Nokea
Nurse Vince is going to refer patient to secondary health facility. Which of the following is an example of secondary health facility?
- A. District hospital
- B. Rural health unit
- C. Puereculture Center
- D. Barangay health station
Correct Answer: A
Rationale: A district hospital is an example of a secondary health facility. Secondary health facilities are the intermediate level of healthcare services, providing a higher level of care compared to primary health facilities like rural health units and barangay health stations. District hospitals typically offer more specialized medical services, diagnostic facilities, and inpatient care that are not available at lower-level health facilities. When Nurse Vince refers a patient to a district hospital, it means that the patient requires more extensive and specialized medical care beyond what can be provided at the primary level of care.
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When caring for patients with hyperbilirubinemia, the nursing care plan should focus on the following, EXCEPT_________.
- A. informing appropriately the significant others
- B. preventing injury
- C. maintaining physiological homeostasis with bilirubin levels increasing
- D. preventing complications.
Correct Answer: C
Rationale: When caring for patients with hyperbilirubinemia, the nursing care plan should focus on informing the significant others, preventing injury, and preventing complications. The primary goal in managing hyperbilirubinemia is to prevent complications associated with high bilirubin levels, such as kernicterus. Therefore, maintaining physiological homeostasis with bilirubin levels increasing would not be appropriate and should not be the focus of the nursing care plan. It is crucial to monitor and manage bilirubin levels to prevent adverse outcomes rather than allowing them to increase.
A patient presents with unilateral facial paralysis, inability to close the eye on the affected side, and loss of taste sensation on the anterior two-thirds of the tongue. Which of the following conditions is most likely responsible for this presentation?
- A. Bell's palsy
- B. Ramsay Hunt syndrome
- C. Glossopharyngeal neuralgia
- D. Acoustic neuroma
Correct Answer: B
Rationale: Ramsay Hunt syndrome is caused by the varicella-zoster virus affecting the geniculate ganglion, leading to a triad of symptoms known as the Hunt syndrome: facial paralysis, ear pain, and a vesicular rash in the ear or palate. The facial paralysis in Ramsay Hunt syndrome is usually peripheral, similar to Bell's palsy, but may be more severe. In addition to facial paralysis, the patient may have the inability to close the eye on the affected side (lagophthalmos) and loss of taste sensation on the anterior two-thirds of the tongue due to involvement of the chorda tympani nerve. This differentiation is important to consider in the context of our patient's presentation.
A patient presents with knee pain and swelling following a fall onto a flexed knee. Physical examination reveals a palpable effusion and tenderness along the joint line. McMurray's test elicits pain and clicking with passive knee flexion and internal rotation. Which condition is most likely?
- A. Patellar tendinitis
- B. Medial meniscus tear
- C. Lateral collateral ligament (LCL) sprain
- D. uadriceps tendon rupture
Correct Answer: B
Rationale: The presentation of knee pain and swelling following a fall onto a flexed knee, along with a palpable effusion and tenderness along the joint line, is highly suggestive of a meniscus injury. The McMurray's test specifically evaluates for meniscal tears. In this case, the presence of pain and clicking with passive knee flexion and internal rotation indicates a medial meniscus tear as the most likely diagnosis. Patellar tendinitis usually presents with anterior knee pain that is worsened by activities such as jumping or running. Lateral collateral ligament (LCL) sprain typically presents with lateral knee pain and instability. Quadriceps tendon rupture would present with significant weakness and inability to fully extend the knee, which is not described in this scenario.
Which of the following is a common complication associated with long-term use of corticosteroids in orthopedic patients?
- A. Osteoporosis
- B. Hypertension
- C. Hyperkalemia
- D. Hyperthyroidism
Correct Answer: A
Rationale: Osteoporosis is a common complication associated with long-term use of corticosteroids in orthopedic patients. Corticosteroids can lead to bone loss by inhibiting bone formation and promoting bone resorption, resulting in decreased bone mineral density and increased risk of fractures. Therefore, patients on long-term corticosteroid therapy, especially in high doses, should be monitored closely for osteoporosis and receive appropriate preventive measures such as calcium, vitamin D supplementation, and bisphosphonates to mitigate the risk of bone thinning and fractures.
A patient presents with chest pain that worsens with exertion and improves with rest. An electrocardiogram (ECG) shows ST-segment depression. Which cardiovascular disorder is most likely responsible for these symptoms?
- A. Stable angina
- B. Unstable angina
- C. Acute myocardial infarction
- D. Prinzmetal's angina
Correct Answer: A
Rationale: The patient is presenting with chest pain that worsens with exertion and improves with rest, which is characteristic of stable angina. Additionally, ST-segment depression on ECG is a common finding in patients with stable angina. Stable angina is typically caused by coronary artery disease, which leads to partial obstruction of the coronary arteries resulting in inadequate blood flow to the heart muscle during periods of increased demand (such as exertion). The chest pain is usually predictable and reproducible, occurring with similar intensity and duration during episodes of exertion. Rest or nitroglycerin can help relieve the symptoms by increasing coronary blood flow. It is important to differentiate stable angina from unstable angina and acute myocardial infarction, which have different management and prognostic implications.