Nokea
A patient with suspected community-acquired pneumonia (CAP) is empirically started on antibiotic therapy pending culture results. Which of the following antibiotic regimens provides appropriate coverage for typical bacterial pathogens commonly implicated in CAP?
- A. Ceftriaxone and azithromycin
- B. Vancomycin and piperacillin/tazobactam
- C. Ampicillin-sulbactam and levofloxacin
- D. Clindamycin and cefepime
Correct Answer: A
Rationale: The correct answer is A: Ceftriaxone and azithromycin. Ceftriaxone covers Streptococcus pneumoniae, the most common pathogen in CAP, while azithromycin covers atypical pathogens like Mycoplasma pneumoniae. Vancomycin and piperacillin/tazobactam (choice B) are not first-line treatments for CAP. Ampicillin-sulbactam and levofloxacin (choice C) cover some pathogens but not as comprehensively as ceftriaxone and azithromycin. Clindamycin and cefepime (choice D) do not provide adequate coverage for typical CAP pathogens.
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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.
Nurse Chona read in one nurse's notes chart this documentation: "Refused to eat and fell from bed". Which of the following is lacking in this documentation?
- A. Time of complaint, for missed and reaction on fall incurred.
- B. Referrals made on fall medications given and reasons of falling.
- C. Contents or complaints, reasons of refusing meal and nature of fall.
- D. Time of eating, medications for back pain and intense of pain.
Correct Answer: C
Rationale: The correct answer is C because the documentation lacks essential details regarding the contents of the complaints, reasons for refusing the meal, and the nature of the fall. This information is crucial for understanding the patient's condition and providing appropriate care. Choice A is not directly related to the documentation provided. Choice B is about referrals and medications, which are not mentioned in the documentation. Choice D is about eating time and medications for pain, which are also not relevant to the documentation provided. Therefore, the correct answer is C as it addresses the specific missing information in the nurse's notes.
To achieve organized work flow in the unit the staff must be aware of the head nurse's role. What is the PRIMARY purpose of supervision and delegation?
- A. Enhances the delivery of quality nursing care
- B. Influences organization's approach in personnel evaluation
- C. Improves staff attendance in seminars
- D. Assigns any staff to do the tasks or project.
Correct Answer: A
Rationale: The correct answer is A: Enhances the delivery of quality nursing care. Supervision and delegation are essential in ensuring efficient and effective healthcare delivery. By supervising and delegating tasks appropriately, the head nurse can ensure that staff members are performing their duties competently, which ultimately leads to improved quality of patient care. Supervision helps in monitoring staff performance, providing feedback, and offering guidance when needed. Delegation ensures that tasks are allocated to the right staff members based on their skills and abilities, optimizing the workflow. Choices B, C, and D are incorrect because they do not directly relate to the primary purpose of supervision and delegation, which is to enhance the quality of nursing care through effective oversight and task allocation.
Which of the following conditions is characterized by inflammation of the glomeruli in the kidneys, leading to hematuria, proteinuria, and hypertension?
- A. Acute tubular necrosis
- B. Acute glomerulonephritis
- C. Chronic kidney disease
- D. Nephrotic syndrome
Correct Answer: B
Rationale: The correct answer is B: Acute glomerulonephritis. Glomerulonephritis is characterized by inflammation of the glomeruli in the kidneys, leading to symptoms like hematuria (blood in urine), proteinuria (excess protein in urine), and hypertension (high blood pressure).
Acute tubular necrosis (A) involves damage to the renal tubules, not the glomeruli. Chronic kidney disease (C) refers to long-term kidney damage and may not always present with the classic symptoms mentioned. Nephrotic syndrome (D) involves excessive protein loss in urine but may not always involve inflammation of the glomeruli.
A 20-year-old woman presents with sudden onset of severe lower abdominal pain and missed menstrual periods for the past two months. She has a positive urine pregnancy test. On transvaginal ultrasound, an empty uterus is visualized, and there is fluid in the cul-de-sac. Which condition is most likely to be responsible for these findings?
- A. Ovarian cyst rupture
- B. Ectopic pregnancy
- C. Septic abortion
- D. Ovarian torsion
Correct Answer: B
Rationale: The correct answer is B: Ectopic pregnancy. In this scenario, the combination of missed periods, positive pregnancy test, and empty uterus on ultrasound with fluid in the cul-de-sac is highly suggestive of an ectopic pregnancy. Ectopic pregnancy occurs when the fertilized egg implants outside the uterus, commonly in the fallopian tube. The presence of fluid in the cul-de-sac indicates possible blood from a ruptured ectopic pregnancy, causing the severe lower abdominal pain. Ovarian cyst rupture (A) typically presents with less severe pain. Septic abortion (C) would present with signs of infection and products of conception in the uterus. Ovarian torsion (D) would present with acute onset of unilateral lower abdominal pain and a palpable adnexal mass, not fluid in the cul-de-sac.