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 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 characteristic of fungal keratitis. Fungal keratitis typically presents with these specific features on clinical examination.
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Non verbal communication is the behavior that accompanies verbal communication, which of the following is NOT an indicator of this
- A. Eye contact
- B. Grunts and groans
- C. Words representing an object
- D. Bochy language
Correct Answer: C
Rationale: Nonverbal communication consists of gestures, facial expressions, body language, posture, tone of voice, touch, and eye contact, among other behaviors. Option C, words representing an object, refers to verbal communication rather than nonverbal communication. Nonverbal communication is the behavior that accompanies verbal communication, providing additional layers of meaning and adding context to the spoken words. Therefore, words representing an object are not indicators of nonverbal communication.
A patient with a history of heart failure is prescribed digoxin. Which assessment finding indicates a potential adverse effect of digoxin therapy?
- A. Bradycardia
- B. Hypotension
- C. Hyperkalemia
- D. Confusion
Correct Answer: D
Rationale: Confusion is a potential adverse effect of digoxin therapy. Digoxin toxicity can manifest as various central nervous system symptoms, including confusion, delirium, and disorientation. It is important to monitor for signs of digoxin toxicity in patients taking this medication, especially those with a history of heart failure or renal impairment. Other common signs of digoxin toxicity may include visual disturbances (like halos around lights), gastrointestinal symptoms (like nausea and vomiting), and cardiac arrhythmias. Monitoring serum digoxin levels can help guide therapy and identify toxicity early.
Which of the following clinical manifestations will NOT be a complaint from Sarah's condition?
- A. Edema of the extremities
- B. Poor wound healing
- C. Decrease libido
- D. Absence of growth in the pubic area
Correct Answer: C
Rationale: Sarah's condition seems to be related to growth and wound healing issues, based on the provided clinical manifestations. Decrease libido is typically unrelated to conditions like edema, poor wound healing, and absence of growth in the pubic area. Therefore, it would not be a complaint stemming from Sarah's condition.
Which of the following actions is appropriate when managing a patient with a suspected heat stroke?
- A. Administering warm intravenous fluids.
- B. Applying ice packs to the patient's skin.
- C. Encouraging the patient to drink cold water rapidly.
- D. Removing the patient from the hot environment and cooling the body.
Correct Answer: D
Rationale: When managing a patient with a suspected heat stroke, the appropriate action is to remove the patient from the hot environment and start cooling the body. Heat stroke is a medical emergency that can be life-threatening if not promptly treated. Cooling the body is essential to lower the core body temperature as quickly as possible. Ice packs should not be directly applied to the skin as they can cause vasoconstriction and may actually hinder heat dissipation. Administering warm intravenous fluids and encouraging the patient to drink cold water rapidly are also not recommended in the initial management of a heat stroke. The priority is to cool the patient down and seek medical attention immediately.
A patient undergoing mechanical ventilation in the ICU develops ventilator-associated pneumonia (VAP) caused by methicillin-resistant Staphylococcus aureus (MRSA). What intervention should the healthcare team prioritize to manage the patient's infection?
- A. Administer vancomycin or linezolid for MRSA coverage.
- B. Perform bronchoalveolar lavage for diagnostic purposes.
- C. Implement contact precautions to prevent transmission.
- D. Recommend prophylactic antifungal therapy to prevent candidiasis.
Correct Answer: A
Rationale: The most important intervention for managing ventilator-associated pneumonia (VAP) caused by methicillin-resistant Staphylococcus aureus (MRSA) in a patient undergoing mechanical ventilation in the ICU is to start appropriate antimicrobial therapy targeting MRSA. Vancomycin or linezolid are commonly used antibiotics for MRSA infections. These medications are effective against MRSA and can help in treating the infection and preventing further complications. It is crucial to initiate antimicrobial therapy promptly once the diagnosis of VAP caused by MRSA is suspected or confirmed to improve patient outcomes. Other interventions such as bronchoalveolar lavage for diagnostic purposes, contact precautions, or antifungal therapy may be relevant but the priority is to start effective antibiotic therapy to target the specific pathogen causing the infection.