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A patient presents with gradual-onset memory loss, impaired judgment, and personality changes. Over time, the patient develops difficulty with language, motor function, and coordination. Which of the following neurological conditions is most likely responsible for these symptoms?
- A. Parkinson's disease
- B. Alzheimer's disease
- C. Huntington's disease
- D. Amyotrophic lateral sclerosis (ALS)
Correct Answer: B
Rationale: The symptoms described such as memory loss, impaired judgment, personality changes, difficulty with language, motor function, and coordination all point towards Alzheimer's disease. Alzheimer's is a progressive neurodegenerative disease that primarily affects memory and cognitive functions. Over time, it leads to severe impairment in daily activities and overall functioning. While Parkinson's disease, Huntington's disease, and ALS can also present with neurological symptoms, the combination of gradual-onset memory loss, cognitive decline, and functional impairments seen in this scenario is most characteristic of Alzheimer's disease.
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While you are doing your physical assessment to patent Aster, she has been exhibiting a UNIQUE clinical manifestation different from patients Claire and Sonia which is characterized by________.
- A. Cyanosis, increasing growth of hands and feet
- B. anemia, weight 1oss and presence of
- C. moon facies, purple striae on trunk and buffalo hump
- D. moon facies, easy fatigability and peripheral edema
Correct Answer: A
Rationale: The clinical manifestations of Aster suggest acromegaly, a condition characterized by the excessive growth of hands and feet due to a tumor in the pituitary gland leading to overproduction of growth hormone. Cyanosis is a bluish discoloration of the skin caused by poor oxygenation, which is not typically associated with acromegaly. The other options do not match the unique clinical manifestation described for Aster. Anemia, weight loss, moon facies, and edema are more commonly associated with other conditions like Cushing's syndrome, anemia, or heart failure.
Which of the following conditions is characterized by chronic hypoxemia, pulmonary hypertension, and right heart failure?
- A. Chronic obstructive pulmonary disease (COPD)
- B. Idiopathic pulmonary fibrosis (IPF)
- C. Pulmonary embolism (PE)
- D. Cor pulmonale
Correct Answer: D
Rationale: Cor pulmonale is a condition characterized by right heart failure secondary to pulmonary hypertension, which is often caused by chronic hypoxemia. Chronic hypoxemia occurs in conditions such as chronic obstructive pulmonary disease (COPD) where there is limited airflow in and out of the lungs, leading to low oxygen levels in the blood. However, the specific characteristic of pulmonary hypertension leading to right heart failure distinguishes cor pulmonale from COPD. Other conditions like idiopathic pulmonary fibrosis (IPF) and pulmonary embolism (PE) may also lead to hypoxemia but are not primarily associated with pulmonary hypertension and right heart failure as in cor pulmonale.
A pregnant woman presents with severe abdominal pain and vaginal bleeding at 8 weeks gestation. On examination, the cervix is closed. Which of the following conditions is the most likely cause of these symptoms?
- A. Ectopic pregnancy
- B. Threatened abortion
- C. Placenta previa
- D. Gestational trophoblastic disease
Correct Answer: B
Rationale: In a pregnant woman presenting with severe abdominal pain and vaginal bleeding at 8 weeks gestation with a closed cervix, the most likely cause of these symptoms is a threatened abortion. A threatened abortion is a common complication of early pregnancy characterized by vaginal bleeding and lower abdominal pain without cervical dilation. The cervix remains closed, indicating that the pregnancy is still intact but at risk of potential miscarriage. Placenta previa typically presents with painless vaginal bleeding in the second or third trimester, whereas ectopic pregnancy usually presents with abdominal pain and vaginal bleeding in the setting of a closed cervix but is less likely at 8 weeks gestation. Gestational trophoblastic disease is a rare cause of vaginal bleeding in pregnancy and typically presents in the first trimester with signs of hyperemesis gravidarum, uterine enlargement, and elevated β-hCG levels.
Which of the following is the BEST evidence of a family whose family coping index on therapeutic competence is rated as coping well?
- A. Shows positive interpersonal relationship
- B. Participates in the weekly clean and green program of the community
- C. Maintain clean and organized household ambiance
- D. Visits the clinic frequently well or sick.
Correct Answer: A
Rationale: Showing positive interpersonal relationships is the best evidence of a family coping well when their family coping index on therapeutic competence is rated as coping well. Positive interpersonal relationships indicate that family members are effectively communicating, supporting each other, and resolving conflicts in a healthy manner. This reflects strong family dynamics, emotional resilience, and adaptability which are important aspects of effective coping. While the other options (B, C, D) are beneficial activities or behaviors, positive interpersonal relationships directly demonstrate the family's ability to cope well together, making it the most relevant evidence for a high therapeutic competence rating.
A client with end-stage renal disease decides against further treatment and requests a "Do Not Resuscitate" (DNR) order. The DNR status is part of the change-of-shift report. The client stops breathing and a nurse begins cardiopulmonary resuscitation. The family is upset and makes a complaint to the charge nurse. The charge nurse appropriately identifies that nurse has committed:
- A. Defamation
- B. assault
- C. battery .
- D. fraud.
Correct Answer: C
Rationale: Battery occurs when there is an intentional touching of another person without their consent. In this case, the nurse began cardiopulintary resuscitation on a client who had requested a "Do Not Resuscitate" (DNR) order, which means the client did not consent to the resuscitation. This action can be considered as battery because the client's wishes were not respected, and the nurse proceeded with a medical intervention against those wishes, leading to harm and potential legal consequences. This is different from assault, which involves a threat of force, and from defamation and fraud, which are not applicable to this situation.