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A patient presents with sudden onset of severe, unilateral ear pain, diminished hearing, and purulent otorrhea. Otoscopic examination reveals a bulging, erythematous tympanic membrane with obscured landmarks. Which of the following conditions is most likely responsible for this presentation?
- A. Otitis externa
- B. Acute otitis media
- C. Mastoiditis
- D. Chronic suppurative otitis media
Correct Answer: B
Rationale: Acute otitis media is the most likely condition responsible for this presentation. The sudden onset of severe, unilateral ear pain, diminished hearing, and purulent otorrhea are classic symptoms of acute otitis media. Otoscopic examination revealing a bulging, erythematous tympanic membrane with obscured landmarks further supports the diagnosis. The bulging of the tympanic membrane is due to the accumulation of fluid and pus behind it, causing the characteristic appearance. Treatment typically involves antibiotics to help clear the infection and relieve symptoms. If left untreated, acute otitis media can lead to complications such as perforation of the eardrum or mastoiditis.
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A patient presents with multiple, discrete, flesh-colored papules with central umbilication on the trunk and extremities. The lesions are asymptomatic and have been present for several months. Which of the following conditions is most likely responsible for this presentation?
- A. Molluscum contagiosum
- B. Basal cell carcinoma
- C. Sebaceous hyperplasia
- D. Dermatofibroma
Correct Answer: A
Rationale: Molluscum contagiosum is a viral skin infection caused by the poxvirus. It typically presents as multiple, flesh-colored, dome-shaped papules with a central umbilication (dimple or depression in the center) on the skin. These lesions are often found on the trunk and extremities and can persist for several months. Molluscum contagiosum is commonly seen in children but can also occur in adults, especially those with weakened immune systems. The lesions are usually asymptomatic but can become inflamed or itchy in some cases. Treatment options include observation, topical therapies, cryotherapy, or curettage.
A postpartum client presents with sudden chest pain, dyspnea, and tachycardia. Which nursing action should be prioritized?
- A. Elevating the head of the bed
- B. Providing supplemental oxygen therapy
- C. Administering analgesics for pain relief
- D. Notifying the healthcare provider immediately
Correct Answer: D
Rationale: Sudden chest pain, dyspnea, and tachycardia in a postpartum client can be indicative of serious conditions such as pulmonary embolism or myocardial infarction. These conditions are emergencies that require immediate medical attention. Notifying the healthcare provider immediately is the priority to ensure prompt evaluation and intervention to address the potential life-threatening situation. While other nursing interventions such as elevating the head of the bed, providing supplemental oxygen therapy, and administering analgesics may be necessary, they should be done after notifying the healthcare provider to ensure appropriate management of the underlying cause.
Ella's states'I wish I were dead . I cannot stand anymore not having lory around." ; your most appropriate Nursing action would be:
- A. Do nothing because Ella will not do it
- B. Stay with Ella
- C. Refer Ella to your supervisor
- D. Explore Ella's feelings
Correct Answer: D
Rationale: It is important for the nurse to explore Ella's feelings further when she expresses thoughts of wishing to be dead and struggling with not having someone around. These statements indicate that Ella may be experiencing emotional distress or depression, which require immediate attention. By exploring Ella's feelings, the nurse can assess the severity of her emotional state, provide appropriate support, and potentially prevent any harm or self-harm. It is crucial to address and validate her emotions, as well as to initiate necessary interventions to ensure her safety and well-being.
A client with congestive heart failure has been receiving digoxin (lanoxin). Which finding indicates that the medication is having a desired effect?
- A. Increased weight
- B. Increased urinary output
- C. Improved appetite
- D. Increased pedal edema
Correct Answer: B
Rationale: Digoxin is a medication commonly used in the treatment of congestive heart failure because it helps to improve cardiac output and reduce heart failure symptoms. One of the desired effects of digoxin is an increase in urinary output. This is because digoxin helps to improve cardiac function, which can lead to better circulation and increased kidney perfusion. As a result, the kidneys are better able to filter and excrete excess fluid, leading to increased urine output. Therefore, an increase in urinary output indicates that the digoxin is having a positive effect in managing the client's congestive heart failure. The other options, such as increased weight, improved appetite, and increased pedal edema, are not indicative of a desired effect of digoxin therapy.
Which of the following historical data MOST probably led to a post-traumatic stress disorder?
- A. Unstable relationship with ex-fiancee.
- B. No gang-relationship with peers
- C. Suicide of her mother
- D. Dropping out of school.
Correct Answer: C
Rationale: The suicide of her mother is the most probable historical data that led to post-traumatic stress disorder. Experiencing the suicide of a close family member, especially a parent, can be an extremely traumatic event that can have long-lasting psychological effects. Witnessing or dealing with such a tragic loss can lead to feelings of helplessness, depression, guilt, and intense emotional distress, all of which are common in individuals with post-traumatic stress disorder (PTSD). This significant and distressing event could have a profound impact on the individual's mental health and well-being, contributing to the development of PTSD symptoms such as intrusive memories, avoidance behaviors, negative mood alterations, and changes in arousal or reactivity.