Nokea
A pregnant woman presents with severe lower abdominal pain, fever, and vaginal discharge. On examination, cervical motion tenderness and adnexal tenderness are noted, along with bilateral adnexal masses. Which of the following conditions is the most likely cause of these symptoms?
- A. Ectopic pregnancy
- B. Pelvic inflammatory disease
- C. Placenta previa
- D. Ovarian torsion
Correct Answer: B
Rationale: The constellation of severe lower abdominal pain, fever, and vaginal discharge in a pregnant woman raises suspicion for pelvic inflammatory disease (PID). Cervical motion tenderness and adnexal tenderness are classic physical exam findings for PID. The presence of bilateral adnexal masses further supports the diagnosis, as PID can lead to the formation of tubo-ovarian abscesses. Ectopic pregnancy may present with similar symptoms but is less likely in this case as bilateral adnexal masses suggest a more diffuse inflammatory process. Placenta previa would typically present with painless vaginal bleeding in the third trimester, which is not consistent with the symptoms described. Ovarian torsion would present with sudden severe unilateral lower abdominal pain and is less likely to involve both ovaries simultaneously.
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The diagnostic examination for osteoporosis is geared towards measuring
- A. Bone density
- B. Weight
- C. Blood volume
- D. Height
Correct Answer: A
Rationale: The diagnostic examination for osteoporosis typically involves measuring bone density. This is usually done through a dual-energy x-ray absorptiometry (DEXA) scan, which is considered the gold standard for assessing bone density. Osteoporosis is characterized by decreased bone mass and deterioration of bone tissue, leading to increased bone fragility and risk of fractures. Measuring bone density helps in diagnosing osteoporosis by identifying areas of low bone density, assessing the risk of fractures, and monitoring the effectiveness of treatment. Weight, blood volume, and height are not directly used as primary indicators for diagnosing osteoporosis.
You encounter a conscious adult choking on a piece of food. The person is coughing forcefully but unable to speak or breathe effectively. What is the most appropriate action?
- A. Encourage continued coughing.
- B. Perform abdominal thrusts (Heimlich maneuver).
- C. Deliver back blows.
- D. Administer rescue breaths.
Correct Answer: B
Rationale: The most appropriate action in this situation is to perform abdominal thrusts, also known as the Heimlich maneuver. This technique is used to clear a blocked airway caused by a choking obstruction. Encouraging continued coughing may not be effective if the person is unable to dislodge the obstruction on their own. Delivering back blows can sometimes be effective, but abdominal thrusts are more commonly recommended in cases of choking in adults. Administering rescue breaths is not recommended if the person is conscious and able to cough, as it may worsen the situation by pushing the obstruction further down. By quickly performing abdominal thrusts, you can help dislodge the obstruction and potentially save the person's life.
Identify the primary indicator that Nurse Mary observes FIDELITY in the practice of her profession.
- A. Faithfully promotes health and prevents desease.
- B. Frequently assists in providing health services.
- C. Fairly evaluates health programs and initiatives.
- D. Collaborates and works with barangay officials.
Correct Answer: A
Rationale: The primary indicator that Nurse Mary observes FIDELITY in the practice of her profession is that she faithfully promotes health and prevents disease. Fidelity in nursing practice refers to being faithful, loyal, and committed to providing the best care and services to patients. By faithfully promoting health and preventing disease, Nurse Mary demonstrates her dedication to her profession, her patients, and the community she serves. This commitment includes following evidence-based practices, upholding ethical standards, being honest and trustworthy, and ensuring the well-being of those under her care. Ultimately, fidelity in nursing practice builds trust and confidence among patients, families, and colleagues, leading to better health outcomes and a stronger healthcare system.
Which of the following actions is appropriate for managing a conscious patient with a suspected heat cramp?
- A. Massaging the affected muscles vigorously.
- B. Applying cold packs to the affected area.
- C. Providing oral rehydration with electrolyte solutions.
- D. Encouraging the patient to continue strenuous activity.
Correct Answer: C
Rationale: Providing oral rehydration with electrolyte solutions is the appropriate action for managing a conscious patient with suspected heat cramps. Heat cramps are muscle pains or spasms that often occur during intense exercise in hot environments when a person sweats excessively, losing both fluids and electrolytes. Replenishing lost fluids and electrolytes through oral rehydration helps address the underlying cause of the cramps and provides relief to the patient. Massaging the affected muscles vigorously can potentially worsen the condition, applying cold packs is not usually recommended for heat-related conditions, and encouraging the patient to continue strenuous activity can lead to further complications.
A patient undergoing mechanical ventilation in the ICU develops ventilator-associated pneumonia (VAP) caused by multidrug-resistant organisms (MDROs). What intervention should the healthcare team prioritize to manage the patient's infection?
- A. Administer combination antibiotic therapy targeting MDROs.
- B. Perform bronchoalveolar lavage for diagnostic purposes.
- C. Implement strict isolation precautions to prevent transmission.
- D. Recommend prophylactic antifungal therapy to prevent candidiasis.
Correct Answer: A
Rationale: The most appropriate intervention for managing ventilator-associated pneumonia (VAP) caused by multidrug-resistant organisms (MDROs) is to administer combination antibiotic therapy targeting the specific resistant pathogens identified in the patient's culture results. MDROs are often resistant to multiple antibiotics, so combination therapy is required to maximize the chances of effectively treating the infection. Identifying the specific pathogens causing the VAP through cultures is crucial in tailoring the antibiotic therapy to target these organisms effectively. Implementing appropriate antibiotic therapy promptly is essential to improve outcomes and prevent further complications in patients with VAP caused by MDROs. Option A is the priority intervention in this case to address the multidrug-resistant nature of the infection and provide targeted treatment for the patient.