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A client with congestive heart failure has been receiving digoxin (lanoxin). Which finding indicates that the medication is having a desired effect?
- A. Increased weight
- B. Increased urinary output
- C. Improved appetite
- D. Increased pedal edema
Correct Answer: B
Rationale: Digoxin is a medication commonly used in the treatment of congestive heart failure because it helps to improve cardiac output and reduce heart failure symptoms. One of the desired effects of digoxin is an increase in urinary output. This is because digoxin helps to improve cardiac function, which can lead to better circulation and increased kidney perfusion. As a result, the kidneys are better able to filter and excrete excess fluid, leading to increased urine output. Therefore, an increase in urinary output indicates that the digoxin is having a positive effect in managing the client's congestive heart failure. The other options, such as increased weight, improved appetite, and increased pedal edema, are not indicative of a desired effect of digoxin therapy.
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A patient presents with knee pain and instability following a twisting injury during sports activity. MRI reveals a tear involving the anterior cruciate ligament (ACL). Which surgical procedure is commonly performed to reconstruct the ACL?
- A. Arthroscopic meniscectomy
- B. Medial patellofemoral ligament (MPFL) reconstruction
- C. Anterior cruciate ligament (ACL) reconstruction
- D. Lateral collateral ligament (LCL) repair
Correct Answer: C
Rationale: Anterior cruciate ligament (ACL) reconstruction is a common surgical procedure performed to repair a torn ACL. This procedure involves replacing the damaged ACL with a graft, often using a portion of the patient's own patellar tendon, hamstring tendon, or an allograft (donor tissue). ACL reconstruction is typically indicated for patients with ACL tears that result in knee instability and functional limitations, especially in active individuals who participate in sports or activities requiring pivoting and cutting movements. Arthroscopic surgery is commonly used to perform ACL reconstruction, allowing for smaller incisions and faster recovery compared to traditional open surgeries. Post-operative rehabilitation and physical therapy are crucial components of the recovery process following ACL reconstruction surgery to optimize outcomes and return to pre-injury activity levels.
Nursing, as a human science, deals with the critical and fundamental differences in attitude toward their respective phenomena. Which of the following is an aim o: human sciences?
- A. Construct prediction.
- B. Sets control
- C. Seeks causal explanation
- D. Makes meaningful interpretation.
Correct Answer: D
Rationale: The aim of human sciences, including nursing as a human science, is to make meaningful interpretations of the phenomena being studied. Unlike natural sciences that may focus on prediction, control, or seeking causal explanations, the human sciences aim to understand and interpret human experiences, behaviors, and relationships in a meaningful way. In nursing, this involves not only understanding the biological aspects of health and illness but also considering the holistic and humanistic aspects of care, such as emotions, values, beliefs, and perceptions. By making meaningful interpretations, nurses can better understand their patients and provide individualized and patient-centered care.
A patient presents with a sensation of fullness and pressure in the left ear, along with hearing loss and occasional tinnitus. Otoscopic examination reveals a retracted tympanic membrane with decreased mobility on pneumatic otoscopy. Which of the following conditions is most likely responsible for this presentation?
- A. Acute otitis media
- B. Otitis externa
- C. Serous otitis media (otitis media with effusion)
- D. Cholesteatoma
Correct Answer: C
Rationale: The presentation described with a sensation of fullness and pressure in the left ear, along with hearing loss and occasional tinnitus, and the findings of a retracted tympanic membrane with decreased mobility on pneumatic otoscopy are most consistent with serous otitis media, also known as otitis media with effusion (OME). OME is characterized by the presence of non-infected fluid in the middle ear space, leading to symptoms such as ear fullness, hearing loss, and occasionally tinnitus.
A patient presents with multiple, discrete, flesh-colored papules with central umbilication on the trunk and extremities. The lesions are asymptomatic and have been present for several months. Which of the following conditions is most likely responsible for this presentation?
- A. Molluscum contagiosum
- B. Basal cell carcinoma
- C. Sebaceous hyperplasia
- D. Dermatofibroma
Correct Answer: A
Rationale: Molluscum contagiosum is a viral skin infection caused by the poxvirus. It typically presents as multiple, flesh-colored, dome-shaped papules with a central umbilication (dimple or depression in the center) on the skin. These lesions are often found on the trunk and extremities and can persist for several months. Molluscum contagiosum is commonly seen in children but can also occur in adults, especially those with weakened immune systems. The lesions are usually asymptomatic but can become inflamed or itchy in some cases. Treatment options include observation, topical therapies, cryotherapy, or curettage.
A patient presents with fever, headache, and a maculopapular rash that started on the face and spread to the trunk and extremities. Laboratory tests reveal leukopenia and thrombocytopenia. Which of the following is the most likely causative agent?
- A. Borrelia burgdorferi
- B. Plasmodium falciparum
- C. Rickettsia rickettsii
- D. Leishmania donovani
Correct Answer: C
Rationale: The clinical presentation described with fever, headache, maculopapular rash starting on the face and spreading to the trunk and extremities, along with leukopenia and thrombocytopenia suggests a likely diagnosis of Rocky Mountain spotted fever (RMSF), which is caused by the bacterium Rickettsia rickettsii.