Nokea
A 38-year-old woman presents with cyclic pelvic pain, dysmenorrhea, and dyspareunia. On pelvic examination, the uterus is retroverted and fixed. 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: A
Rationale: Endometriosis is the most likely condition responsible for the symptoms described in this scenario. Endometriosis is a chronic condition in which endometrial-like tissue grows outside the uterus, commonly affecting the pelvic structures such as the ovaries, fallopian tubes, and pelvic peritoneum. The main symptoms include cyclic pelvic pain, dysmenorrhea (painful periods), and dyspareunia (pain during intercourse). The retroverted and fixed uterus on examination may be due to adhesions from endometriosis, causing the uterus to be fixed in position. Endometriosis should be considered in women of reproductive age presenting with these symptoms and pelvic examination findings.
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A patient presents with multiple, flesh-colored, dome-shaped papules with a central umbilication on the face. Which of the following conditions is most likely responsible for this presentation?
- A. Molluscum contagiosum
- B. Acne vulgaris
- C. Sebaceous hyperplasia
- D. Basal cell carcinoma
Correct Answer: A
Rationale: Molluscum contagiosum is a viral skin infection caused by the poxvirus. It commonly presents as flesh-colored, dome-shaped papules with central umbilication on the face, trunk, and extremities. The central umbilication indicates the presence of a crater-like indentation in the center of the lesion. It is a benign condition and usually self-limited, but it can be persistent and contagious. Treatment options include cryotherapy, curettage, topical therapies, and observation. Acne vulgaris presents with comedones, papules, pustules, and nodules primarily on the face, chest, and back. Sebaceous hyperplasia is characterized by yellowish papules with central dell on the face. Basal cell carcinoma typically presents as a pearly papule with telangiectasias and may have ulceration or bleeding.
Nurse Gayle is guided that the initial step of delegation is ______.
- A. demonstrate the task and let the staff continue the next activities
- B. Assess the capability of the staff, change him if not performing
- C. Determine the competency level of staff for the task being given
- D. Explain the task to be done with accompanying job description
Correct Answer: C
Rationale: The initial step of delegation is to determine the competency level of the staff for the task being given. Before delegating a task, a nurse must assess the knowledge, skills, and abilities of the staff member to ensure that they are competent and capable of performing the task safely and effectively. This step is crucial in ensuring that tasks are delegated appropriately and that quality patient care is maintained. By determining the competency level of the staff, Nurse Gayle can make informed decisions about delegation, provide appropriate support and resources, and facilitate effective communication throughout the delegation process.
What drug should the nurse prepare for administration to reverse all signs of toxicity?
- A. Digibind (Digoxin)
- B. Atropine sulfate
- C. Naloxone (Narcan)
- D. Diazepam (Valium)
Correct Answer: C
Rationale: Naloxone, also known by the brand name Narcan, is used to reverse the effects of opioid overdose. Opioids can cause respiratory depression, sedation, and other signs of toxicity. Administering naloxone can quickly reverse these effects, restoring the patient's breathing and consciousness. This makes it the appropriate choice for reversing all signs of toxicity related to opioids. Digibind (Digoxin) is used to reverse toxicity from digoxin specifically. Atropine sulfate is used for bradycardia. Diazepam (Valium) is a benzodiazepine used for anxiety, seizures, and muscle relaxation, not for reversing toxicity.
There are five criteria in prioritizing community health problems. If Nurse Maris is estimating the proportion of the population affected by the problem, she is using what criterion in prrioritization?
- A. Social concern
- B. Nature of the problem
- C. Magnitude of the problem
- D. Modifiability of the problem
Correct Answer: C
Rationale: When Nurse Maris is estimating the proportion of the population affected by the problem, she is assessing the magnitude of the problem. The magnitude criterion involves determining the extent of the issue within the community, such as the number of individuals affected or at risk. By understanding the magnitude of a health problem, nurses can better prioritize their efforts to address the most pressing issues that affect a large portion of the population. This criterion helps in identifying which health problems have the highest impact and require immediate attention in order to improve community health outcomes.
A patient with acute respiratory distress syndrome (ARDS) develops refractory hypoxemia despite maximal ventilatory support and prone positioning. Which of the following adjunctive therapies is most likely to improve oxygenation and reduce mortality in this patient?
- A. High-frequency oscillatory ventilation (HFOV)
- B. Continuous renal replacement therapy (CRRT)
- C. Extracorporeal membrane oxygenation (ECMO)
- D. Inhaled nitric oxide (iNO)
Correct Answer: C
Rationale: In a patient with ARDS who is experiencing refractory hypoxemia despite maximal ventilatory support and prone positioning, the use of extracorporeal membrane oxygenation (ECMO) is a potentially life-saving adjunctive therapy. ECMO works by providing temporary support for gas exchange outside the body, allowing the lungs to rest and heal while providing adequate oxygenation and carbon dioxide removal. The use of ECMO has been associated with improved oxygenation and reduced mortality in severe cases of ARDS, especially in patients who fail conventional therapies. High-frequency oscillatory ventilation (HFOV) has not consistently shown mortality benefit in ARDS, continuous renal replacement therapy (CRRT) is not directly indicated for hypoxemia in ARDS, and inhaled nitric oxide (iNO) has shown limited benefit in improving oxygenation in ARDS without a clear impact on mortality.