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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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A nurse is preparing to assist with a thoracentesis procedure for a patient with pleural effusion. What action should the nurse prioritize to ensure procedural safety?
- A. Administering pre-procedure antibiotics to prevent infection
- B. Ensuring the patient empties their bladder before the procedure
- C. Positioning the patient upright with arms supported on a bedside table
- D. Confirming the patient's informed consent before the procedure
Correct Answer: D
Rationale: Confirming the patient's informed consent before the procedure is the most crucial action for the nurse to prioritize to ensure procedural safety during a thoracentesis. Informed consent is a legal and ethical requirement that ensures the patient understands the purpose of the procedure, its potential risks, benefits, and alternatives. By confirming informed consent, the nurse ensures that the patient has the necessary information and has willingly agreed to undergo the procedure. This process promotes patient autonomy, prevents misunderstandings, and reduces the likelihood of legal issues related to the procedure. Additionally, verifying informed consent helps establish a foundation of trust between the healthcare team and the patient. While other actions like positioning the patient correctly and ensuring pre-procedure antibiotics may also contribute to the safety of the procedure, obtaining informed consent is the foundational step that must be prioritized.
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.
The nurse who uses appropriate therapeutic listening skills will display which BEST behavior?
- A. Presume an understanding of the patient needs.
- B. Read quickly to the message.
- C. Reassure the patient that everything will be fine.
- D. Absorb both the content and the feeling which patient is conveying
Correct Answer: D
Rationale: The nurse who uses appropriate therapeutic listening skills will display the best behavior by absorbing both the content and the feeling which the patient is conveying. In the given scenario, Belle is experiencing a range of symptoms due to her mental health issues, trauma, and past experiences. By actively listening and absorbing both the content (symptoms, concerns) and the feelings (depressed mood, worry, irritability) which Belle is conveying, the nurse can demonstrate empathy, understanding, and validation of Belle's experiences. This type of therapeutic listening helps to build trust, rapport, and a supportive therapeutic relationship between the nurse and the patient, which is crucial for effective communication, assessment, and treatment in mental health care settings.
A patient presents with sudden onset of severe vertigo, nausea, vomiting, and nystagmus. The patient reports a recent upper respiratory tract infection. Which of the following conditions is most likely responsible for this presentation?
- A. Vestibular neuritis
- B. Benign paroxysmal positional vertigo (BPPV)
- C. Ménière's disease
- D. Acoustic neuroma
Correct Answer: A
Rationale: The sudden onset of severe vertigo, nausea, vomiting, and nystagmus in a patient with a recent upper respiratory tract infection is highly suggestive of vestibular neuritis. Vestibular neuritis is typically caused by inflammation of the vestibular nerve, often following a viral infection such as an upper respiratory tract infection. This condition presents with acute, severe, continuous vertigo without associated hearing loss. The presence of nystagmus, along with the absence of hearing loss, helps differentiate vestibular neuritis from Meniere's disease (which typically presents with episodic vertigo, hearing loss, and tinnitus) and acoustic neuroma (which presents with gradual onset of symptoms including unilateral hearing loss, tinnitus, and imbalance). Benign paroxysmal positional vertigo (BPPV) typically presents with brief episodes of vertigo triggered by specific head movements, rather than the continuous vertigo seen in this case.
Which among the members of the multidisciplinary team that the nurse BEST to collaborate with when the patient can benefit the use of leg prosthesis?
- A. Occupationa l therapist
- B. Podiatrist
- C. Physical therapist
- D. Pharmacist
Correct Answer: C
Rationale: A physical therapist would be the best member of the multidisciplinary team to collaborate with when a patient can benefit from using a leg prosthesis. Physical therapists specialize in assessing and treating movement disorders, including those related to amputation and prosthetic use. They can help the patient improve their mobility, strength, balance, and overall functional abilities with the prosthesis. Physical therapists can provide training on how to use the prosthesis effectively, reduce the risk of falls, and optimize the patient's independence and quality of life. Collaborating with a physical therapist ensures that the patient receives comprehensive care tailored to their specific needs and goals related to using a leg prosthesis.