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A patient presents with sudden-onset unilateral facial droop, arm weakness, and slurred speech. Symptoms began approximately 30 minutes ago but have partially resolved since then. Which of the following neurological conditions is most likely responsible for these symptoms?
- A. Transient ischemic attack (TIA)
- B. Ischemic stroke
- C. Hemorrhagic stroke
- D. Intracerebral hemorrhage
Correct Answer: A
Rationale: The presentation of sudden-onset unilateral facial droop, arm weakness, and slurred speech that partially resolved within 30 minutes is more consistent with a transient ischemic attack (TIA) rather than an ischemic or hemorrhagic stroke. TIAs are caused by temporary decreases in blood flow to a specific area of the brain, leading to transient neurological deficits that typically last for less than 24 hours. In this case, the symptoms partially resolving suggest a temporary and reversible ischemic event, characteristic of a TIA. Ischemic strokes involve more prolonged or permanent impairment due to blockage of a blood vessel supplying the brain, while hemorrhagic strokes involve bleeding within the brain tissue or the surrounding membranes.
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After formulating and delimiting the research problem, which following will be a PRIORITY action of Gloria?
- A. Develop the theoretical framework of the study
- B. Formulate the hypothesis
- C. Plan the research design of the study
- D. Conduct a 1iterature search on the topic
Correct Answer: C
Rationale: After formulating and delimiting the research problem, the priority action would be to plan the research design of the study. This is crucial because the research design will outline the specific methods and procedures that Gloria will use to investigate the research problem and answer the research questions. Planning the research design involves determining the overall structure of the study, selecting the appropriate research methods, and outlining how data will be collected and analyzed. This step is essential for ensuring that the study is well-organized, rigorous, and will yield reliable results. Developing a solid research design early on will set a strong foundation for the rest of the research process.
A patient presents with recurrent episodes of sudden, severe vertigo lasting hours, accompanied by nausea, vomiting, and nystagmus. Vestibular function tests demonstrate unilateral weakness. Which of the following conditions is most likely responsible for this presentation?
- A. Vestibular neuritis
- B. Benign paroxysmal positional vertigo (BPPV)
- C. Ménière's disease
- D. Acoustic neuroma Ophthalmology
Correct Answer: A
Rationale: The patient's presentation of recurrent episodes of sudden, severe vertigo lasting hours with nausea, vomiting, and nystagmus, along with unilateral weakness on vestibular function tests, is most consistent with vestibular neuritis. Vestibular neuritis is characterized by inflammation of the vestibular nerve leading to sudden onset vertigo that can last for hours to days. It is often associated with nausea, vomiting, and nystagmus. Unilateral weakness on vestibular function tests indicates dysfunction of one vestibular system. Differential diagnosis for this type of presentation includes other conditions such as Meniere's disease, BPPV, and acoustic neuroma. However, the combination of symptoms and unilateral vestibular weakness makes vestibular neuritis the most likely diagnosis in this case.
A patient expresses frustration with the healthcare system's inefficiencies. What is the nurse's best response?
- A. Dismiss the patient's frustration and assure them that the system is functioning optimally.
- B. Listen actively to the patient's concerns, acknowledge the challenges, and offer support.
- C. Ignore the patient's frustration and proceed with providing care.
- D. Tell the patient that their frustration is unwarranted and unnecessary.
Correct Answer: B
Rationale: The nurse's best response when a patient expresses frustration with the healthcare system's inefficiencies is to listen actively to the patient's concerns, acknowledge the challenges they are facing, and offer support. It is important for the nurse to validate the patient's feelings and demonstrate empathy, rather than dismissing or ignoring their frustrations. By offering support and showing understanding, the nurse can help the patient feel heard and valued, which is an essential aspect of providing patient-centered care. This approach can also help to strengthen the nurse-patient relationship and build trust, ultimately leading to better outcomes for the patient's overall healthcare experience.
A patient receiving palliative care for end-stage chronic obstructive pulmonary disease (COPD) expresses a desire to discuss advance care planning. What action should the palliative nurse take?
- A. Dismiss the patient's request and focus on symptom management.
- B. Initiate a conversation about advance directives and future care preferences.
- C. Encourage the patient to postpone discussions about advance care planning.
- D. Refer the patient to a social worker for assistance with advance care planning.
Correct Answer: B
Rationale: When a patient receiving palliative care for end-stage COPD expresses a desire to discuss advance care planning, the palliative nurse should initiate a conversation about advance directives and future care preferences. Advance care planning involves discussing and documenting a patient's preferences regarding future medical care, particularly in situations where the patient may no longer be able to make decisions. This discussion helps ensure that the patient's wishes are respected and followed in the event they are unable to communicate their preferences. By engaging in advance care planning discussions, the nurse can help the patient feel empowered, supported, and in control of their medical care decisions. It also allows healthcare providers to align care with the patient's values and goals, ultimately improving quality of life and ensuring dignity at the end of life.
In the tertiary hospital where the patient is referred , he was considered an emergency case. The nurse immediately call for a specialist who is ______.
- A. Neurologist
- B. Plebotomist
- C. Urologist
- D. Nephrologist
Correct Answer: A
Rationale: In the scenario described, the patient was considered an emergency case upon referral to the tertiary hospital. Since a specialist was immediately called for by the nurse, the most likely specialist needed in an emergency situation is a neurologist. Neurologists are physicians who specialize in diagnosing and treating disorders of the nervous system, including the brain, spinal cord, and nerves. In an emergency case where a patient's neurological condition needs urgent attention, a neurologist would be the most appropriate specialist to address the situation promptly and effectively.