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A patient presents with tremors, rigidity, bradykinesia, and postural instability. On examination, the patient demonstrates a shuffling gait, stooped posture, and a masked facies. Which of the following neurological conditions is most likely responsible for these symptoms?
- A. Alzheimer's disease
- B. Parkinson's disease
- C. Multiple sclerosis (MS)
- D. Amyotrophic lateral sclerosis (ALS)
Correct Answer: B
Rationale: The symptoms described in the patient, such as tremors, rigidity, bradykinesia (slow movement), and postural instability, along with the presence of a shuffling gait, stooped posture, and masked facies, are classic features of Parkinson's disease. These motor symptoms are primarily caused by the degeneration of dopamine-producing neurons in the substantia nigra region of the brain. This results in an imbalance of neurotransmitters, particularly dopamine, leading to motor dysfunction and characteristic movement abnormalities seen in Parkinson's disease.
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A patient in the ICU develops acute respiratory distress syndrome (ARDS) secondary to sepsis. What intervention should the healthcare team prioritize to manage the patient's respiratory failure?
- A. Initiate lung-protective mechanical ventilation with low tidal volume.
- B. Administer inhaled nitric oxide (iNO) for pulmonary vasodilation.
- C. Perform prone positioning to improve oxygenation.
- D. Recommend high-dose corticosteroid therapy for anti-inflammatory effects.
Correct Answer: A
Rationale: ** In a patient with ARDS, the priority intervention to manage respiratory failure is to initiate lung-protective mechanical ventilation with low tidal volume. ARDS is characterized by widespread inflammation and injury to the alveoli, leading to impaired gas exchange and severe hypoxemia. Lung-protective ventilation strategies aim to minimize ventilator-induced lung injury by using lower tidal volumes (around 6 mL/kg of predicted body weight) to reduce barotrauma and volutrauma.
The QA team has been bombarded by complaints of patients on their long waiting period in the OPD, before the health care professionals are examining them. In response to this concern, which type of quality assessment should the team implement?
- A. Outcome evaluation
- B. Ongoing evaluation
- C. Process evaluation
- D. Structures evaluation
Correct Answer: C
Rationale: Process evaluation focuses on assessing how well the activities and procedures are being conducted to achieve the desired outcomes. In this situation, the long waiting period in the OPD is a process issue related to the efficiency of patient flow and appointment scheduling practices. By implementing a process evaluation, the QA team can analyze and improve the workflow, identify bottlenecks causing delays, and streamline the processes to reduce waiting times for patients. This approach allows the team to make targeted improvements in the processes directly associated with the patient experience, leading to a more effective and efficient OPD operation.
A patient asks the nurse several questions about their diagnosis and treatment options. What is the nurse's primary responsibility in responding to these questions?
- A. Provide brief and vague answers to avoid overwhelming the patient.
- B. Refer the patient to the physician for all medical-related questions.
- C. Listen actively and provide accurate, honest, and comprehensive answers.
- D. Ignore the patient's questions and focus on completing other tasks.
Correct Answer: C
Rationale: The nurse's primary responsibility in responding to a patient's questions about their diagnosis and treatment options is to listen actively and provide accurate, honest, and comprehensive answers. This approach helps build trust between the patient and the healthcare team, allows the patient to make informed decisions about their care, and ensures that the patient understands their condition and the recommended treatment plan. Providing vague answers or ignoring the patient's questions can lead to confusion, anxiety, and mistrust, which can hinder the patient's overall care and recovery. Referring the patient to the physician for all questions may be appropriate for certain medical inquiries, but the nurse plays a crucial role in educating and supporting the patient throughout their healthcare journey.
A postpartum client exhibits signs of anxiety, restlessness, and palpitations. Which nursing intervention should be prioritized?
- A. Providing education on relaxation techniques
- B. Encouraging the client to practice deep breathing exercises
- C. Notifying the healthcare provider immediately
- D. Administering a benzodiazepine for anxiety relief
Correct Answer: C
Rationale: In a postpartum client exhibiting signs of anxiety, restlessness, and palpitations, it is essential to prioritize notifying the healthcare provider immediately. These symptoms could indicate a serious condition such as postpartum preeclampsia, postpartum hemorrhage, or postpartum cardiomyopathy, which require urgent medical attention. It is crucial to rule out any life-threatening conditions and ensure the client receives appropriate treatment promptly. While relaxation techniques and deep breathing exercises can be helpful for anxiety management in some cases, in this situation, the priority is to ensure the client's safety and well-being by seeking medical evaluation and intervention. Administering a benzodiazepine without consulting the healthcare provider first could potentially mask symptoms or interact with other medications the client may be taking, making it unsafe to proceed without professional guidance.
Patient Haydee comes to the perinatal unit of Hospital DEE. Nurse Arcee does through SCREENING assessment. Which is the Least screening assessment to be used by the nurse/
- A. Physical examination
- B. Radiologic procedures
- C. Interview
- D. Laboratory review
Correct Answer: B
Rationale: Radiologic procedures are typically not used as the least screening assessment by nurses in a perinatal unit. The nurse's initial screening assessments usually focus on gathering information through techniques such as physical examination, interviews, and reviewing laboratory results. Radiologic procedures, such as X-rays or CT scans, are usually ordered by physicians once a more specific diagnostic need has been identified, based on the initial screening assessments performed by the nurse. Therefore, in this scenario, the least screening assessment to be used by the nurse would be radiologic procedures.