Nokea
A patient presents with sudden-onset, painless vision loss in the right eye. Fundoscopic examination reveals a cherry-red spot at the macula and attenuated retinal vessels. Which of the following conditions is most likely responsible for this presentation?
- A. Central retinal artery occlusion
- B. Central retinal vein occlusion
- C. Retinal detachment
- D. Acute angle-closure glaucoma
Correct Answer: A
Rationale: The presentation of sudden-onset, painless vision loss in the right eye with a cherry-red spot at the macula and attenuated retinal vessels is classic for central retinal artery occlusion (CRAO). In this condition, the blockage of the central retinal artery results in severe ischemia of the retina, leading to rapid and profound vision loss. The cherry-red spot at the macula is a result of preserved choroidal circulation contrasting with the pale, ischemic retina. Attenuated retinal vessels are also commonly observed due to decreased blood flow. Prompt evaluation and management are critical in CRAO to potentially restore some vision and prevent further ischemic damage to the retina.
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A patient presents with well-demarcated, erythematous plaques with silvery scales on the trunk and extensor surfaces of the limbs. The patient reports a family history of similar skin lesions. Which of the following conditions is most likely responsible for this presentation?
- A. Pityriasis rosea
- B. Psoriasis
- C. Erythema multiforme
- D. Lichen planus
Correct Answer: B
Rationale: The patient's presentation of well-demarcated, erythematous plaques with silvery scales on the trunk and extensor surfaces of the limbs is classic for psoriasis. Additionally, the family history of similar skin lesions further supports the diagnosis of psoriasis, as it is a condition with a genetic predisposition. Pityriasis rosea typically presents with a herald patch followed by oval, scaly lesions in a Christmas tree pattern. Erythema multiforme is characterized by target-like lesions. Lichen planus presents as purple, polygonal, flat-topped papules that may have fine white lines on their surface known as Wickham striae.
Which of the following is the preventive measure to osteoporosis development
- A. Iron rich food
- B. Daily jogging
- C. Calcium rich food and supplement
- D. Vigorous exercise
Correct Answer: C
Rationale: Calcium is essential for maintaining strong and healthy bones. Osteoporosis is a condition characterized by weakened bones, making them more prone to fractures. Consuming calcium-rich foods such as dairy products, leafy greens, and fortified foods can help prevent osteoporosis development. Additionally, incorporating calcium supplements under the guidance of a healthcare provider can further support bone health and reduce the risk of osteoporosis. Regular intake of adequate calcium is considered a crucial preventive measure for osteoporosis.
You accidentally touch Claudia's eyelid during eye drop instillation causing her to blink. What should have you done to prevent this from occurring?
- A. Touch the inner side of the medicine cap
- B. Tilt back Claudia's head slightly
- C. Hold the dropper close to the eye but do not allow the medication to fall into the cornea
- D. Have Claudia look up and focus on something
Correct Answer: B
Rationale: Tilt back Claudia's head slightly would have been the correct action to prevent her from blinking during eye drop instillation. By tilting her head back, you create a more stable position for instilling the eye drops, reducing the likelihood of accidental contact with her eyelid. Additionally, tilting the head back slightly helps in making it easier for the drops to enter the eye and stay within the conjunctival sac, improving the efficacy of the medication.
A patient receiving palliative care for end-stage liver disease experiences severe pruritus. What intervention should the palliative nurse prioritize to address the patient's symptoms?
- A. Administer antihistamine medications for itch relief.
- B. Recommend topical corticosteroid creams to alleviate itching.
- C. Encourage the patient to avoid hot showers or baths to prevent exacerbation of pruritus.
- D. Prescribe cholestyramine or other bile acid sequestrants for pruritus management.
Correct Answer: D
Rationale: In end-stage liver disease, pruritus (itching) can be a distressing symptom caused by the accumulation of bile salts in the skin due to impaired liver function. Cholestyramine and other bile acid sequestrants are the primary treatment for managing pruritus in these patients. These medications bind to the bile salts in the intestine, preventing their reabsorption and reducing the itching symptoms. Antihistamines may not be as effective for this type of pruritus since it is not histamine-mediated. Topical corticosteroids are generally not recommended for long-term use in liver disease due to the risk of systemic absorption and adverse effects. Avoiding hot showers or baths may provide some temporary relief but is not a definitive treatment. Therefore, prioritizing the prescription of cholestyramine or bile acid sequestrants would be the most appropriate intervention to address the severe pruritus in a patient with end-stage liver disease
Because Mr. Steve cannot pay for his medical bills, he is referred to the social worker. which of the following rights is applicable in this case the right to_______.
- A. Considerate and respectful care and respectful care irrespective of his socio-economics status.
- B. Expect reasonable continuity of care
- C. Examine and receive an explanation of his medical bills regardless of the source of payment
- D. Know what hospital rules and regulation apply to his conduct as a client.
Correct Answer: A
Rationale: The right to considerate and respectful care irrespective of socio-economic status is applicable in this case because Mr. Steve is facing financial difficulties in paying for his medical bills. This right ensures that all patients receive proper treatment and care regardless of their ability to pay. It emphasizes that every individual deserves to be treated with dignity and respect, regardless of their financial situation. In Mr. Steve's case, being referred to a social worker due to inability to pay should not impact the quality of care and respect he receives from healthcare providers.