Nokea
A patient presents with recurrent episodes of throat pain, odynophagia, and fever. Physical examination reveals tonsillar enlargement with yellow-white exudates and tender cervical lymphadenopathy. Which of the following organisms is most likely responsible for this presentation?
- A. Streptococcus pneumoniae
- B. Haemophilus influenzae
- C. Group A beta-hemolytic Streptococcus (GAS)
- D. Epstein-Barr virus (EBV)
Correct Answer: C
Rationale: The correct answer is C: Group A beta-hemolytic Streptococcus (GAS). GAS is the most likely organism responsible for this presentation, known as acute bacterial tonsillitis. GAS commonly causes symptoms such as throat pain, odynophagia, fever, tonsillar enlargement with exudates, and cervical lymphadenopathy. Streptococcal pharyngitis is a common bacterial infection of the throat caused by GAS. The other options are less likely as Streptococcus pneumoniae typically causes pneumonia and Haemophilus influenzae is associated with respiratory tract infections. Epstein-Barr virus (EBV) commonly causes infectious mononucleosis, which presents with different symptoms than those described in the question.
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To promote drainage and reduce pressure from fluid, Nurse Selma nursing intervention is to have the child assume any of the following positions, EXCEPT _____.
- A. tilt head to side if sitting up.
- B. Lie on the affected area
- C. put the pillows behind the head
- D. lie on the non-affected ear.
Correct Answer: B
Rationale: The correct answer is B: Lie on the affected area. This position would hinder drainage and increase pressure on the affected area. A: Tilt head to the side if sitting up, is correct as it promotes drainage. C: Putting pillows behind the head can also aid drainage. D: Lying on the non-affected ear can help reduce pressure on the affected side.
A patient with chronic kidney disease presents with fatigue, dyspnea on exertion, peripheral edema, and hypertension. Laboratory findings reveal elevated serum creatinine and urea levels, metabolic acidosis, and hyperkalemia. What is the most appropriate initial management for this patient?
- A. Initiation of angiotensin-converting enzyme (ACE) inhibitor therapy
- B. Hemodialysis
- C. Intravenous administration of calcium gluconate
- D. Sodium bicarbonate administration
Correct Answer: B
Rationale: The most appropriate initial management for the patient described is hemodialysis. Hemodialysis is essential for managing chronic kidney disease with severe symptoms and electrolyte imbalances like hyperkalemia and metabolic acidosis. Hemodialysis helps to remove urea and creatinine from the blood, correct electrolyte abnormalities, and improve symptoms such as fatigue, dyspnea, and peripheral edema. Initiation of ACE inhibitor therapy (Choice A) is contraindicated in severe kidney disease due to the risk of worsening renal function. Intravenous administration of calcium gluconate (Choice C) is used for acute hyperkalemia with cardiac toxicity, not for initial management. Sodium bicarbonate administration (Choice D) may help correct metabolic acidosis, but it does not address the underlying cause or the need for urgent renal replacement therapy.
Norse Sophie checks the gauge of the patient ' s intravenous catheter. Which is the smallest gauge catheter that the nurse can use to administer blood?
- A. 22-Gauge
- B. 20-Gauge
- C. 18-Gauge
- D. 12-Gauge
Correct Answer: B
Rationale: The correct answer is B: 20-Gauge. The smaller the gauge number, the larger the diameter of the catheter. Blood transfusions typically require a larger catheter size to prevent hemolysis and ensure proper flow. A 20-Gauge catheter is larger than 22-Gauge, 18-Gauge, and 12-Gauge, making it suitable for administering blood. 22-Gauge is too small and can cause hemolysis, 18-Gauge is smaller than the recommended size for blood transfusions, and 12-Gauge is too large and can cause damage to the vein.
Latex allergy can be a type I IgE-mediated immediate hypersensitivity to plant proteins from the latex of rubber. It can manifest in its MOST severe form as _____.
- A. Pruritus, erythema and swelling
- B. Asthma
- C. Anaphylaxis
- D. Blisters and other skin lesions
Correct Answer: C
Rationale: The correct answer is C: Anaphylaxis. Anaphylaxis is the MOST severe form of an allergic reaction, including latex allergy. It is a systemic, potentially life-threatening reaction that can involve multiple organ systems. Symptoms can include difficulty breathing, swelling of the throat, a rapid drop in blood pressure, and cardiovascular collapse. Pruritus, erythema, and swelling (choice A) are common symptoms of allergic reactions but not specific to anaphylaxis. Asthma (choice B) can be a manifestation of latex allergy but is not the most severe form. Blisters and other skin lesions (choice D) are not typical of anaphylaxis but can occur in some cases of contact dermatitis from latex exposure.
Upon entry of the patient to ER, the nurse must FIRST perform which nursing intervention?
- A. Inject with rabies immune globulin.
- B. Cleanse the bite with soap and running water.
- C. Inject the rabies vaccine immediately.
- D. Administer the pain reliever, as ordered.
Correct Answer: B
Rationale: The correct answer is B: Cleanse the bite with soap and running water. This is the first nursing intervention because it is crucial to prevent infection. Cleaning the bite area helps remove bacteria and debris, reducing the risk of infection. Injecting with rabies immune globulin (choice A) and rabies vaccine (choice C) should be done later as per protocol after assessing the situation. Administering pain reliever (choice D) is important but not the first priority in this scenario.