Nokea
A patient presents with unilateral facial paralysis, inability to close the eye on the affected side, and loss of taste sensation on the anterior two-thirds of the tongue. Which of the following conditions is most likely responsible for this presentation?
- A. Bell's palsy
- B. Ramsay Hunt syndrome
- C. Glossopharyngeal neuralgia
- D. Acoustic neuroma
Correct Answer: B
Rationale: Ramsay Hunt syndrome is caused by the varicella-zoster virus affecting the geniculate ganglion, leading to a triad of symptoms known as the Hunt syndrome: facial paralysis, ear pain, and a vesicular rash in the ear or palate. The facial paralysis in Ramsay Hunt syndrome is usually peripheral, similar to Bell's palsy, but may be more severe. In addition to facial paralysis, the patient may have the inability to close the eye on the affected side (lagophthalmos) and loss of taste sensation on the anterior two-thirds of the tongue due to involvement of the chorda tympani nerve. This differentiation is important to consider in the context of our patient's presentation.
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An infant's current weight indicates that the maximum safe dose of Tylenol is 30 mg by mouth. The physician orders 65 mg to be given, the pharmacist is responsible for filling the medication order, and the nurse administers Tylenol 65 mg. Who is legally responsible in the event that the infant has a toxic reaction to the medication?
- A. nurse
- B. physician
- C. pharmacist
- D. pharmacist and physician
Correct Answer: C
Rationale: The pharmacist is legally responsible in this situation because they are the healthcare professional authorized to dispense medications according to the physician's order. In this case, the physician ordered a dose higher than the maximum safe dose recommended based on the infant's current weight. While the nurse administers the medication, the pharmacist has the responsibility to ensure that the correct dose is dispensed and to alert the physician if there is a discrepancy in the order. If the pharmacist dispensed the incorrect dose without verifying with the physician, they would bear legal responsibility for any adverse effects resulting from the medication error.
A patient presents with symptoms of severe allergies, including difficulty breathing, hives, and swelling. Which of the following cells is primarily responsible for mediating these allergic responses?
- A. Eosinophils
- B. Basophils
- C. Mast cells
- D. Neutrophils
Correct Answer: C
Rationale: Mast cells are primarily responsible for mediating allergic responses such as severe allergies. When an allergen triggers the immune response, mast cells release histamine, leukotrienes, and other inflammatory mediators. These substances cause symptoms such as difficulty breathing, hives, and swelling. Basophils also release histamine, but mast cells are more abundant in tissues and play a significant role in allergic reactions. Eosinophils are involved in allergic reactions but are more focused on combating parasitic infections. Neutrophils are not typically involved in allergic responses but play a key role in combating bacterial infections.
Some postpartum mothers will experience difficulty voiding because of the edema and trauma of the perineum. Which PRIORITY nursing measures stimulate the sensation of voiding?
- A. Encouraging her to void.
- B. Running water in the sink or shower.
- C. Helping the mother into the shower.
- D. providing cold tea or fluids of choice.
Correct Answer: B
Rationale: Running water in the sink or shower is a priority nursing measure to stimulate the sensation of voiding in postpartum mothers experiencing difficulty due to edema and trauma of the perineum. The sound and sight of running water can help relax the pelvic floor muscles and trigger the urge to void. This technique is commonly used in clinical practice to facilitate voiding and prevent urinary retention in postpartum women.
A patient expresses frustration with the long wait times in the healthcare facility. What is the nurse's best response?
- A. Dismiss the patient's frustration and assure them that wait times are unavoidable.
- B. Listen actively to the patient's concerns, acknowledge the inconvenience, 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 in this situation is to listen actively to the patient's concerns, acknowledge the inconvenience they are experiencing, and offer support. It is essential to validate the patient's feelings and show empathy towards their frustration. By actively listening and addressing the patient's concerns, the nurse can help alleviate some of their frustration and build a positive rapport with the patient. This approach demonstrates respect for the patient's feelings and promotes effective communication in the healthcare setting. Dismissing or ignoring the patient's frustration can lead to further dissatisfaction and impact the quality of care provided.
Which of the following is NOT TRUE of type 2 diabetes Mellitus?
- A. Increased production of glucose from the liver
- B. Insulin resistance in the peripheral tissues
- C. Destruction of beta cell from autoimmune mechanism which result in lack of insulin and hyperglycemia
- D. Defective beta cell secretion with loss of insulin
Correct Answer: C
Rationale: Type 2 diabetes mellitus is characterized by insulin resistance in the peripheral tissues and defective beta cell secretion with loss of insulin. In type 2 diabetes, there is typically not destruction of beta cells from an autoimmune mechanism that leads to lack of insulin and hyperglycemia as seen in type 1 diabetes mellitus. Instead, in type 2 diabetes, the pancreas initially produces insulin, but the body's cells become resistant to its effects. This results in hyperglycemia due to the inability of the body to properly regulate blood sugar levels. Therefore, choice C is not true for type 2 diabetes mellitus.