Nokea
A pregnant woman presents with severe abdominal pain and syncope at 6 weeks gestation. On examination, she has signs of hypovolemic shock. Which of the following conditions is the most likely cause of these symptoms?
- A. Ectopic pregnancy
- B. Threatened abortion
- C. Placenta previa
- D. Gestational trophoblastic disease
Correct Answer: A
Rationale: In a pregnant woman presenting with severe abdominal pain, syncope, signs of hypovolemic shock, and gestational age of 6 weeks, the most likely cause is an ectopic pregnancy. An ectopic pregnancy occurs when a fertilized egg implants outside the uterus, commonly in the fallopian tube. As the pregnancy grows and the tube stretches, it can lead to rupture, causing severe abdominal pain, internal bleeding, and signs of shock. This is a life-threatening emergency that requires prompt diagnosis and management. It is important to consider ectopic pregnancy in any pregnant woman presenting with abdominal pain and signs of shock, especially in the first trimester.
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A patient undergoing mechanical ventilation in the ICU develops ventilator-associated pneumonia (VAP) caused by methicillin-resistant Staphylococcus aureus (MRSA). What intervention should the healthcare team prioritize to manage the patient's infection?
- A. Administer vancomycin or linezolid for MRSA coverage.
- B. Perform bronchoalveolar lavage for diagnostic purposes.
- C. Implement contact precautions to prevent transmission.
- D. Recommend prophylactic antifungal therapy to prevent candidiasis.
Correct Answer: A
Rationale: The most important intervention for managing ventilator-associated pneumonia (VAP) caused by methicillin-resistant Staphylococcus aureus (MRSA) in a patient undergoing mechanical ventilation in the ICU is to start appropriate antimicrobial therapy targeting MRSA. Vancomycin or linezolid are commonly used antibiotics for MRSA infections. These medications are effective against MRSA and can help in treating the infection and preventing further complications. It is crucial to initiate antimicrobial therapy promptly once the diagnosis of VAP caused by MRSA is suspected or confirmed to improve patient outcomes. Other interventions such as bronchoalveolar lavage for diagnostic purposes, contact precautions, or antifungal therapy may be relevant but the priority is to start effective antibiotic therapy to target the specific pathogen causing the infection.
After washing her hands and gently cleaning any discharge that can be removed easily from the outer ear, Nurse Selma positions the child. Which of the following steps follows?
- A. Gently press the tragus of the ear four times in a pumping motion.
- B. Gently pull the outer ear
- C. Drop the medicine into the ear canal.
- D. Keep the ear up for five minutes.
Correct Answer: C
Rationale: The correct next step after positioning the child is to drop the medicine into the ear canal. This is typically the next step in administering ear drops for a child. The cleaning and positioning steps are to prepare the ear for receiving the medication. Dropping the medicine into the ear canal ensures that the medication can reach the affected area effectively. Once the medicine is dropped into the ear canal, it is important to follow any additional instructions provided by the healthcare provider regarding keeping the ear in a certain position or any other post-administration care steps.
The CI is expected to set the atmosphere by welcoming everyone and by _________.
- A. showing every one the picture of the breast
- B. Discussing the objectives of the ward class
- C. giving an anecdote about an old man
- D. going ahead with the first part of the lecture
Correct Answer: B
Rationale: In a professional setting like a classroom or a meeting, it is important for the CI (chief instructor) to set the atmosphere by welcoming everyone and discussing the objectives of the ward class. By discussing the objectives, the CI can provide a clear direction for the session and ensure that everyone is on the same page in terms of what needs to be accomplished. This not only helps focus the participants but also creates a sense of purpose and organization, setting a positive tone for the rest of the interaction. Showing a picture of the breast or giving an anecdote about an old man may not be appropriate or relevant in this context. Going ahead with the first part of the lecture without any welcoming or setting the atmosphere may make the participants feel rushed or disconnected from the session's purpose.
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.
Which of the following statements accurately describes the process of opsonization during the immune response?
- A. Opsonins facilitate the lysis of target cells by forming membrane attack complexes.
- B. Opsonins promote the phagocytosis of pathogens by coating them with proteins.
- C. Opsonins neutralize toxins produced by pathogens.
- D. Opsonins stimulate the release of histamine from mast cells.
Correct Answer: B
Rationale: Opsonization is a process in the immune response where opsonins, which are proteins such as antibodies and complement proteins, bind to pathogens such as bacteria, making them more easily recognized and engulfed by phagocytic cells like macrophages and neutrophils. This coating of pathogens by opsonins enhances the efficiency of phagocytosis, helping in the elimination of pathogens from the body. Opsonins do not facilitate cell lysis, neutralize toxins, or stimulate histamine release; their main function is to tag pathogens for phagocytosis.