Nokea
A 22-year-old woman presents with cyclic pelvic pain, dysmenorrhea, and infertility. On pelvic examination, the uterus is retroverted and enlarged. Which of the following conditions is most likely to be responsible for these findings?
- A. Endometriosis
- B. Adenomyosis
- C. Leiomyomas (uterine fibroids)
- D. Pelvic inflammatory disease (PID)
Correct Answer: B
Rationale: Adenomyosis is a condition characterized by the presence of endometrial tissue within the myometrium (muscle wall) of the uterus. It can present with symptoms such as cyclic pelvic pain, dysmenorrhea (painful periods), and infertility. On pelvic examination, the uterus may be retroverted (tilted backward) and enlarged due to the presence of adenomyotic nodules within the uterine muscle. Adenomyosis can also cause heavy menstrual bleeding (menorrhagia). Endometriosis, on the other hand, involves the presence of endometrial tissue outside the uterus and can cause similar symptoms but is less likely to result in uterine enlargement or retroversion. Leiomyomas (uterine fibroids) are benign tumors of the uterine muscle and can also cause pelvic pain and abnormal uterine enlargement but are less likely to be associated with dysmenorrhea and infertility
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When the findings of the study can be applied to all patients with MI under stress patients in the whole Philippines, it satisfies which of the following criteria in research?
- A. Reliability
- B. Generalizability
- C. Validity
- D. Transferability
Correct Answer: B
Rationale: Generalizability refers to the extent to which research findings and conclusions can be applied beyond the specific conditions of the study to a larger population or different settings. In this case, if the findings of a study on patients with myocardial infarction (MI) under stress can be applied to all such patients in the whole Philippines, it indicates that the study results are generalizable beyond the specific sample studied. Therefore, the criteria satisfied in this context is generalizability.
A patient presents with well-demarcated, hypopigmented macules with fine scaling, affecting the trunk and proximal extremities. The patient reports a history of sun exposure and outdoor activities. Which of the following conditions is most likely responsible for this presentation?
- A. Tinea versicolor
- B. Vitiligo
- C. Pityriasis rosea
- D. Seborrheic keratosis
Correct Answer: A
Rationale: The presentation described in the question is characteristic of tinea versicolor, a fungal skin infection caused by Malassezia furfur. The hypopigmented macules with fine scaling are often seen on the trunk and proximal extremities, particularly in areas that are more prone to sebum production. Patients with tinea versicolor may have a history of sun exposure and outdoor activities as the organism responsible for the infection thrives in warm, humid environments. Treatment typically involves the use of topical antifungal agents such as ketoconazole or selenium sulfide.
A patient with advanced dementia is no longer able to communicate verbally and displays signs of distress. What should the palliative nurse consider when assessing and managing the patient's distress?
- A. Focus solely on physical comfort measures to alleviate distress.
- B. Assume the patient's distress is solely related to physical discomfort.
- C. Explore non-verbal cues and behaviors to identify the underlying causes of distress.
- D. Administer sedative medications to manage the patient's agitation.
Correct Answer: C
Rationale: When assessing and managing distress in a patient with advanced dementia who is no longer able to communicate verbally, the palliative nurse should consider exploring non-verbal cues and behaviors to identify the underlying causes of distress. Since the patient cannot communicate through words, it is essential to pay close attention to their non-verbal cues such as facial expressions, body language, and changes in behavior. Distress in dementia patients can be caused by a variety of factors including physical discomfort, unmet needs, environmental stressors, emotional distress, or even medication side effects. By carefully observing and interpreting non-verbal cues, the nurse can gain insight into what might be causing the patient's distress and tailor interventions accordingly. Simply focusing on physical comfort measures may not address the root cause of the distress, and administering sedative medications without understanding the underlying cause is not considered best practice in palliative care for dementia patients.
The nurse reviews the patient 's plan of care. Which of the following nursing diagnose will be the PRIORITY?
- A. Fluid volume, deficit
- B. Risk for pain, acute
- C. Coping, ineffective
- D. Body image, disturbed
Correct Answer: A
Rationale: In prioritizing nursing diagnoses, the nurse should consider issues that pose the greatest risk to the patient's immediate well-being. A fluid volume deficit can lead to dehydration and potentially life-threatening complications, making it a priority to address. It is crucial to restore fluid balance to maintain normal body functions and prevent further deterioration of the patient's condition. Ensuring adequate hydration is essential for the patient's overall health and recovery. The other options, such as risk for pain, coping, and body image disturbances, while important, are not as urgent as addressing a fluid volume deficit.
A nurse is preparing to perform a tracheostomy tube change for a patient. What action should the nurse prioritize to ensure patient safety during the procedure?
- A. Using sterile technique during the tube change
- B. Administering sedation to the patient before the procedure
- C. Skipping the suctioning step to minimize patient discomfort
- D. Changing the tracheostomy ties after completing the tube change
Correct Answer: A
Rationale: The nurse should prioritize using sterile technique during the tracheostomy tube change to ensure patient safety. Tracheostomy procedures involve a direct entry into the airway, making it crucial to prevent infection and reduce the risk of complications. Sterile technique, including proper hand hygiene, wearing sterile gloves, and using sterile equipment, helps minimize the introduction of pathogens into the patient's airway, reducing the risk of infection. By maintaining a sterile field, the nurse can protect the patient from potential harm and promote a successful outcome of the tracheostomy tube change.