Nokea
A patient presents with a yellowish-white spot on the cornea, surrounded by a ring of inflammation. Slit-lamp examination reveals branching, filamentous opacities extending from the corneal lesion. Which of the following conditions is most likely responsible for this presentation?
- A. Herpes simplex keratitis
- B. Bacterial keratitis
- C. Fungal keratitis
- D. Acanthamoeba keratitis
Correct Answer: C
Rationale: The described clinical presentation of a yellowish-white spot on the cornea with a ring of inflammation, along with branching, filamentous opacities extending from the corneal lesion, is highly suggestive of fungal keratitis. Fungal keratitis is commonly caused by filamentous fungi such as Fusarium and Aspergillus species. The characteristic finding of branching, filamentous opacities seen on slit-lamp examination is classic for fungal infections of the cornea. It is important to promptly diagnose and treat fungal keratitis since delayed or inadequate management can result in vision-threatening complications.
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Which of the following clinical findings is most consistent with a diagnosis of pneumonia?
- A. Inspiratory crackles and dullness to percussion
- B. Hemoptysis and pleuritic chest pain
- C. Clubbing of the fingers and cyanosis
- D. Decreased breath sounds and tracheal deviation
Correct Answer: A
Rationale: The clinical findings of inspiratory crackles (also known as rales) and dullness to percussion are most consistent with a diagnosis of pneumonia. Inspiratory crackles are abnormal lung sounds heard on auscultation and are typically due to the presence of fluid or mucus in the alveoli. Dullness to percussion can indicate consolidation of lung tissue, which is a common finding in pneumonia where the alveolar spaces are filled with inflammatory exudate. These findings suggest localized lung pathology and are commonly observed in patients with pneumonia. Hemoptysis and pleuritic chest pain (Choice B) are more suggestive of pulmonary embolism or pleurisy. Clubbing of the fingers and cyanosis (Choice C) are signs of chronic hypoxemia and are not specific to pneumonia. Decreased breath sounds and tracheal deviation (Choice D) are more indicative of conditions such as a pneumoth
A nurse is resistant to the change and is not taking an active part in facilitating the process of change. Which is the BEST approach in dealing with the nurse?
- A. Exert coercion on the nurse
- B. Provide a positive reward system for the nurse
- C. Talk and encourage verbalizing feelings of the change
- D. Ignore the resistance of the nurse.
Correct Answer: C
Rationale: The best approach in dealing with a nurse who is resistant to change and not actively participating is to communicate and encourage verbalizing feelings about the change. By talking with the nurse and allowing them to express their concerns and feelings, you can address any underlying issues that may be causing the resistance. This approach can help build trust, improve communication, and ultimately increase the nurse's engagement in the change process. Coercion (Choice A) can create negative feelings and resistance, while ignoring the nurse's resistance (Choice D) will not resolve the issue. Providing positive rewards (Choice B) may be helpful but may not address the underlying reasons for resistance. Communication is key in addressing resistance to change and fostering a positive, open environment for all involved.
Sexual dysfunctions 1ike impotence, erectile dysfunction, and lack of libido are likely possibilities in what, prostatic surgery?
- A. Suprapubic prostatectomy
- B. Transurethral resection of the prostate
- C. Laparoscopic prostatectomy
- D. Perineal prostatectomy
Correct Answer: B
Rationale: Sexual dysfunctions like impotence, erectile dysfunction, and lack of libido are common complications following prostatic surgery. Among the options provided, transurethral resection of the prostate (TURP) is associated with a higher risk of these sexual dysfunctions. This is because during TURP, the surgical procedure may damage nerves and blood vessels that are crucial for sexual function, leading to impotence, erectile dysfunction, and decreased libido postoperatively.
A postpartum client reports persistent, severe perineal pain despite analgesic medication. On assessment, the nurse observes ecchymosis and swelling of the perineum. Which nursing action is most appropriate?
- A. Applying ice packs to the perineum for pain relief
- B. Encouraging the client to sit on a donut cushion
- C. Notifying the healthcare provider immediately
- D. Administering additional analgesic medication
Correct Answer: C
Rationale: The presence of ecchymosis (bruising) and significant swelling in the perineum despite analgesic medication suggests a potential complication such as a hematoma. A hematoma is a collection of blood that can occur due to trauma or during childbirth. It is important to notify the healthcare provider immediately so that further assessment and interventions, such as drainage of the hematoma, can be initiated promptly to prevent complications and alleviate the client's pain. Applying ice packs or encouraging the client to sit on a donut cushion may provide temporary relief but will not address the underlying issue of a potentially serious hematoma. Administering additional analgesic medication may not be effective in this case if the pain is primarily due to the hematoma. Prompt notification of the healthcare provider is crucial for proper management of this situation.
What is the appropriate initial management for a conscious patient experiencing a syncopal episode (fainting)?
- A. Elevating the legs above the level of the heart.
- B. Administering intravenous fluids rapidly.
- C. Providing reassurance and assisting the patient to a lying position.
- D. Administering oxygen via nasal cannula.
Correct Answer: C
Rationale: The appropriate initial management for a conscious patient experiencing a syncopal episode (fainting) is to provide reassurance and assist the patient to a lying position. This is important to ensure adequate blood flow to the brain and to prevent further injury in case the patient faints again. Elevating the legs above the level of the heart is not recommended as a routine intervention for syncope. Administering intravenous fluids rapidly is not usually needed in the initial management of syncope without signs of dehydration or significant bleeding. Administering oxygen via nasal cannula is not necessary for most cases of syncope unless there are specific indications such as signs of respiratory distress.