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A patient presents with fever, malaise, and a maculopapular rash that started on the face and spread to the trunk and extremities. Laboratory tests reveal leukopenia and thrombocytopenia. Which of the following is the most likely causative agent?
- A. Borrelia burgdorferi
- B. Plasmodium falciparum
- C. Rickettsia rickettsii
- D. Leishmania donovani
Correct Answer: C
Rationale: The clinical presentation of fever, malaise, maculopapular rash starting on the face and spreading to the trunk and extremities, along with leukopenia and thrombocytopenia, is highly suggestive of Rocky Mountain spotted fever (RMSF) caused by Rickettsia rickettsii. RMSF is a tick-borne illness transmitted by the American dog tick, Rocky Mountain wood tick, and brown dog tick. The constellation of symptoms described aligns well with the typical presentation of RMSF. Borrelia burgdorferi causes Lyme disease, which presents with erythema migrans but does not typically cause leukopenia or thrombocytopenia. Plasmodium falciparum is the causative agent of severe malaria and would present with symptoms such as cyclic fevers, anemia, and jaundice but not the described rash distribution.
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Inductive Reasoning process is applied in:
- A. Qualitative research
- B. Action research
- C. Quantitative research
- D. Applied research
Correct Answer: A
Rationale: Inductive reasoning is the process of drawing general conclusions from specific observations or examples. It is often used in qualitative research to develop theories or explanations based on the data collected. Qualitative research focuses on understanding phenomena in their natural settings and uses inductive reasoning to interpret and make sense of the data. This approach allows researchers to explore complex issues and uncover new insights by analyzing the details and patterns within the data.
Which intervention should the nurse use to promote rest?
- A. Develop a routine with the patient to balance her studies and her rest needs .
- B. Include a significant other in helping the patient understand the need for. rest.
- C. Instruct the patient that the: baby 's health is more important than her studies at this time,
- D. Ask her why she is not complying with the prescription of bed rest.
Correct Answer: A
Rationale: Developing a routine with the patient to balance her studies and rest needs is the most appropriate intervention to promote rest. This approach considers the patient's responsibilities and can help her organize her time effectively to ensure she gets adequate rest while managing her studies. It acknowledges the importance of rest without completely disregarding the patient's other commitments, ultimately fostering a balanced approach to self-care. This intervention is patient-centered and collaborative, empowering the patient to take an active role in prioritizing rest alongside her educational responsibilities.
Patient was visited by the anesthesiologist and explained the anesthesia for his surgery. Which of the following type of anesthesia would you expect to be ordered?
- A. Spinal
- B. Local
- C. Caudal
- D. General
Correct Answer: D
Rationale: When the anesthesiologist visits a patient to explain the anesthesia for surgery, the most likely type of anesthesia to be ordered in this scenario would be general anesthesia. General anesthesia is a state of controlled unconsciousness where the patient is completely unaware and unresponsive during the procedure. This type of anesthesia is typically used for surgeries that are more complex, lengthy, or invasive, requiring the patient to be completely still and asleep throughout the operation.
What must be stressed to all participants attending a health fair?
- A. A screening program is not a substitute for ongoing health supervision from a health care provider.
- B. All test results are only tentative, and so participants who receive negative test results may nonetheless be suffering from a disease.
- C. Results are true today, but disease can develop any time, so participants should attend any future health fairs as well.
- D. There are many other diseases that may be attacking participants that the health fair did not screen for, and so continued vigilance is necessary.
Correct Answer: A
Rationale: Stressing to all participants attending a health fair that a screening program is not a substitute for ongoing health supervision from a healthcare provider is crucial for several reasons. Health fairs are intended to provide a snapshot of an individual's health at a specific point in time and are not comprehensive assessments. Participants need to understand that these screenings are not a replacement for regular check-ups with their healthcare provider, who can provide continued monitoring, follow-up care, and more in-depth evaluations if necessary. It's important for participants to recognize that the results from a health fair screening are just one piece of their overall health picture and that ongoing care from a healthcare provider is essential for maintaining their well-being.
A patient with a history of multiple myeloma presents with weakness, bone pain, and recurrent infections. Laboratory tests reveal anemia, hypercalcemia, renal insufficiency, and monoclonal spike on serum protein electrophoresis. Which of the following conditions is most likely to cause these findings?
- A. Waldenstrom macroglobulinemia
- B. Hodgkin lymphoma
- C. Chronic lymphocytic leukemia (CLL)
- D. Multiple myeloma
Correct Answer: D
Rationale: Multiple myeloma is a plasma cell neoplasm characterized by the presence of abnormal monoclonal plasma cells in the bone marrow, which produce a monoclonal spike on serum protein electrophoresis. The clinical presentation of weakness, bone pain, and recurrent infections is typical of multiple myeloma. Anemia can result from bone marrow infiltration by the abnormal plasma cells, hypercalcemia is due to bone destruction and release of calcium, renal insufficiency can result from hypercalcemia and protein deposition in the kidneys, and the monoclonal spike in serum protein electrophoresis indicates the presence of a monoclonal protein. Waldenström macroglobulinemia, Hodgkin lymphoma, and chronic lymphocytic leukemia do not typically present with the classic tetrad of findings seen in multiple myeloma.