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A patient presents with swelling of the ankles, dyspnea on exertion, and orthopnea. An echocardiogram reveals decreased left ventricular ejection fraction and dilated left ventricle. Which cardiovascular disorder is most likely responsible for these symptoms?
- A. Stable angina
- B. Heart failure with preserved ejection fraction
- C. Heart failure with reduced ejection fraction
- D. Valvular heart disease
Correct Answer: C
Rationale: The patient's presentation of swelling of the ankles, dyspnea on exertion, and orthopnea is highly suggestive of heart failure. The echocardiogram findings of decreased left ventricular ejection fraction and dilated left ventricle are characteristic of heart failure with reduced ejection fraction (HFrEF), also known as systolic heart failure. In this condition, the heart's ability to pump blood effectively is compromised, leading to symptoms of congestion and decreased cardiac output. The decreased ejection fraction indicates that the heart is not able to efficiently pump out blood with each contraction. Dilatation of the left ventricle is a compensatory mechanism in response to increased volume overload.
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A patient with a history of chronic liver disease presents with bruising, petechiae, and mucosal bleeding. Laboratory tests reveal prolonged prothrombin time (PT) and activated partial thromboplastin time (aPTT) with decreased platelet count. Which of the following conditions is most likely to cause these findings?
- A. Immune thrombocytopenic purpura (ITP)
- B. Disseminated intravascular coagulation (DIC)
- C. Hemophilia A
- D. Von Willebrand disease
Correct Answer: B
Rationale: Disseminated intravascular coagulation (DIC) is a condition characterized by widespread activation of coagulation leading to both thrombosis and hemorrhage. In patients with chronic liver disease, especially in the setting of advanced cirrhosis, DIC can develop due to factors such as decreased synthesis of coagulation factors and impaired clearance of activated clotting factors. The patient in this scenario presents with signs of both abnormal bleeding (bruising, petechiae, mucosal bleeding) and laboratory findings consistent with DIC, including prolonged prothrombin time (PT) and activated partial thromboplastin time (aPTT) along with decreased platelet count.
As an epidemiology nurse, Nurse Rona's PRIMARY function and responsibility is to _____.
- A. Assist the epidemiologist in making reports
- B. Implement public health surveillance
- C. Render nursing care to sick residents
- D. Follow up cases and contacts Situation.
Correct Answer: B
Rationale: As an epidemiology nurse, Nurse Rona's primary function and responsibility is to implement public health surveillance. Epidemiology nurses play a crucial role in monitoring and controlling the spread of diseases within communities. This involves conducting surveillance activities to identify patterns of disease occurrence, investigating outbreaks, collecting and analyzing data, and collaborating with various stakeholders to develop strategies for disease prevention and control. While providing nursing care to sick residents is important, the primary focus of an epidemiology nurse is on population-based health issues rather than individual patient care. Additionally, while Nurse Rona may assist epidemiologists in making reports and follow up cases and contacts, her main role is to implement public health surveillance to protect and promote the health of the community as a whole.
Some common examples of screening tests are the following, EXCEPT ________.
- A. Pap smears for cervical cancer screening in women.
- B. Cholesterol levels in heart disease screening.
- C. PSA levels for prostate CA in men.
- D. Urinalysis for male and female clients.
Correct Answer: D
Rationale: While urinalysis can provide valuable information about a person's health status and can be part of a clinical assessment, it is not typically considered a common screening test for specific diseases or conditions. The other options listed - Pap smears for cervical cancer screening, cholesterol levels for heart disease screening, and PSA levels for prostate cancer screening - are all commonly used screening tests aimed at early detection of specific diseases. Urinalysis is more commonly used as part of a broader health assessment or diagnostic evaluation rather than a dedicated screening tool for a specific condition.
Nurse Gayle is guided that the initial step of delegation is ______.
- A. demonstrate the task and let the staff continue the next activities
- B. Assess the capability of the staff, change him if not performing
- C. Determine the competency level of staff for the task being given
- D. Explain the task to be done with accompanying job description
Correct Answer: C
Rationale: The initial step of delegation is to determine the competency level of the staff for the task being given. Before delegating a task, a nurse must assess the knowledge, skills, and abilities of the staff member to ensure that they are competent and capable of performing the task safely and effectively. This step is crucial in ensuring that tasks are delegated appropriately and that quality patient care is maintained. By determining the competency level of the staff, Nurse Gayle can make informed decisions about delegation, provide appropriate support and resources, and facilitate effective communication throughout the delegation process.
Which of the following structures is responsible for transporting food from the oral cavity to the esophagus during swallowing?
- A. Tongue
- B. Pharynx
- C. Esophagus
- D. Epiglottis
Correct Answer: B
Rationale: The pharynx is the structure responsible for transporting food from the oral cavity to the esophagus during swallowing. When food is chewed and mixed with saliva in the oral cavity, it forms a bolus that is propelled to the pharynx by the tongue. The pharynx serves as a common passageway for both air and food, allowing the bolus to pass into the esophagus while preventing it from entering the trachea. The epiglottis, although important in preventing food from entering the airway, is not directly involved in the transportation of food from the oral cavity to the esophagus.