A patient presents with fever, chills, headache, and myalgia after returning from a camping trip. Laboratory tests reveal thrombocytopenia and leukopenia. Which of the following is the most likely causative agent?
- A. Plasmodium falciparum
- B. Trypanosoma cruzi
- C. Borrelia burgdorferi
- D. Leishmania donovani
Correct Answer: A
Rationale: The most likely causative agent in this scenario is Plasmodium falciparum, which is the parasite that causes malaria. The symptoms of fever, chills, headache, and myalgia following a camping trip are highly suggestive of malaria, especially if the patient has thrombocytopenia and leukopenia. Plasmodium falciparum is known to cause severe malaria with complications such as thrombocytopenia and leukopenia. The other options, Trypanosoma cruzi, Borrelia burgdorferi, and Leishmania donovani, do not typically present with all of the symptoms described and are not associated with the laboratory findings of thrombocytopenia and leukopenia.
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A patient presents with unilateral facial paralysis, inability to close the eye on the affected side, and loss of taste sensation on the anterior two-thirds of the tongue. Which of the following conditions is most likely responsible for this presentation?
- A. Bell's palsy
- B. Ramsay Hunt syndrome
- C. Glossopharyngeal neuralgia
- D. Acoustic neuroma
Correct Answer: B
Rationale: Ramsay Hunt syndrome is caused by the varicella-zoster virus affecting the geniculate ganglion, leading to a triad of symptoms known as the Hunt syndrome: facial paralysis, ear pain, and a vesicular rash in the ear or palate. The facial paralysis in Ramsay Hunt syndrome is usually peripheral, similar to Bell's palsy, but may be more severe. In addition to facial paralysis, the patient may have the inability to close the eye on the affected side (lagophthalmos) and loss of taste sensation on the anterior two-thirds of the tongue due to involvement of the chorda tympani nerve. This differentiation is important to consider in the context of our patient's presentation.
A woman in active labor has a prolonged second stage with inadequate expulsive efforts. What nursing intervention is appropriate to facilitate fetal descent?
- A. Encourage the mother to push forcefully during contractions.
- B. Apply fundal pressure to assist with fetal descent.
- C. Prepare for immediate cesarean section.
- D. Administer intravenous magnesium sulfate for uterine relaxation.
Correct Answer: B
Rationale: In the scenario of a woman in active labor experiencing a prolonged second stage with inadequate expulsive efforts, the appropriate nursing intervention to facilitate fetal descent would be to apply fundal pressure. Fundal pressure, or applying pressure on the upper abdomen just above the uterine fundus, can help in directing the fetal head downwards and aiding in the descent through the birth canal. It is important to note that fundal pressure should be applied carefully and with proper technique to prevent excessive force that could potentially harm the mother or the baby. Encouraging the mother to push forcefully during contractions can be helpful, but the addition of fundal pressure can provide extra assistance in cases of inadequate progress. Immediate cesarean section may be considered if other interventions are unsuccessful or if there are concerns for fetal distress. Administering intravenous magnesium sulfate for uterine relaxation is not indicated in this situation.
A patient has been advised by the psychiatrist that he needs inpatient hospitalization. The patient agrees, signs the admission forms, and agrees to receive treatment. What type of admission is this?
- A. Formal
- B. Informal
- C. Voluntary
- D. Involuntary
Correct Answer: C
Rationale: This type of admission is considered voluntary because the patient willingly agrees to be admitted to the hospital for treatment. The patient has signed the admission forms and consented to receive the necessary care, indicating a willingness to participate in their treatment plan. In a voluntary admission, the individual retains the right to make decisions about their treatment and can choose to leave the hospital against medical advice if they wish to do so.
Nurse Vince is going to refer patient to secondary health facility. Which of the following is an example of secondary health facility?
- A. District hospital
- B. Rural health unit
- C. Puereculture Center
- D. Barangay health station
Correct Answer: A
Rationale: A district hospital is an example of a secondary health facility. Secondary health facilities are the intermediate level of healthcare services, providing a higher level of care compared to primary health facilities like rural health units and barangay health stations. District hospitals typically offer more specialized medical services, diagnostic facilities, and inpatient care that are not available at lower-level health facilities. When Nurse Vince refers a patient to a district hospital, it means that the patient requires more extensive and specialized medical care beyond what can be provided at the primary level of care.
A risk is any event that causes problems or benefits on the healthcare institution. The Medical Director knows that potential risks must be identified across the hospital in order to prevent the following, EXCEPT
- A. financial loss
- B. accidents
- C. incident reports
- D. injuries
Correct Answer: C
Rationale: Incident reports are a crucial tool for capturing data on adverse events, near misses, and other incidents within a healthcare institution. These reports help in analyzing patterns, identifying areas for improvement, and implementing quality and safety measures. Therefore, incident reports themselves are not something that needs to be prevented; instead, they are a critical part of the risk management process to enhance patient safety and quality of care.