A patient presents with flank pain, hematuria, and a palpable mass in the abdomen. Imaging reveals a solid renal mass with calcifications. Which of the following conditions is most likely?

Correct Answer: A

Rationale: The presentation of flank pain, hematuria, and a palpable mass in the abdomen is characteristic of renal cell carcinoma. Renal cell carcinoma is a common type of kidney cancer that often presents with these symptoms. The presence of a solid renal mass with calcifications on imaging further supports this diagnosis, as renal cell carcinoma is known to have this appearance on imaging studies. It is important to promptly evaluate and manage patients with suspected renal cell carcinoma to optimize outcomes.

Correct Answer: A

Rationale: Rheumatoid arthritis is a common cause of secondary osteoporosis. Chronic inflammation in rheumatoid arthritis can lead to bone loss due to increased osteoclast activity and decreased bone formation. Patients with rheumatoid arthritis are at an increased risk for developing osteoporosis, resulting in decreased bone density and increased fracture risk. Monitoring and managing bone health is an important aspect of care for individuals with rheumatoid arthritis to help prevent osteoporosis-related complications.

Correct Answer: A

Rationale: Acute narrow-angle glaucoma is a medical emergency that requires timely intervention to reduce intraocular pressure. Acetazolamide (Diamox) is a medication commonly used to treat this condition as it works as a carbonic anhydrase inhibitor, reducing the production of aqueous humor in the eye. By reducing the production of aqueous humor, acetazolamide helps decrease intraocular pressure rapidly, which is crucial in managing acute narrow-angle glaucoma. Other options listed, such as Furosemide (Lasix), Atropine, and Urokinase (Abbokinase), are not typically used in the treatment of acute narrow-angle glaucoma.

Correct Answer: D

Rationale: Activating emergency medical services (EMS) for rapid transport to a stroke center is the most appropriate action for managing a conscious patient with a suspected stroke. Time is critical in stroke care, and receiving specialized treatment at a stroke center as soon as possible can significantly improve outcomes for stroke patients. EMS providers are trained to recognize the signs of stroke and can begin essential pre-hospital care measures while en route to the hospital. Administering aspirin immediately is not recommended without medical evaluation, as certain types of strokes (such as hemorrhagic strokes) can be worsened by aspirin. Placing the patient in a supine position may not be ideal, as maintaining an elevated position can help prevent aspiration in stroke patients. Encouraging the patient to eat and drink is not appropriate, as swallowing difficulties are common in stroke patients and can lead to aspiration pneumonia.

Correct Answer: C

Rationale: Neuman's adaptation model, also known as the Neuman Systems Model, is a nursing theory that focuses on how individuals respond to stressors in their environment. The model views individuals as being in a constant state of dynamic equilibrium, where they are interacting with stressors that can disrupt their normal functioning. Nursing care, according to this model, is aimed at helping individuals maintain or restore their optimal level of wellness by assisting them in adapting to these stressors. Therefore, Nurse Sandy's selection of a framework that emphasizes the constant relationship between humans and stressors in the environment aligns best with Neuman's adaptation model.

Correct Answer: C

Rationale: Intracerebral hemorrhage is characterized by bleeding directly into the brain parenchyma, leading to the sudden onset of severe headache, vomiting, altered mental status, and neurological deficits. The hyperdense lesion seen on imaging is caused by the presence of blood within the brain tissue. This condition is often associated with hypertension and can be life-threatening if not promptly diagnosed and managed. Subdural hematoma is an accumulation of blood between the brain and its outermost covering (dura mater), typically presenting with a slower onset of symptoms compared to intracerebral hemorrhage. Subarachnoid hemorrhage involves bleeding into the space between the arachnoid membrane and the pia mater (subarachnoid space), commonly caused by the rupture of an aneurysm. Ischemic stroke results from the blockage of a blood vessel supplying the brain, leading to a lack of oxygen and nutrients to

Correct Answer: B

Rationale: Cardiogenic shock is a life-threatening condition where the heart is unable to pump enough blood to meet the body's demands. Monitoring the patient's cardiac index, which is a measure of cardiac output adjusted for body surface area, can help detect the risk of developing cardiogenic shock. A decrease in cardiac index would indicate a decrease in the heart's ability to effectively pump blood, putting the patient at risk for cardiogenic shock. Monitoring cardiac index is essential in assessing cardiac function and guiding interventions to prevent the progression to cardiogenic shock. The other factors listed may provide important information in assessing the patient's condition, but specifically in detecting the risk of developing cardiogenic shock, monitoring the cardiac index is crucial.

Correct Answer: B

Rationale: In planning their care, Nurse Gina should consider holistic care, which emphasizes treating the patient as a whole person - including their physical, mental, emotional, and spiritual needs. By addressing all aspects of the patient's well-being, Nurse Gina can provide comprehensive care that promotes overall health and wellness. This approach recognizes that physical health is interconnected with other aspects of a person's life and aims to support the individual in achieving balance and harmony in all areas. Holistic care also encourages the patient to be actively involved in their own healing process, fostering a sense of empowerment and self-awareness.

Correct Answer: D

Rationale: Incident reports (IR) are filed in the Records Section of the hospital. It is important for incident reports to be kept in the Records Section for various reasons. By being filed in the hospital's official records, incident reports are included in the hospital's documentation of events, which is crucial for legal and quality improvement purposes. Placing IRs in the Records Section ensures that they are accessible to relevant personnel who may need to refer to them in the future for investigations, audits, or further actions related to the incidents. Keeping incident reports in a centralized location like the Records Section also helps in standardizing the process of documenting and tracking incidents, maintaining consistency and accountability within the healthcare facility.