Nokea
A patient presents with sudden-onset severe headache, altered mental status, and focal neurological deficits. Imaging reveals a hemorrhagic lesion within the right basal ganglia. Which of the following neurological conditions is most likely responsible for these symptoms?
- A. Ischemic stroke
- B. Subarachnoid hemorrhage
- C. Intracerebral hemorrhage
- D. Transient ischemic attack (TIA)
Correct Answer: C
Rationale: Intracerebral hemorrhage occurs when there is bleeding directly into the brain tissue, often due to conditions such as hypertension or vascular malformations. The sudden-onset severe headache, altered mental status, and focal neurological deficits described in the patient are typical symptoms of an intracerebral hemorrhage. The location of the hemorrhagic lesion within the right basal ganglia corresponds to the clinical presentation. Ischemic stroke, subarachnoid hemorrhage, and transient ischemic attack (TIA) typically have different presentations and imaging findings compared to an intracerebral hemorrhage. Therefore, in this scenario, intracerebral hemorrhage is the most likely cause of the patient's symptoms.
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A patient in the ICU develops acute respiratory distress syndrome (ARDS) with severe hypoxemia refractory to conventional oxygen therapy. What intervention should the healthcare team prioritize to improve the patient's oxygenation?
- A. Initiate prone positioning to optimize lung recruitment.
- B. Administer inhaled pulmonary vasodilators for vasodilation.
- C. Perform recruitment maneuvers to open collapsed alveoli.
- D. Recommend extracorporeal membrane oxygenation (ECMO) for respiratory support.
Correct Answer: D
Rationale: In the scenario described, the patient is experiencing severe hypoxemia refractory to conventional oxygen therapy, indicating a need for advanced respiratory support. When a patient with ARDS fails to respond to conservative management, including mechanical ventilation strategies, prone positioning, and recruitment maneuvers, the next step may involve extracorporeal membrane oxygenation (ECMO). ECMO provides a way to bypass the lungs and oxygenate the blood directly, allowing for enhanced gas exchange and support for severely compromised respiratory function. Therefore, in this critical situation, prioritizing the recommendation for ECMO can offer the patient the best chance of improving oxygenation and survival.
A nurse is communicating with attending physician about the Intervention prescribed for a patient-post-spine surge statement is INDICATIVE of a collaborative relationship?
- A. "Can we talk about Mrs. Santos?"
- B. " I am Worried about Mrs. Santos blood pressure. It is not decreasing even with the new antihypertensive medication"
- C. "That new medication you prescribed for Mrs.-Santos ineffective"
- D. "We do not need to talk about Mrs. Santos blood pressure."
Correct Answer: A
Rationale: Option A, "Can we talk about Mrs. Santos?" is indicative of a collaborative relationship between the nurse and the attending physician. It shows open communication and a willingness to discuss the patient's case together, which is essential for optimal patient care. This statement implies teamwork and a shared responsibility for the patient's well-being. The other options either lack a collaborative tone, show concern without inviting discussion, or suggest a dismissive attitude towards addressing the patient's needs.
A pregnant woman presents with severe lower abdominal pain, fever, and vaginal discharge. On examination, cervical motion tenderness and adnexal tenderness are noted, along with bilateral adnexal masses. Which of the following conditions is the most likely cause of these symptoms?
- A. Ectopic pregnancy
- B. Pelvic inflammatory disease
- C. Placenta previa
- D. Ovarian torsion
Correct Answer: B
Rationale: The constellation of severe lower abdominal pain, fever, and vaginal discharge in a pregnant woman raises suspicion for pelvic inflammatory disease (PID). Cervical motion tenderness and adnexal tenderness are classic physical exam findings for PID. The presence of bilateral adnexal masses further supports the diagnosis, as PID can lead to the formation of tubo-ovarian abscesses. Ectopic pregnancy may present with similar symptoms but is less likely in this case as bilateral adnexal masses suggest a more diffuse inflammatory process. Placenta previa would typically present with painless vaginal bleeding in the third trimester, which is not consistent with the symptoms described. Ovarian torsion would present with sudden severe unilateral lower abdominal pain and is less likely to involve both ovaries simultaneously.
When communicating with a patient from a different cultural background, what should the nurse prioritize?
- A. Ignoring cultural differences to avoid making the patient uncomfortable.
- B. Using medical jargon to ensure clarity and precision.
- C. Recognizing and respecting the patient's cultural beliefs and practices.
- D. Minimizing the time spent communicating with the patient.
Correct Answer: C
Rationale: When communicating with a patient from a different cultural background, the nurse should prioritize recognizing and respecting the patient's cultural beliefs and practices. This is essential in providing culturally competent care, fostering trust and rapport with the patient, and ultimately improving health outcomes. By acknowledging and understanding the cultural context of the patient, the nurse can adapt communication strategies, address the patient's needs effectively, and avoid misunderstandings or misinterpretations. Building a culturally sensitive approach can enhance the quality of care and strengthen the therapeutic relationship between the nurse and patient.
Nurse Noli should include in his teachings the following EXCEPT:
- A. Less saturated fat
- B. Weight within normal limits
- C. Exercise regularly
- D. More fats in the diet
Correct Answer: D
Rationale: Nurse Noli should include in his teachings less saturated fat, maintaining weight within normal limits, and exercising regularly as these are all components of a healthy lifestyle. However, including "more fats in the diet" goes against the principles of healthy eating and weight management. Consuming excessive amounts of fats, especially unhealthy saturated fats, can contribute to various health issues such as obesity, cardiovascular diseases, and other medical conditions. Therefore, it is crucial for Nurse Noli to emphasize reducing saturated fat intake rather than promoting more fats in the diet for overall health and wellness.