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A patient presents with chest pain that occurs during heavy lifting or physical exertion and is relieved by rest. An electrocardiogram (ECG) may show transient ST-segment depression. Which cardiovascular disorder is most likely responsible for these symptoms?
- A. Stable angina
- B. Unstable angina
- C. Acute myocardial infarction
- D. Prinzmetal's angina
Correct Answer: A
Rationale: The patient's symptoms of chest pain occurring during heavy lifting or physical exertion and being relieved by rest are classic characteristics of stable angina. Stable angina is caused by transient myocardial ischemia due to a fixed coronary artery obstruction. Typically, the pain is predictable and reproducible, occurring with exertion and relieved by rest. The transient ST-segment depression on ECG is also a common finding in stable angina, reflecting myocardial ischemia during episodes of chest pain.
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A patient presents with petechiae, purpura, and mucosal bleeding. Laboratory tests reveal thrombocytopenia, elevated serum creatinine, and schistocytes on peripheral blood smear. Which of the following conditions is most likely to cause these findings?
- A. Thrombotic thrombocytopenic purpura (TTP)
- B. Idiopathic thrombocytopenic purpura (ITP)
- C. Hemolytic uremic syndrome (HUS)
- D. Disseminated intravascular coagulation (DIC)
Correct Answer: A
Rationale: Thrombotic thrombocytopenic purpura (TTP) is a rare but serious condition characterized by microangiopathic hemolytic anemia, thrombocytopenia, neurological abnormalities, fever, and renal dysfunction. The classic pentad of symptoms includes fever, neurologic changes, renal impairment, thrombocytopenia, and microangiopathic hemolytic anemia. The presence of petechiae, purpura, and mucosal bleeding along with thrombocytopenia, elevated serum creatinine, and schistocytes on peripheral blood smear are consistent with TTP. In TTP, there is usually a deficiency of ADAMTS13 (a von Willebrand factor-cleaving protease) leading to excessive platelet adhesion, aggregation, and microthrombi formation within small blood vessels. Treatment typically
A patient with a history of chronic liver disease presents with jaundice, ascites, and spider angiomas. Laboratory tests reveal elevated serum bilirubin levels, prolonged prothrombin time, and hypoalbuminemia. Which condition is the patient most likely experiencing?
- A. Hepatic encephalopathy
- B. Hepatorenal syndrome
- C. Cirrhosis
- D. Acute liver failure
Correct Answer: C
Rationale: The patient's presentation of jaundice, ascites, spider angiomas, elevated serum bilirubin levels, prolonged prothrombin time, and hypoalbuminemia are all indicative of cirrhosis. Cirrhosis is a late stage of liver disease characterized by liver scarring and poor liver function. Jaundice, which is the yellowing of the skin and eyes due to elevated bilirubin levels, is a common manifestation of liver dysfunction seen in cirrhosis. Ascites, the accumulation of fluid in the abdomen, is also a common complication of cirrhosis. Spider angiomas, which are small blood vessels near the skin's surface, are a result of altered blood flow in the liver due to cirrhosis. Prolonged prothrombin time and hypoalbuminemia are consequences of reduced liver synthesis function in cirrhosis. Hepatic encephalopathy and hepatorenal syndrome
Which of the following actions is appropriate for managing a conscious patient with a dislocated shoulder?
- A. Attempting to reduce the dislocation by pulling on the affected arm.
- B. Applying a splint to immobilize the arm in the dislocated position.
- C. Providing analgesia and applying ice packs to the affected shoulder.
- D. Administering intravenous fluids to prevent dehydration.
Correct Answer: C
Rationale: For managing a conscious patient with a dislocated shoulder, the appropriate action is to provide analgesia to help manage the pain and discomfort associated with the dislocation. Applying ice packs to the affected shoulder can also help reduce swelling and provide some relief. It is important to refrain from attempting to reduce the dislocation by pulling on the affected arm, as this can cause further damage and worsen the injury. Applying a splint to immobilize the arm in the dislocated position is also not recommended, as this can lead to complications and hinder the reduction process. Administering intravenous fluids to prevent dehydration is not directly related to managing a dislocated shoulder in a conscious patient.
The toddlers years are a time of great cognitive, emotional and social development. The toddles is a child _______ months old.
- A. 6 to 12
- B. 36 to 48
- C. 9 to 36
- D. 12 to 36
Correct Answer: C
Rationale: Toddlers are typically children who are 1 to 3 years old. In this context, the toddlers are children in the age range of 9 to 36 months old. This period is marked by significant cognitive, emotional, and social development as children in this age group start to explore their environments, develop their language skills, begin to understand emotions, and interact with others. It is a crucial stage in a child's development where they start becoming more independent and forming their own identities.
As part of the teaching plan, Nurse Angie teaches that oral contraceptives contains estrogen. Which of the following is the Action of Estrogen? It inhibits the _______.
- A. GnRH thereby inhibiting FSH and LH productions.
- B. Luteinising Hormone (LH) thereby inhibiting ovulation.
- C. Testosterone production.
- D. Follicle Stimulating Hormone (FSH) thereby inhibiting maturation of ovum.
Correct Answer: A
Rationale: Estrogen exerts negative feedback on the hypothalamus by inhibiting the release of GnRH (Gonadotropin-Releasing Hormone). GnRH plays a crucial role in the regulation of follicle-stimulating hormone (FSH) and luteinizing hormone (LH) production from the pituitary gland. By inhibiting the release of GnRH, estrogen ultimately leads to a decrease in FSH and LH levels. This process helps to suppress the maturation of the egg and ovulation, providing contraceptive effects.