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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 with a history of multiple myeloma presents with weakness, bone pain, and recurrent infections. Laboratory tests reveal anemia, hypercalcemia, renal insufficiency, and monoclonal spike on serum protein electrophoresis. Which of the following conditions is most likely to cause these findings?
- A. Waldenstrom macroglobulinemia
- B. Hodgkin lymphoma
- C. Chronic lymphocytic leukemia (CLL)
- D. Multiple myeloma
Correct Answer: D
Rationale: Multiple myeloma is a plasma cell neoplasm characterized by the presence of abnormal monoclonal plasma cells in the bone marrow, which produce a monoclonal spike on serum protein electrophoresis. The clinical presentation of weakness, bone pain, and recurrent infections is typical of multiple myeloma. Anemia can result from bone marrow infiltration by the abnormal plasma cells, hypercalcemia is due to bone destruction and release of calcium, renal insufficiency can result from hypercalcemia and protein deposition in the kidneys, and the monoclonal spike in serum protein electrophoresis indicates the presence of a monoclonal protein. Waldenström macroglobulinemia, Hodgkin lymphoma, and chronic lymphocytic leukemia do not typically present with the classic tetrad of findings seen in multiple myeloma.
A patient with advanced heart failure expresses fear and anxiety about the progression of their illness. What is the palliative nurse's most appropriate response?
- A. Provide reassurance and minimize discussions about end-of-life care.
- B. Encourage the patient to focus on positive thoughts and avoid discussing fears.
- C. Offer empathetic listening and explore the patient's concerns about the future.
- D. Suggest distraction techniques to divert the patient's attention from their worries.
Correct Answer: C
Rationale: The palliative nurse's most appropriate response in this scenario is to offer empathetic listening and explore the patient's concerns about the future. By providing a compassionate and supportive environment for the patient to express their fears and anxieties, the nurse can help the patient feel heard and understood. This approach allows the nurse to address the patient's emotional needs and provide appropriate support to help them cope with their feelings. Avoiding discussions or minimizing the patient's concerns may invalidate their emotions and hinder the therapeutic relationship. Encouraging distraction techniques or focusing solely on positive thoughts may not address the underlying fears and anxieties that the patient is experiencing. Therefore, offering empathetic listening and exploring the patient's concerns is the most appropriate way for the nurse to provide holistic care for the patient with advanced heart failure.
Inductive Reasoning process is applied in:
- A. Qualitative research
- B. Action research
- C. Quantitative research
- D. Applied research
Correct Answer: A
Rationale: Inductive reasoning is the process of drawing general conclusions from specific observations or examples. It is often used in qualitative research to develop theories or explanations based on the data collected. Qualitative research focuses on understanding phenomena in their natural settings and uses inductive reasoning to interpret and make sense of the data. This approach allows researchers to explore complex issues and uncover new insights by analyzing the details and patterns within the data.
A patient presents with sudden onset of weakness and numbness on one side of the body, along with difficulty speaking and understanding speech. Imaging reveals an acute infarction involving the left middle cerebral artery territory. Which of the following neurological conditions is most likely responsible for these symptoms?
- A. Transient ischemic attack (TIA)
- B. Intracerebral hemorrhage
- C. Ischemic stroke
- D. Subarachnoid hemorrhage
Correct Answer: C
Rationale: The patient is presenting with sudden onset weakness and numbness on one side of the body, along with difficulty speaking and understanding speech, which are typical symptoms of a stroke. Imaging revealing an acute infarction involving the left middle cerebral artery territory is consistent with an ischemic stroke. Ischemic stroke occurs when there is a blockage in a blood vessel supplying blood to the brain, leading to a lack of oxygen and nutrients to the affected area, resulting in neurological deficits. This is in contrast to an intracerebral hemorrhage, which is caused by bleeding into the brain tissue, or a subarachnoid hemorrhage, which involves bleeding into the space surrounding the brain. A transient ischemic attack (TIA) is a temporary episode of neurological dysfunction caused by a brief blockage of blood flow to a part of the brain, usually resolving within 24 hours. In this case, the presentation and imaging findings are most
On which occasion would a nurse can be charged with negligence?
- A. Giving the patient the wrong medication.
- B. Giving competent care.
- C. Following standards of care.
- D. Communicating with another health team.
Correct Answer: A
Rationale: A nurse can be charged with negligence when they give the patient the wrong medication. Negligence in healthcare typically refers to a situation where a healthcare provider fails to provide a standard level of care, resulting in harm to the patient. Giving the wrong medication can lead to serious consequences for the patient, including adverse reactions, worsening of the condition, or even death. It is a clear violation of the duty of care that a nurse owes to their patients, and such a mistake can have legal and professional repercussions for the nurse.