Nokea
Nursing programs that are based on needs assessment and needs analysis and should ne offered free is which of the following?
- A. Continuing Development Program
- B. In-service Training Program
- C. Nursing Education Program
- D. Post-graduate program
Correct Answer: C
Rationale: Nursing programs that are based on needs assessment and needs analysis are meant to provide education and training to current or aspiring nurses according to specific needs within the healthcare system. These programs are usually foundational education programs that are essential for producing competent and skilled nurses. Offering such programs for free ensures that individuals with a passion for nursing but limited financial resources can access quality education and training opportunities. This helps in bridging the gap in the healthcare workforce and ultimately contributes to the overall health and well-being of the population.
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A patient presents with fever, malaise, and a maculopapular rash that started on the face and spread to the trunk and extremities. Laboratory tests reveal leukopenia and thrombocytopenia. Which of the following is the most likely causative agent?
- A. Borrelia burgdorferi
- B. Plasmodium falciparum
- C. Rickettsia rickettsii
- D. Leishmania donovani
Correct Answer: C
Rationale: The clinical presentation of fever, malaise, maculopapular rash starting on the face and spreading to the trunk and extremities, along with leukopenia and thrombocytopenia, is highly suggestive of Rocky Mountain spotted fever (RMSF) caused by Rickettsia rickettsii. RMSF is a tick-borne illness transmitted by the American dog tick, Rocky Mountain wood tick, and brown dog tick. The constellation of symptoms described aligns well with the typical presentation of RMSF. Borrelia burgdorferi causes Lyme disease, which presents with erythema migrans but does not typically cause leukopenia or thrombocytopenia. Plasmodium falciparum is the causative agent of severe malaria and would present with symptoms such as cyclic fevers, anemia, and jaundice but not the described rash distribution.
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.
A patient is prescribed a loop diuretic for the management of heart failure. Which electrolyte imbalance is most commonly associated with loop diuretic therapy?
- A. Hypercalcemia
- B. Hypokalemia
- C. Hypernatremia
- D. Hypomagnesemia
Correct Answer: B
Rationale: Loop diuretics such as furosemide are commonly prescribed for the management of heart failure to reduce fluid overload and lower blood pressure by increasing the excretion of sodium and water. These medications promote the loss of potassium through increased urinary output. Hypokalemia, or low potassium levels in the blood, is the most common electrolyte imbalance associated with loop diuretic therapy. Potassium is an essential electrolyte for proper functioning of the heart, muscles, and nerves. Low potassium levels can lead to symptoms such as muscle weakness, cramps, and potentially life-threatening cardiac arrhythmias. Patients on loop diuretics are often monitored for potassium levels, and sometimes potassium supplements may be prescribed to prevent or correct hypokalemia.
A patient presents with sudden-onset unilateral headache, along with ipsilateral ptosis, miosis, and anhidrosis. Which of the following neurological conditions is most likely responsible for these symptoms?
- A. Cluster headache
- B. Migraine headache
- C. Tension-type headache
- D. Trigeminal neuralgia
Correct Answer: D
Rationale: The presentation described in the question – sudden-onset unilateral headache along with ipsilateral ptosis, miosis, and anhidrosis – is characteristic of Horner syndrome. Horner syndrome is caused by disruption of the sympathetic nerve pathway and can occur in trigeminal neuralgia. Trigeminal neuralgia is a painful condition affecting the trigeminal nerve commonly characterized by sudden and severe facial pain that can be triggered by various stimuli. The involvement of the sympathetic pathway in trigeminal neuralgia can lead to Horner syndrome symptoms such as ptosis (drooping eyelid), miosis (constricted pupil), and anhidrosis (lack of sweating) on the affected side of the face. Cluster headaches usually involve severe unilateral pain around the eye, but they do not typically present with Horner syndrome symptoms. Migraine and tension-type headaches also do not typically present with Horner syndrome symptoms.
A patient admitted to the ICU develops severe sepsis with refractory hypotension despite adequate fluid resuscitation. What intervention should the healthcare team prioritize to manage the patient's septic shock?
- A. Administer vasopressor medications to restore vascular tone.
- B. Perform blood cultures to identify the causative pathogen.
- C. Initiate broad-spectrum antibiotics targeting likely pathogens.
- D. Recommend prophylactic anticoagulation to prevent thrombosis.
Correct Answer: A
Rationale: In the scenario described, the patient is experiencing refractory hypotension despite adequate fluid resuscitation, indicating the presence of septic shock. In septic shock, systemic vasodilation and vascular hyporesponsiveness contribute to hypotension. Therefore, the primary management approach is to restore vascular tone and blood pressure to maintain organ perfusion. Administering vasopressor medications (Choice A) is the crucial intervention to achieve this goal. Vasopressors, such as norepinephrine or vasopressin, constrict blood vessels and increase blood pressure, helping to stabilize the patient in septic shock. While options B and C (performing blood cultures and initiating broad-spectrum antibiotics) are important for identifying the causative pathogen and treating the infection, they are secondary to the immediate need for hemodynamic support in septic shock. Prophylactic anticoagulation (Choice D) is not the primary intervention for