Nokea
After several days in the hospital, the physician ordered the patient to be discharged. Which of the following is a PRIORITY restriction that you should emphasize when he goes home?
- A. Stool softener to induce bowel elimination.
- B. Driving if not using narcotic drug.
- C. Take shower even if ´still with surgical drain.
- D. Lifting of objects not more than 10 lbs.
Correct Answer: D
Rationale: The priority restriction that should be emphasized when the patient is discharged from the hospital is the lifting of objects not more than 10 lbs. This is important to prevent any strain on the body, especially if the patient is still recovering or weak from their hospitalization. Lifting heavy objects can lead to complications, injuries, or setbacks in the recovery process. It is essential for the patient to follow this restriction to promote healing and avoid any further health issues.
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A few days later, the patient comes into the emergency department via ambulance stretcher and reveals a work-up of blood sugar level at 800mg/dl, ketones are absent in the urine, she is dehydrated, and has an altered mental status. Based on the data, t he patient is most likely suferring from what specifi medical condition?
- A. Hyperosmolar nonketotic coma (HNKC)
- B. Diabetic retinopathy
- C. Acute renal failure
- D. Diabetic ketoacidosis (DKA)
Correct Answer: A
Rationale: The patient's presentation with a blood sugar level of 800mg/dL, absence of ketones in the urine, dehydration, and altered mental status points towards Hyperosmolar nonketotic coma (HNKC). HNKC typically occurs in patients with Type 2 diabetes and is characterized by extremely high blood glucose levels (hyperglycemia) without significant ketosis. The absence of ketones in the urine distinguishes HNKC from Diabetic ketoacidosis (DKA). Patients with HNKC often present with severe dehydration, altered mental status, and hyperosmolarity. It is crucial to address the underlying cause of the hyperglycemia, correct dehydration, and normalize blood glucose levels promptly in the management of HNKC.
What is the best way for Myra to collect data from these participants?
- A. Focus group discussion
- B. Individual Interview
- C. Survey, questionnaire
- D. Observation
Correct Answer: C
Rationale: The best way for Myra to collect data from these participants is through a survey or questionnaire. Surveys and questionnaires are structured instruments that allow for the systematic collection of data from a large number of participants efficiently. They can be easily distributed and completed by participants, making them a convenient method for gathering information. Surveys and questionnaires also provide a standardized approach to data collection, ensuring consistency in the responses obtained. Additionally, they can be designed to include both closed-ended and open-ended questions, allowing for a comprehensive understanding of the participants' perspectives and experiences. Overall, using a survey or questionnaire would enable Myra to collect data from the participants in a systematic and efficient manner.
Ms. C is at risk for refeeding syndrome that is caused by rapid feeding. What should be the priority action of the health care team to prevent complications associated with this syndrome?
- A. Assess for signs of pallor of the extremities and sluggish capillary refill
- B. Monitor for decreased bowel sounds, nausea, bloating, and abdominal distention
- C. Observe for signs of secret purging and ingestion of water to increase weight
- D. Monitor for peripheral edema, crackles in the lungs, and jugular vein distention
Correct Answer: B
Rationale: Refeeding syndrome is a potentially dangerous condition that can occur in malnourished individuals when nutrition is reintroduced too quickly. It is characterized by shifts in electrolytes, fluid imbalance, and metabolic abnormalities. Monitoring for decreased bowel sounds, nausea, bloating, and abdominal distention is the priority action to prevent complications associated with refeeding syndrome. These symptoms can indicate gastrointestinal issues such as ileus or overfeeding, which can lead to further complications. Early recognition and intervention can help prevent serious consequences of refeeding syndrome.
What is the appropriate initial management for a conscious patient experiencing a syncopal episode (fainting)?
- A. Elevating the legs above the level of the heart.
- B. Administering intravenous fluids rapidly.
- C. Providing reassurance and assisting the patient to a lying position.
- D. Administering oxygen via nasal cannula.
Correct Answer: C
Rationale: The appropriate initial management for a conscious patient experiencing a syncopal episode (fainting) is to provide reassurance and assist the patient to a lying position. This is important to ensure adequate blood flow to the brain and to prevent further injury in case the patient faints again. Elevating the legs above the level of the heart is not recommended as a routine intervention for syncope. Administering intravenous fluids rapidly is not usually needed in the initial management of syncope without signs of dehydration or significant bleeding. Administering oxygen via nasal cannula is not necessary for most cases of syncope unless there are specific indications such as signs of respiratory distress.
Which diagnostic test could be useful in confirming the diagnosis of Dengue Fever?
- A. Rumpell -Leede
- B. Elisa
- C. Mantoux
- D. Widal
Correct Answer: B
Rationale: The diagnostic test that could be useful in confirming the diagnosis of Dengue Fever is the ELISA test. ELISA stands for Enzyme-Linked Immunosorbent Assay. This test detects the presence of dengue virus-specific antibodies (IgM and IgG) in the blood of an individual suspected to have dengue fever. Elevated levels of these antibodies indicate a recent or ongoing dengue virus infection. ELISA is a standard and reliable test used in diagnosing dengue fever, along with clinical symptoms and other laboratory tests.