role of changing the lens shape. Choice B is incorrect as it only addresses the lens shape without mentioning the role of the cornea in focusing light. Choice C is incorrect as it only focuses on the function of photoreceptor cells in the retina without considering the lens and cornea's role in focusing light.

Correct answer:

The presentation of knee pain and swelling following a fall onto a flexed knee, along with a palpable effusion and tenderness along the joint line, is highly suggestive of a meniscus injury. The McMurray's test specifically evaluates for meniscal tears. In this case, the presence of pain and clicking with passive knee flexion and internal rotation indicates a medial meniscus tear as the most likely diagnosis. Patellar tendinitis usually presents with anterior knee pain that is worsened by activities such as jumping or running. Lateral collateral ligament (LCL) sprain typically presents with lateral knee pain and instability. Quadriceps tendon rupture would present with significant weakness and inability to fully extend the knee, which is not described in this scenario.

Correct answer:

The nurse should reposition the patient to alleviate pressure on vulnerable areas. Pressure injuries can develop when there is prolonged pressure on specific areas of the skin, leading to reduced blood flow and tissue damage. Repositioning the patient helps to relieve the pressure and prevent the development of pressure injuries. Applying a pressure-relieving device may also be helpful, but the immediate action should be to reposition the patient to address the issue. Documenting the observation is important for documentation purposes, but the priority is to take action to prevent harm to the patient. Continuing with the positioning as planned without addressing the inadequate skin protection could lead to the development of pressure injuries, which should be avoided.

Correct answer:

The correct answer is A: Light chains isotypes are functionally different. This statement is NOT true because light chain isotypes (kappa and lambda) have distinct primary structures but serve the same function in antigen binding. The heavy chain determines the effector function of antibodies. The other choices are correct: B) The antigen binding site of a B cell receptor is identical to the antigen binding site of antibodies secreted by the same B cell, as both use the same variable regions for antigen recognition. C) Both heavy and light chain domains assume a compact barrel structure, which is essential for antibody stability and function. D) The hinge region assumes a more open and flexible structure, allowing antibodies to bind antigens at different orientations.

Correct answer:

The correct answer is B because an empowered nurse feels in control and valued, leading to job satisfaction. Enthusiasm shows motivation and engagement with their work. Being ethical indicates a commitment to moral principles, contributing to a sense of fulfillment. Choice A is incorrect as competitiveness and self-centeredness do not necessarily equate to job satisfaction. Euphoria may not be a sustainable indicator of satisfaction. Choice C is incorrect because being a loner and egoistic are not traits associated with job satisfaction. Reactivity may suggest a lack of control or frustration. Choice D is incorrect as being outgoing and competitive might not directly translate to job satisfaction. Sensitivity alone does not guarantee satisfaction in the workplace.

Correct answer:

The best immediate action by the nurse in this situation is to place the client on a cardiac monitor immediately. A serum potassium level of 6.5 mmol/L indicates hyperkalemia, which can lead to life-threatening dysrhythmias. Monitoring the cardiac status is crucial to detect any potential arrhythmias promptly. Teaching the client to limit high-potassium foods (Choice B) may be important for long-term management, but it is not the priority at this moment. Continuing to monitor intake and output (Choice C) is important for assessing renal function but does not address the immediate risk of dysrhythmias. Asking to have the laboratory redraw the blood specimen (Choice D) is unnecessary since the current results indicate a critical situation that requires immediate action.

Correct answer:

The correct answer is A: Light chains isotypes are functionally different. This statement is NOT true because light chain isotypes (kappa and lambda) have distinct primary structures but serve the same function in antigen binding. The heavy chain determines the effector function of antibodies. The other choices are correct: B) The antigen binding site of a B cell receptor is identical to the antigen binding site of antibodies secreted by the same B cell, as both use the same variable regions for antigen recognition. C) Both heavy and light chain domains assume a compact barrel structure, which is essential for antibody stability and function. D) The hinge region assumes a more open and flexible structure, allowing antibodies to bind antigens at different orientations.

Correct answer:

Hydrocolloid is the correct dressing to promote moist wound healing in a stage 3 pressure ulcer. Its occlusive, adhesive nature forms a gel over the wound, retaining moisture, facilitating autolytic debridement, and protecting from contamination ideal for deeper wounds with moderate drainage. Transparent film allows oxygen exchange but doesn't absorb exudate or cushion, better for stage 1 ulcers. Calcium alginate is highly absorbent for heavy drainage, more suited to stage 4 ulcers, and less focused on moisture retention alone. Gauze can stick and dry out, disrupting healing and causing trauma. Hydrocolloid's moisture-maintaining properties support granulation and epithelialization in a stage 3 ulcer, reducing pain and enhancing recovery, making it the optimal choice.

Correct answer:

The guiding principle that health is an integral part of the education process is of utmost importance for a school nurse in performing their role and functions. This principle emphasizes the interconnectedness of health and academic success, highlighting that healthy students are better able to learn and succeed in school. As a school nurse, understanding and prioritizing this principle means focusing on promoting health and wellness, providing healthcare services, and implementing health education programs to support the overall well-being and academic achievement of students. By recognizing the significance of this principle, school nurses can effectively contribute to creating a healthy and supportive school environment that fosters student growth and development.