Nokea
A patient presents with watery diarrhea, abdominal cramps, and nausea after consuming contaminated water from a stream during a camping trip. Laboratory tests reveal oocysts in the stool sample. Which of the following parasites is most likely responsible for this infection?
- A. Giardia lamblia
- B. Entamoeba histolytica
- C. Cryptosporidium parvum
- D. Cyclospora cayetanensis
Correct Answer: C
Rationale: The patient is likely infected with Cryptosporidium parvum based on the symptoms of watery diarrhea, abdominal cramps, and nausea after consuming contaminated water. Cryptosporidium is a protozoan parasite that can be transmitted through contaminated water sources, such as streams. Laboratory tests revealing oocysts in the stool sample further support the diagnosis of Cryptosporidium infection, as these oocysts are characteristic of this parasite. Giardia lamblia is another common protozoan parasite that can cause similar symptoms but is usually associated with more foul-smelling, greasy diarrhea. Entamoeba histolytica causes amoebic dysentery, which presents with bloody diarrhea and abdominal pain. Cyclospora cayetanensis also causes watery diarrhea, but it is usually associated with foodborne outbreaks rather than waterborne transmission.
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A patient with chronic obstructive pulmonary disease (COPD) presents with acute exacerbation and severe dyspnea. Arterial blood gas (ABG) analysis reveals pH 7.28, PaO2 55 mmHg, PaCO2 65 mmHg, and HCO3- 30 mEq/L. Which of the following acid-base disturbances is most likely present in this patient?
- A. Respiratory acidosis with metabolic compensation
- B. Respiratory alkalosis with metabolic compensation
- C. Metabolic acidosis with respiratory compensation
- D. Metabolic alkalosis with respiratory compensation
Correct Answer: A
Rationale: In this case, the patient is experiencing respiratory acidosis as indicated by the low pH (7.28), elevated PaCO2 (65 mmHg), and elevated HCO3- (30 mEq/L). The primary acid-base disturbance is respiratory acidosis due to the retention of carbon dioxide (PaCO2 >45 mmHg) leading to an increase in HCO3- as a compensatory mechanism to maintain pH within normal limits. The elevated HCO3- levels (metabolic compensation) are trying to counterbalance the increased PaCO2 levels (respiratory acidosis) by increasing bicarbonate to attempt to normalize the pH. Overall, the ABG analysis shows respiratory acidosis with metabolic compensation in this COPD patient with an acute exacerbation and severe dyspnea.
Which BEST describes the planning function of Nurse Ellen in her role as nurse manager?
- A. Get and develop people to do work
- B. Distributes and arranges work to ensure smooth operation of the unit.
- C. Determines the actual performance compared with the desired output.
- D. Determine how to achieve the mandate of work.
Correct Answer: D
Rationale: The planning function of Nurse Ellen in her role as a nurse manager best corresponds to option D, which is to determine how to achieve the mandate of work. Planning involves setting objectives, developing strategies, and outlining the steps to accomplish those objectives. As a nurse manager, Nurse Ellen would be responsible for creating plans to ensure the effective delivery of patient care, efficient allocation of resources, and meeting the organizational goals of the unit. By determining how to achieve the work mandate, Nurse Ellen can effectively lead her team, allocate resources efficiently, and navigate any challenges that may arise in the operation of the nursing unit.
A woman in active labor demonstrates persistent posterior fetal position, contributing to prolonged labor and severe back pain. What nursing intervention should be implemented to facilitate fetal rotation and optimize labor progress?
- A. Encourage frequent position changes, including hands-and-knees position.
- B. Administer intravenous analgesics to manage maternal discomfort.
- C. Prepare for immediate instrumental delivery.
- D. Initiate continuous fetal monitoring to assess fetal well-being.
Correct Answer: A
Rationale: Encouraging frequent position changes, including the hands-and-knees position, is the most appropriate nursing intervention in this scenario. This position is known to help rotate the baby from a persistent posterior position to an optimal anterior position for delivery. The hands-and-knees position can help take pressure off the mother's back, alleviate back pain, and facilitate the rotation of the baby's head to engage in the mother's pelvis, thus promoting labor progress. It is a non-invasive and effective way to promote fetal rotation without the need for immediate instrumental delivery or intravenous analgesics. Continuous fetal monitoring is important for assessing fetal well-being but would not directly address the issue of posterior fetal position and the associated prolonged labor.
The nurse knows that the diagnosis of contact latex allergy is based on history and ____.
- A. Latex specific IgE
- B. finding IgE in serum
- C. skin patch test
- D. ELISA
Correct Answer: C
Rationale: The diagnosis of contact latex allergy is primarily based on the patient's history of exposure to latex-containing products and the development of symptoms upon contact with latex. To confirm the diagnosis, skin patch testing is performed. Skin patch testing exposes the skin to small amounts of latex allergens to observe for any localized allergic reaction, such as redness, swelling, or itchiness. This test helps determine if the individual has developed a delayed-type hypersensitivity reaction to latex. Latex-specific IgE testing (choice A) and finding IgE in serum (choice B) are methods used in diagnosing immediate-type latex allergy but are not sufficient for confirming contact latex allergy specifically. ELISA (choice D) is a type of laboratory technique used for various purposes, including measuring the levels of specific substances in the blood, but it is not typically used as a diagnostic tool for contact latex allergy.
Nurse Rona and her team has been utilizing the EEPIDEMIOLOGIC TRIAD model - identifying causative factors of diseases. Which of the following is not relevant this, model?
- A. External agent
- B. Treatment Regimen
- C. Susceptible host
- D. Environment
Correct Answer: B
Rationale: The Epidemiologic Triad model focuses on identifying the causative factors of diseases, particularly infectious diseases. The three components of the triad are the external agent, the susceptible host, and the environment. These factors interact to result in the occurrence of disease. Treatment Regimen, on the other hand, is not one of the causative factors but rather a response to manage and treat the disease once it has occurred. While treatment is essential, it is not part of the factors that contribute to the initial development of the disease within the Epidemiologic Triad model.