Nokea
A patient presents with multiple, hyperpigmented, velvety plaques in flexural areas such as the axillae and neck. The lesions are associated with obesity and insulin resistance. Which of the following conditions is most likely responsible for this presentation?
- A. Acanthosis nigricans
- B. Seborrheic keratosis
- C. Dermatofibroma
- D. Epidermal nevus
Correct Answer: A
Rationale: Acanthosis nigricans is a skin condition characterized by multiple, hyperpigmented, velvety plaques typically seen in flexural areas such as the axillae, neck, and groin. These lesions are often associated with obesity and insulin resistance. The appearance of acanthosis nigricans is distinct from other skin conditions such as seborrheic keratosis, dermatofibroma, and epidermal nevus. Acanthosis nigricans is commonly seen in conditions like obesity, type 2 diabetes, and metabolic syndrome due to the insulin resistance that leads to the overgrowth of keratinocytes.
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Which of the following conditions is characterized by the presence of multiple fluid-filled sacs within the ovaries and is associated with menstrual irregularities and hyperandrogenism?
- A. Polycystic ovary syndrome (PCOS)
- B. Ovarian torsion
- C. Ovarian cyst rupture
- D. Ovarian cancer
Correct Answer: A
Rationale: Polycystic ovary syndrome (PCOS) is a common endocrine disorder in women of reproductive age. It is characterized by the presence of multiple fluid-filled sacs (cysts) within the ovaries, which can be visualized on ultrasound. Women with PCOS often experience menstrual irregularities such as irregular periods or no periods, as well as symptoms of hyperandrogenism like hirsutism (excessive hair growth) and acne. Other common features of PCOS include insulin resistance and obesity. It is important to note that not all women with PCOS will have ovarian cysts, but the presence of multiple cysts is a common finding in this condition.
A nurse is preparing to perform a continuous bladder irrigation (CBI) procedure for a patient following urological surgery. What action should the nurse prioritize to prevent complications during CBI?
- A. Adjusting the irrigation flow rate based on the patient's urine output
- B. Changing the irrigation solution every 24 hours to maintain sterility
- C. Using tap water for irrigation to prevent electrolyte imbalances
- D. Limiting the duration of CBI to minimize the risk of bladder distention
Correct Answer: A
Rationale: The nurse should prioritize adjusting the irrigation flow rate based on the patient's urine output to prevent complications during continuous bladder irrigation (CBI). Proper adjustment of the irrigation flow rate helps maintain adequate bladder drainage while preventing bladder distention, clot formation, and potential irrigation fluid overload. Monitoring the patient's urine output and adjusting the flow rate accordingly ensures optimal functioning of the CBI system and enhances patient safety. This proactive approach minimizes the risk of complications and promotes effective postoperative care following urological surgery.
A patient presents with watery diarrhea, abdominal cramps, and nausea after consuming contaminated water from a stream during a camping trip. Laboratory tests reveal oocysts in the stool sample. Which of the following parasites is most likely responsible for this infection?
- A. Giardia lamblia
- B. Entamoeba histolytica
- C. Cryptosporidium parvum
- D. Cyclospora cayetanensis
Correct Answer: C
Rationale: The patient is likely infected with Cryptosporidium parvum based on the symptoms of watery diarrhea, abdominal cramps, and nausea after consuming contaminated water. Cryptosporidium is a protozoan parasite that can be transmitted through contaminated water sources, such as streams. Laboratory tests revealing oocysts in the stool sample further support the diagnosis of Cryptosporidium infection, as these oocysts are characteristic of this parasite. Giardia lamblia is another common protozoan parasite that can cause similar symptoms but is usually associated with more foul-smelling, greasy diarrhea. Entamoeba histolytica causes amoebic dysentery, which presents with bloody diarrhea and abdominal pain. Cyclospora cayetanensis also causes watery diarrhea, but it is usually associated with foodborne outbreaks rather than waterborne transmission.
Lillian asks the nurse the cause of this ailment. Which of the following would the nurse explain as predisposing factors of mastitis? (Select all that apply) I. Milk stasis II. Nipple trauma III. Using alcohol in cleaning nipples IV. Baby 's sitting position
- A. II and IV
- B. I and II
- C. I and IV
- D. II and III
Correct Answer: B
Rationale: Mastitis is typically caused by bacterial infection, with predisposing factors including milk stasis (I) and nipple trauma (II). Milk stasis occurs when milk is not effectively removed from the breast, leading to a build-up that can block ducts and predispose to infection. Nipple trauma, such as cracks or damage, can provide entry points for bacteria to infect the breast tissue. Factors like using alcohol in cleaning nipples (III) and the baby's sitting position (IV) are not directly associated with the development of mastitis.
Ms. Cruz is the supervisor of a hospital on night shift. Several nurses did not report due to Jeepney strike. When the supervisor is executing proper allocation of nurses to the PRIORITY wards to address this concern, she is observing what type of principle?
- A. Beneficence
- B. Justice
- C. Non-maleficence
- D. Fidelity
Correct Answer: B
Rationale: When the supervisor allocates nurses to the priority wards in response to the situation of several nurses not reporting due to the Jeepney strike, she is practicing the ethical principle of justice. Justice in healthcare pertains to the fair distribution of resources and the equitable treatment of individuals. By ensuring that nurses are allocated fairly and appropriately to address the urgent needs of the hospital and its patients, the supervisor is upholding the principle of justice. This decision aims to ensure that all patients receive the care they need despite the unexpected staffing shortage.