Nokea
A pregnant woman presents with severe abdominal pain and passage of tissue at 12 weeks gestation. On examination, the cervix is partially dilated, and products of conception are protruding through the cervical os. Which of the following conditions is the most likely cause of these symptoms?
- A. Ectopic pregnancy
- B. Incomplete abortion
- C. Placenta previa
- D. Gestational trophoblastic disease
Correct Answer: B
Rationale: In this scenario, the pregnant woman is presenting with severe abdominal pain, passage of tissue, and cervical dilation with products of conception protruding through the cervical os at 12 weeks gestation. These are classic signs and symptoms of an incomplete abortion. Incomplete abortion occurs when not all of the products of conception are expelled from the uterus. It can present with vaginal bleeding, abdominal pain, cervical dilation, and passage of tissue. The management of incomplete abortion may involve expectant, medical, or surgical options depending on the clinical context and the patient's condition.
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Which of the following clinical manifestations is most indicative of acute respiratory distress syndrome (ARDS)?
- A. Hypocapnia with respiratory alkalosis
- B. Bradypnea with metabolic acidosis
- C. Tachypnea with hypoxemia refractory to supplemental oxygen
- D. Hypercapnia with hyperkalemia
Correct Answer: C
Rationale: Rationale:
- ARDS is characterized by severe hypoxemia and respiratory distress.
- Tachypnea is a hallmark sign of ARDS due to the body's compensatory mechanism to increase oxygenation.
- Hypoxemia refractory to supplemental oxygen signifies the inability to improve oxygen levels despite intervention.
- Choices A, B, and D do not align with typical manifestations of ARDS, as they do not directly reflect severe hypoxemia or respiratory distress.
Which of the following is the PRIMARY reason for surgical repair of myelomeningocele? To ____________.
- A. Decrease risk of infection
- B. Correct the neurologic defect
- C. Prevent seizure disorders
- D. Prevent hydrocephalus
Correct Answer: B
Rationale: The primary reason for surgical repair of myelomeningocele is to correct the neurologic defect. This is because myelomeningocele is a type of neural tube defect where the spinal cord and its protective covering do not close properly. Surgical repair aims to close the opening in the spinal cord to prevent further damage, improve neurological function, and reduce the risk of complications such as paralysis and infection. The other choices are incorrect as they are not the primary goal of the surgery. Preventing infection (Choice A) is important but not the primary reason. Seizure disorders (Choice C) and hydrocephalus (Choice D) may be associated complications but are not the main purpose of the surgical repair.
A patient in the ICU develops acute exacerbation of chronic obstructive pulmonary disease (COPD) characterized by worsening dyspnea and increased sputum production. What intervention should the healthcare team prioritize to manage the patient's exacerbation?
- A. Administer bronchodilator medications via nebulization for bronchodilation.
- B. Initiate non-invasive positive pressure ventilation (NIPPV) for respiratory support.
- C. Perform arterial blood gas analysis to assess oxygenation and ventilation.
- D. Recommend chest physiotherapy to promote airway clearance.
Correct Answer: B
Rationale: The correct answer is B: Initiate non-invasive positive pressure ventilation (NIPPV) for respiratory support. In acute exacerbations of COPD, NIPPV helps improve ventilation and oxygenation, reducing the work of breathing and preventing the need for intubation. This intervention is a priority as it can rapidly stabilize the patient's respiratory status.
A: Administering bronchodilator medications is important in COPD management, but in severe exacerbations, NIPPV takes precedence.
C: Arterial blood gas analysis is important for assessing oxygenation and ventilation status, but it does not directly address the acute respiratory distress.
D: Chest physiotherapy can help with airway clearance in COPD, but in acute exacerbations, respiratory support with NIPPV is more urgent.
A Patients to take regularly Lithium after discharged. The MOST important information to impart to the patient and his family is that the patient should
- A. not eat foods which has high tyramine content like cheese, wine, liver
- B. limit his fluid intake
- C. have a limited intake of sodium
- D. have an adequate intake of sodium
Correct Answer: C
Rationale: The correct answer is C, to have a limited intake of sodium. Lithium can lead to increased sodium levels in the body, potentially causing toxicity. By limiting sodium intake, the patient can maintain a balance and prevent adverse effects. Choice A is incorrect as tyramine content is not directly related to lithium intake. Choice B is incorrect as fluid intake does not have a significant impact on lithium levels. Choice D is incorrect because an adequate intake of sodium can lead to worsening lithium toxicity.
Outbreak of cases of typhoid fever occurs in the community. Nurse Keena should inform the residents that the transmission of the disease is through _______.
- A. A vector
- B. Blood and body fluids
- C. Food and water
- D. Air
Correct Answer: C
Rationale: The correct answer is C: Food and water. Typhoid fever is primarily transmitted through contaminated food and water by the bacterium Salmonella typhi. The bacteria are shed in the feces of infected individuals and can contaminate water sources or food prepared with contaminated water. This transmission route aligns with the typical epidemiology of typhoid fever outbreaks.
Now, let's discuss why the other choices are incorrect:
A: A vector - Typhoid fever is not transmitted by a vector such as mosquitoes or ticks.
B: Blood and body fluids - Typhoid fever is not typically spread through blood or body fluids but rather through ingestion of contaminated food or water.
D: Air - Typhoid fever is not an airborne disease and is not transmitted through the air.