The nurse is admitting a 55-year-old male patient diagnosed with a retinal detachment in his left eye. While assessing this patient, what characteristic symptom would the nurse expect to find?

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Question 1 of 9

The nurse is admitting a 55-year-old male patient diagnosed with a retinal detachment in his left eye. While assessing this patient, what characteristic symptom would the nurse expect to find?

Correct Answer: A

Rationale: Step-by-step rationale for why A is correct: 1. Retinal detachment causes traction on the retina. 2. Traction on the retina can stimulate photoreceptors. 3. Stimulation of photoreceptors can lead to perception of flashing lights. 4. Therefore, the characteristic symptom of retinal detachment is flashing lights in the visual field. Summary: B: Sudden eye pain is not a characteristic symptom of retinal detachment. C: Loss of color vision is not typically associated with retinal detachment. D: Colored halos around lights are more indicative of conditions like glaucoma or corneal edema, not retinal detachment.

Question 2 of 9

For which of the following population groups would an annual clinical breast examination be recommended?

Correct Answer: C

Rationale: The correct answer is C: Women over age 40. Annual clinical breast examinations are recommended for this population group because they have an increased risk of developing breast cancer compared to younger age groups. Regular screenings starting at age 40 can help in early detection and improve survival rates. A: Women over age 21 - This age group is generally recommended to start clinical breast examinations every 1-3 years, not necessarily annually. B: Women over age 25 - While it's important to be vigilant about breast health, the risk of breast cancer increases with age, making annual exams more crucial for older women. D: All post-pubescent females with a family history of breast cancer - While family history is a risk factor, the recommendation for annual clinical breast examinations typically begins at age 40, regardless of family history.

Question 3 of 9

A patient has sought care, stating that she developed hives overnight. The nurses inspection confirms the presence of urticaria. What type of allergic hypersensitivity reaction has the patient developed?

Correct Answer: A

Rationale: The correct answer is A: Type I hypersensitivity reaction. This type of reaction involves the release of histamine from mast cells and basophils, leading to symptoms like hives. It is characterized by the involvement of IgE antibodies. In this case, the patient developed hives quickly after exposure to the allergen, indicating an immediate hypersensitivity reaction typical of Type I. Choices B, C, and D are incorrect because they are associated with different mechanisms and timeframes of hypersensitivity reactions. Type II involves antibody-mediated cell destruction, Type III involves immune complex deposition, and Type IV is a delayed-type hypersensitivity reaction mediated by T cells, none of which are consistent with the rapid onset of hives seen in this patient.

Question 4 of 9

The nurse is providing care for a patient who has experienced a type I hypersensitivity reaction. What condition is an example of such a reaction?

Correct Answer: A

Rationale: The correct answer is A: Anaphylactic reaction after a bee sting. Type I hypersensitivity reactions involve an immediate response triggered by exposure to an allergen, leading to the release of histamine and other inflammatory mediators. In this case, a bee sting would introduce an allergen, causing a rapid and severe systemic reaction, known as anaphylaxis. B: Skin reaction resulting from adhesive tape is an example of a Type IV hypersensitivity reaction, mediated by T cells, not IgE antibodies as in Type I reactions. C: Myasthenia gravis is an autoimmune disorder involving antibodies attacking acetylcholine receptors, not a Type I hypersensitivity reaction. D: Rheumatoid arthritis is an autoimmune disorder involving immune complexes and inflammatory responses, not a Type I hypersensitivity reaction.

Question 5 of 9

A hospital nurse has experienced percutaneous exposure to an HIV-positive patients blood as a result of a needlestick injury. The nurse has informed the supervisor and identified the patient. What action should the nurse take next?

Correct Answer: B

Rationale: The correct answer is B: Report to the emergency department or employee health department. 1. Immediate action is crucial after exposure to HIV-positive blood. 2. Reporting to the emergency department or employee health department ensures prompt evaluation and appropriate management. 3. The supervisor should also be informed to initiate the necessary protocols. 4. The other choices are incorrect: - A: Chlorhexidine may not be sufficient for post-exposure prophylaxis. - C: Hydrocolloid dressing is not appropriate for managing needlestick injuries. - D: Following up with the primary care provider may cause delays in receiving timely post-exposure prophylaxis.

Question 6 of 9

Traditionally, nurses have been involved with tertiary cancer prevention. However, an increasing emphasis is being placed on both primary and secondary prevention. What would be an example of primary prevention?

Correct Answer: C

Rationale: The correct answer is C: Teaching patients to wear sunscreen, which is an example of primary prevention. Primary prevention aims to prevent the occurrence of a disease before it occurs by addressing risk factors. In this case, teaching patients to wear sunscreen helps prevent skin cancer by reducing exposure to harmful UV rays. Yearly Pap tests (A) are a secondary prevention measure for cervical cancer, detecting precancerous changes. Testicular self-examination (B) is a form of secondary prevention for testicular cancer, aiming to detect any abnormalities early. Screening mammograms (D) are also a secondary prevention measure for breast cancer, detecting tumors at an early stage.

Question 7 of 9

The nurse is planning health education for a patient who has experienced a vaginal infection. What guidelines should the nurse include in this program regarding prevention?

Correct Answer: C

Rationale: The correct answer is C: Avoid feminine hygiene products, such as sprays. This is because feminine hygiene products can disrupt the natural balance of vaginal flora, leading to an increased risk of vaginal infections. Tight-fitting synthetic underwear (choice A) can trap moisture and promote bacterial growth. Using bubble bath (choice B) can irritate the genital area and disrupt the pH balance. Restricting daily bathing (choice D) is not recommended as regular hygiene practices are important for preventing infections. In summary, choice C is correct as it promotes maintaining the natural vaginal flora and pH balance to prevent infections, while the other choices can contribute to an increased risk of vaginal infections.

Question 8 of 9

A nurse is watching a nursing assistive personnel(NAP) perform a postvoid bladder scan on a female with a previous hysterectomy. Which action will require the nurse to follow up?

Correct Answer: D

Rationale: The correct answer is D because setting the scanner to female is incorrect for a patient who has had a hysterectomy as they do not have a uterus. This could lead to inaccurate results. Palpating the symphysis pubis (A) ensures proper positioning, wiping the scanner head with alcohol (B) maintains infection control, and applying gel (C) facilitates sound wave transmission.

Question 9 of 9

A patient who is scheduled for an open prostatectomy is concerned about the potential effects of the surgery on his sexual function. What aspect of prostate surgery should inform the nurses response?

Correct Answer: B

Rationale: Step 1: Prostate surgery can damage nerves responsible for erectile function. Step 2: Nerve damage can lead to erectile dysfunction post-prostatectomy. Step 3: Choice B correctly states that all prostatectomies carry a risk of nerve damage and consequent erectile dysfunction, aligning with the potential impact of surgery on sexual function. Step 4: Other choices lack accuracy: A incorrectly attributes erectile dysfunction solely to hormonal changes, C falsely suggests temporary nature of dysfunction, and D wrongly claims no risk of dysfunction due to modern techniques.

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