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A patient with a history of chronic liver disease presents with jaundice, ascites, and spider angiomas. Laboratory tests reveal elevated serum bilirubin levels, prolonged prothrombin time, and hypoalbuminemia. Which condition is the patient most likely experiencing?
- A. Hepatic encephalopathy
- B. Hepatorenal syndrome
- C. Cirrhosis
- D. Acute liver failure
Correct Answer: C
Rationale: The patient's presentation of jaundice, ascites, spider angiomas, elevated serum bilirubin levels, prolonged prothrombin time, and hypoalbuminemia are all indicative of cirrhosis. Cirrhosis is a late stage of liver disease characterized by liver scarring and poor liver function. Jaundice, which is the yellowing of the skin and eyes due to elevated bilirubin levels, is a common manifestation of liver dysfunction seen in cirrhosis. Ascites, the accumulation of fluid in the abdomen, is also a common complication of cirrhosis. Spider angiomas, which are small blood vessels near the skin's surface, are a result of altered blood flow in the liver due to cirrhosis. Prolonged prothrombin time and hypoalbuminemia are consequences of reduced liver synthesis function in cirrhosis. Hepatic encephalopathy and hepatorenal syndrome
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The nurse assists a health care provider in performing a liver biopsy. After the biopsy, the nurse should place the client in which position?
- A. Prone
- B. Supine
- C. A left side-lying position with a small pillow or folded towel under the puncture site
- D. A right side-lying position with a small pillow or folded towel under the puncture site
Correct Answer: C
Rationale: Placing the client in a left side-lying position after a liver biopsy helps to promote pressure on the puncture site, which can reduce the risk of bleeding. Placing a small pillow or folded towel under the puncture site provides additional support and helps to maintain pressure on the area. This position also helps prevent the client from putting pressure on the abdomen, which could potentially affect the biopsy site and increase the risk of bleeding or complications. Overall, positioning the client on the left side with support under the puncture site is the most appropriate and safest option after a liver biopsy.
A patient presents with crushing chest pain that lasts longer than 20 minutes, diaphoresis, and dyspnea. An electrocardiogram (ECG) shows ST-segment elevation in the anterior leads. Which cardiovascular disorder is most likely responsible for these symptoms?
- A. Stable angina
- B. Unstable angina
- C. Acute myocardial infarction
- D. Prinzmetal's angina
Correct Answer: C
Rationale: The patient is most likely experiencing an acute myocardial infarction (MI) based on the presentation of crushing chest pain lasting longer than 20 minutes, diaphoresis, dyspnea, and ST-segment elevation on the ECG. These symptoms are consistent with the classic presentation of an ST-segment elevation myocardial infarction (STEMI), which is a type of acute MI that is characterized by prolonged ischemia leading to myocardial cell death. In this case, the ST-segment elevation in the anterior leads indicates myocardial damage in the corresponding area of the heart supplied by the affected coronary artery. This is a medical emergency that requires urgent intervention to restore blood flow to the affected myocardium and prevent further complications.
The day of discharge came and Marlene 's face becomes all the more sad. When asked why, she answered she has no money to pay the bill. The BEST way of communicating her piece of advice is stating which of the following?
- A. You can go to the cashier for to find out what she can advise you
- B. The government has agencies for those who need financial assistance. I will give you the list.
- C. You can always pay in staggered amounts to be given every 15 days
- D. Ask help from generous relatives so you can have additional for down payment.
Correct Answer: B
Rationale: In this situation, the best way to communicate Marlene's piece of advice would be to inform her about government agencies that provide financial assistance. This option provides a long-term solution for her financial difficulties rather than short-term fixes like asking relatives for help or paying in staggered amounts. By giving her information about available resources, you are empowering her to seek sustainable help for her financial situation. This approach focuses on addressing the root cause of her inability to pay the bill rather than temporary solutions.
The type of epidemiologic study that is used to describe a group of persons enrolled in a study who share some characteristic of interest and who are followed over a period of time to observe some health outcome is a/an:
- A. Cross-sectional study
- B. Cohort study
- C. Experimental study
- D. Case control study
Correct Answer: B
Rationale: Cohort studies are types of epidemiological studies that involve a group of individuals who share a common characteristic or experience and are followed over time to observe the development of a particular health outcome. This type of study is useful in determining the incidence of a disease, identifying risk factors, and studying the natural history of a disease. Cohort studies allow researchers to investigate the relationship between exposure and outcome by following participants forward in time. It helps in establishing causality and is particularly useful for studying rare exposures or outcomes. In contrast, cross-sectional studies involve collecting data from a population at a single point in time, experimental studies involve interventions and control groups, and case-control studies involve comparing individuals with a particular health outcome (cases) to those without the outcome (controls) retrospectively.
A patient presents with a pruritic, annular rash with fine scaling and central clearing, affecting the trunk and proximal extremities. The patient reports recent exposure to a new soap and laundry detergent. Which of the following conditions is most likely responsible for this presentation?
- A. Tinea corporis (ringworm)
- B. Nummular eczema
- C. Pityriasis rosea
- D. Lichen planus
Correct Answer: B
Rationale: The presentation described is consistent with nummular eczema, also known as discoid eczema. Nummular eczema typically presents as circular or oval-shaped patches of eczematous rash with fine scaling and central clearing. It is often pruritic and can be triggered by exposure to irritants such as new soaps or laundry detergents. The distribution on the trunk and proximal extremities is also typical for nummular eczema. Tinea corporis (ringworm) would present with a more raised, scaly, and well-defined border with central clearing. Pityriasis rosea presents with a herald patch followed by smaller oval or round lesions in a "Christmas tree" distribution. Lichen planus would present with polygonal, purplish, flat-topped papules typically located on flexural surfaces and extremities.