Nokea
A patient with a history of chronic liver disease presents with ecchymoses, mucosal bleeding, and altered mental status. Laboratory tests reveal prolonged PT and aPTT, low fibrinogen levels, and elevated D-dimer. Which of the following conditions is most likely to cause these findings?
- A. Liver cirrhosis
- B. Disseminated intravascular coagulation (DIC)
- C. Hemophilia A
- D. Vitamin K deficiency
Correct Answer: B
Rationale: The correct answer is B: Disseminated intravascular coagulation (DIC). In DIC, there is widespread activation of coagulation leading to consumption of clotting factors, resulting in prolonged PT and aPTT, low fibrinogen levels, and elevated D-dimer. This pattern matches the laboratory findings in the patient. In liver cirrhosis (choice A), there is a decrease in clotting factors synthesis, leading to prolonged PT but not aPTT. Hemophilia A (choice C) is a genetic disorder that affects specific clotting factors, typically leading to prolonged aPTT but not PT. Vitamin K deficiency (choice D) impairs the synthesis of clotting factors, leading to prolonged PT but not aPTT and low levels of factors II, VII, IX, and X.
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Which of the following is the best predictor of adolescents attempting suicide?
- A. Depressed mood
- B. Feeling of euphoria
- C. Joyful mood
- D. Feeling of hopelessness
Correct Answer: D
Rationale: The correct answer is D: Feeling of hopelessness. Adolescents who feel hopeless are at a higher risk of attempting suicide due to a lack of belief in positive outcomes. This feeling can lead to a sense of being trapped and unable to see a way out. Depressed mood (A) can contribute to suicide risk, but specifically feeling hopeless is a more direct predictor. Feeling of euphoria (B) and joyful mood (C) are actually less likely to be associated with suicide attempts, as they may temporarily mask underlying issues or provide a sense of distraction. Hopelessness is a key psychological factor that can lead to suicidal thoughts and behaviors in adolescents.
During a surgical procedure, the nurse notices a sudden decrease in the patient's oxygen saturation on the monitor. What immediate action should the nurse take?
- A. Inform the surgeon and anesthesiologist
- B. Increase the flow rate of oxygen
- C. Check the endotracheal tube placement
- D. Assess the patient's respiratory status
Correct Answer: A
Rationale: The correct immediate action is to inform the surgeon and anesthesiologist (Choice A) because a sudden decrease in oxygen saturation during surgery is a critical situation that requires prompt attention from the entire surgical team. The surgeon and anesthesiologist need to be made aware of the situation so that they can assess the patient's condition and make any necessary adjustments to the surgical procedure or anesthesia delivery. Increasing the flow rate of oxygen (Choice B) may help temporarily but does not address the underlying cause of the oxygen desaturation. Checking the endotracheal tube placement (Choice C) is important but may not be the immediate priority in this critical situation. Assessing the patient's respiratory status (Choice D) is important but should be done after informing the surgeon and anesthesiologist to ensure coordinated and timely interventions.
Which of the following structures is responsible for the initial mechanical breakdown of food during mastication?
- A. Tongue
- B. Pharynx
- C. Salivary glands
- D. Teeth
Correct Answer: D
Rationale: The correct answer is D: Teeth. Teeth are responsible for the initial mechanical breakdown of food during mastication. Step 1: Teeth use their hard surfaces to chew and grind food into smaller pieces. Step 2: This process increases the surface area of the food, making it easier for digestive enzymes to break down. Step 3: The tongue aids in moving the food around the mouth but does not break down the food mechanically. Pharynx is responsible for swallowing, not mastication. Salivary glands produce saliva that helps in the lubrication and digestion of food, but they do not directly participate in the mechanical breakdown of food.
Which of the indicators BEST describes an effective outcome of school nursing programs and initiatives.
- A. Zero absenteeism and tardiness of pupils.
- B. Teachers are observers of school health program.
- C. Limited information in school health initiatives
- D. constant visits and phone calls of parents.
Correct Answer: A
Rationale: The correct answer is A because zero absenteeism and tardiness of pupils indicate that the school nursing programs are effectively promoting student health and well-being. This outcome shows that students are healthy, engaged, and present in school, which is a key goal of school nursing initiatives.
Choice B is incorrect as teachers being observers does not directly measure the effectiveness of the nursing programs.
Choice C is incorrect as limited information hinders the success and impact of school health initiatives.
Choice D is incorrect as constant visits and phone calls from parents may not necessarily reflect the success of the nursing programs.
While patient Sarah is confined in the hospital, the safety measure to be observed by the nurses is prevention from fall. This is brought about by the patient being prone to fracture as a result of________.
- A. aging process
- B. osteoporosis
- C. change in vision
- D. hematologic condition
Correct Answer: B
Rationale: The correct answer is B: osteoporosis. Osteoporosis is a condition characterized by weakened bones, making individuals more susceptible to fractures, especially with minor trauma or falls. In the context of a patient prone to fractures, nurses should be particularly cautious about fall prevention.
A: The aging process alone does not necessarily lead to an increased risk of fractures. While aging is a risk factor for osteoporosis, it is not the direct cause of fractures in this case.
C: Changes in vision can contribute to an increased risk of falls, but it is not the primary reason for the patient being prone to fractures in this scenario.
D: Hematologic conditions may affect bone health, but they are not typically the primary cause of increased fracture risk in patients.