A 70-year-old patient is scheduled for open-heart surgery. The surgeon plans to use the great saphenous vein for the coronary bypass grafts. The patient asks, 'What happens to my circulation when this vein is removed?' The nurse should reply:

Correct Answer: D

Rationale: Rationale for Correct Answer D: 1. The great saphenous vein is a superficial vein and removal doesn't significantly impact circulation. 2. Deeper veins, like the femoral and popliteal veins, are responsible for major venous return. 3. These deeper veins will compensate for the removal of the great saphenous vein, maintaining circulation. 4. Therefore, removing the great saphenous vein won't harm circulation due to the presence of deeper veins. Summary of Incorrect Choices: A: Incorrect. Venous insufficiency isn't a common problem post-surgery as other veins compensate. B: Incorrect. Dismissing the significance of vein removal and its impact on circulation is inaccurate. C: Incorrect. While there may be decreased circulation in the superficial system, deep venous return is preserved.

Correct Answer: D

Rationale: The correct answer is D. Asking the patient to describe what happened provides crucial information about the onset, possible cause, and nature of the knee pain. This helps in understanding the context and determining the appropriate follow-up questions or examinations. Option A focuses solely on pain intensity, neglecting important context. Option B assumes a past injury without gathering current information. Option C asks for a specific timeframe without capturing the full picture of the pain episode.

Correct Answer: D

Rationale: The correct answer is D: Emergency database. In the case of an OxyContin overdose, an emergency database would be the most appropriate type of data collection. This is because an overdose requires immediate and urgent attention, necessitating quick and focused data collection to assess the situation and provide necessary interventions promptly. A complete database (choice A) would be too time-consuming and comprehensive for an emergency situation. A focused or problem-centered database (choice B) may not capture all relevant information in a timely manner. A follow-up database (choice C) would be more suitable for monitoring and tracking progress after the initial emergency has been addressed, rather than for the immediate response to an overdose.

Correct Answer: C

Rationale: Beginning the interview by asking open, friendly questions about school and hobbies is the correct approach to establish rapport with a 15-year-old patient. This strategy helps create a comfortable and non-threatening environment, allowing the adolescent to feel more at ease and willing to engage in the conversation. By showing genuine interest in the patient's personal life and interests, you are demonstrating respect and building trust. This approach also allows the adolescent to feel heard and valued, which can lead to more open and honest communication during the rest of the interview. It sets a positive tone for the interaction and helps establish a connection before delving into more sensitive topics related to health.

Correct Answer: C

Rationale: The correct answer is C because a Hill-Sachs lesion is indeed a compression fracture of the posterolateral aspect of the humeral head caused by abutment against the anterior rim of the glenoid fossa. This occurs during anterior shoulder dislocations. Option A is incorrect because a Hill-Sachs lesion is associated with anterior, not posterior, dislocations. Option B is incorrect because shoulder instability due to a Hill-Sachs lesion depends on the size and location of the defect, not a specific percentage of the articular surface. Option D is incorrect because Speed's test is used to assess biceps tendon pathology, not Hill-Sachs lesions.