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A patient presents with fever, chills, headache, and myalgia after returning from a trip to sub-Saharan Africa. Laboratory tests reveal intraerythrocytic ring forms and trophozoites on blood smear examination. 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 clinical presentation of fever, chills, headache, and myalgia following a trip to sub-Saharan Africa is highly suggestive of malaria, which is caused by the Plasmodium species. Specifically, the presence of intraerythrocytic ring forms and trophozoites on blood smear examination points towards Plasmodium falciparum as the most likely causative agent.
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A patient with renal failure presents with confusion, seizures, asterixis, and a sweet odor to the breath. Laboratory findings reveal severe metabolic acidosis, hyperkalemia, and elevated blood urea nitrogen (BUN) and creatinine levels. What is the most likely diagnosis?
- A. Diabetic ketoacidosis (DKA)
- B. Uremic encephalopathy
- C. Hyperosmolar hyperglycemic state (HHS)
- D. Hepatic encephalopathy
Correct Answer: B
Rationale: The patient's presentation with renal failure, confusion, seizures, asterixis, and a sweet odor to the breath, along with laboratory findings of severe metabolic acidosis, hyperkalemia, and elevated BUN and creatinine levels, is consistent with uremic encephalopathy. Uremic encephalopathy is a neurological complication of acute or chronic renal failure resulting from the buildup of uremic toxins in the blood, leading to various neurological symptoms such as confusion and seizures. The sweet odor to the breath can be attributed to the presence of urea, a waste product that accumulates in renal failure. Other metabolic abnormalities like hyperkalemia and severe metabolic acidosis are also common in renal failure. It is crucial to promptly recognize and manage uremic encephalopathy to prevent further neurological complications.
Which of the following conditions is characterized by the formation of calcium oxalate or calcium phosphate stones within the renal collecting system?
- A. Ureteropelvic junction (UPJ) obstruction
- B. Ureterovesical junction (UVJ) obstruction
- C. Renal colic
- D. Nephrolithiasis
Correct Answer: D
Rationale: Nephrolithiasis refers to the formation of stones within the kidney or urinary tract. The most common types of kidney stones are either composed of calcium oxalate or calcium phosphate. When these stones form within the renal collecting system, they can lead to symptoms such as flank pain, hematuria, and urinary obstruction. Ureteropelvic junction (UPJ) obstruction and ureterovesical junction (UVJ) obstruction are specific types of blockages within the urinary system that can be caused by kidney stones but are not characteristic of the stone formation itself. Renal colic is the term used to describe the severe pain associated with the passage of a kidney stone through the ureter.
When determining the existence of malpractice, which factor is NOT considered?
- A. Injury
- B. Causation
- C. Duty
- D. Intent
Correct Answer: D
Rationale: When determining the existence of malpractice, intent is not considered as a factor. Malpractice typically involves unintentional actions or negligence rather than a deliberate intent to cause harm. The key factors that are usually considered in a malpractice case include duty (a legal obligation to provide a certain standard of care), causation (the link between the provider's actions and the patient's injury), and the existence of an injury resulting from the provider's actions or omissions. Intent does not play a direct role in malpractice cases, as they are focused on the standard of care provided by the healthcare professional and the harm caused as a result.
To ensure quality nursing care to a patient in skin traction, what is the PRIORTTY intervention that a nurse has to assess frequently?
- A. Signs of infection around the pin site.
- B. Signs of skin breakdown
- C. Urinary incontinence
- D. Presence' of bowel sounds
Correct Answer: B
Rationale: When a patient is in skin traction, the constant pressure and rubbing against the skin from the traction device can lead to skin breakdown. Therefore, assessing for signs of skin breakdown, such as redness, irritation, or pressure injuries, is crucial to prevent complications and ensure the patient's comfort and safety. Prompt identification and intervention for any skin issues can prevent further damage and promote healing, making this the priority intervention for quality nursing care in skin traction. While monitoring for signs of infection, urinary incontinence, and bowel sounds are important, skin breakdown poses a more immediate threat to the patient's well-being in this scenario.
Nurse Maris is correct in identifying whinch of the following is a health resource problem?
- A. Increase in number of deaths fromm Pneumonia
- B. Feud between Midwife andHead of t he Sanitation Committee
- C. Absence of midwife in the communtiy to render health services
- D. High Maternal Mortality Rate
Correct Answer: C
Rationale: The correct answer, C, reflects a health resource problem. The absence of a midwife in the community means that there is a lack of a critical health resource necessary for providing essential health services, especially for pregnant women and infants. This directly impacts the access to healthcare services and can contribute to negative health outcomes, such as high maternal mortality rates. The other options do not directly address a health resource problem but rather focus on specific issues or conflicts within the community.