Nokea
Patient was visited by the anesthesiologist and explained the anesthesia for his surgery. Which of the following type of anesthesia would you expect to be ordered?
- A. Spinal
- B. Local
- C. Caudal
- D. General
Correct Answer: D
Rationale: When the anesthesiologist visits a patient to explain the anesthesia for surgery, the most likely type of anesthesia to be ordered in this scenario would be general anesthesia. General anesthesia is a state of controlled unconsciousness where the patient is completely unaware and unresponsive during the procedure. This type of anesthesia is typically used for surgeries that are more complex, lengthy, or invasive, requiring the patient to be completely still and asleep throughout the operation.
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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.
A patient with a history of heart failure is prescribed digoxin. Which assessment finding indicates a potential adverse effect of digoxin therapy?
- A. Bradycardia
- B. Hypotension
- C. Hyperkalemia
- D. Confusion
Correct Answer: D
Rationale: Confusion is a potential adverse effect of digoxin therapy. Digoxin toxicity can manifest as various central nervous system symptoms, including confusion, delirium, and disorientation. It is important to monitor for signs of digoxin toxicity in patients taking this medication, especially those with a history of heart failure or renal impairment. Other common signs of digoxin toxicity may include visual disturbances (like halos around lights), gastrointestinal symptoms (like nausea and vomiting), and cardiac arrhythmias. Monitoring serum digoxin levels can help guide therapy and identify toxicity early.
When writting a memorandum, which of the following is the MOST important guideline
- A. Purpose is included
- B. Friendly tone
- C. Content clear
- D. One topic at a time
Correct Answer: C
Rationale: When writing a memorandum, clarity in the content is the most important guideline to follow. It is crucial that the information provided in the memorandum is clearly understood by the recipients. Clear content ensures that the intended message is effectively communicated, reducing the possibility of confusion or misinterpretation. By focusing on clarity, the purpose of the memorandum can be effectively conveyed, maintaining professionalism and ensuring that the recipients are well-informed.
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.
The patient during labor would anticipate some emotional support. Which of the following nursing interventions should Nurse Sarah provide to keep the patient calm?
- A. Giving praise for her the sense of satisfaction regarding quick labor.
- B. Support in maintaining a sense of control.
- C. Explanation of the effect of labor on the newborn.
- D. Allowing the patient to express pain and anxiety
Correct Answer: B
Rationale: Support in maintaining a sense of control is essential in keeping the patient calm during labor. Giving the patient a sense of control allows them to feel empowered and more in charge of their experience. This can help reduce anxiety and fear, ultimately promoting a more positive and calm labor experience. Providing emotional support by assisting the patient in maintaining control can greatly benefit their overall emotional well-being during this stressful time.