Public health services are provided by government facilities. What is the most appropriate response of a public health nurse to the statement: The government should give these health services free of charge to people?
- A. "Yes and for that reason, we should choose our government officials wisely during elections".
- B. "Yes, I agree. But right now, the government does not have enough resources to do that".
- C. "That is an ideal situation that our government does not have enough resources to do that".
- D. "Many of the health services are given free, but we people pay for them just the same through our taxes".
Correct Answer: D
Rationale: The most appropriate response is "Many of the health services are given free, but we people pay for them just the same through our taxes." This response acknowledges the fact that public health services are funded by taxpayers, even though they may be perceived as free by the public. It highlights the connection between government funding and the provision of health services, emphasizing that these services are not truly free but are paid for through taxes. It also addresses the misconception that these services are entirely free without any costs involved.
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Which of the following is a common clinical manifestation of osteoarthritis in the hip joint?
- A. Baker's cyst
- B. Heberden's nodes
- C. Trendelenburg gait
- D. Swan-neck deformity
Correct Answer: C
Rationale: Osteoarthritis in the hip joint can lead to weakness or dysfunction in the hip abductor muscles, causing a Trendelenburg gait. This gait abnormality is characterized by a dropping of the pelvis on the opposite side of the affected hip during weight-bearing on the affected leg. It is a common clinical manifestation of hip osteoarthritis due to the muscle weakness and altered mechanics in the hip joint. Baker's cyst is associated with knee osteoarthritis, Heberden's nodes are commonly seen in osteoarthritis of the fingers, and Swan-neck deformity is typically seen in rheumatoid arthritis, not osteoarthritis.
A patient with acute exacerbation of chronic obstructive pulmonary disease (COPD) demonstrates hypercapnia and respiratory acidosis on arterial blood gas analysis. Which of the following ventilatory strategies is most appropriate for managing the patient's respiratory failure?
- A. Low tidal volume ventilation
- B. High-flow nasal cannula therapy
- C. Non-invasive positive pressure ventilation (NIPPV)
- D. Invasive mechanical ventilation with lung protective strategy
Correct Answer: D
Rationale: In a patient with acute exacerbation of COPD who presents with hypercapnia and respiratory acidosis, the most appropriate ventilatory strategy is invasive mechanical ventilation with a lung protective strategy. This involves using lower tidal volumes and limiting plateau pressures to prevent ventilator-induced lung injury.
Nurse Myrna is taking care of a family chose there young children are sick with malnutrition particularly protein deficiency, which of the following behaviors is indicative of the family's positive coping index
- A. Observing erratic mealtime due to work schedule of parents
- B. Bringing children to health enter for consult only when needed.
- C. Serving foods that children like but with high in carbohydrates
- D. Cooking foods in variety that include meat, dairy products and beans.
Correct Answer: D
Rationale: Cooking foods in a variety that includes meat, dairy products, and beans demonstrates a positive coping index for the family in addressing the protein deficiency and malnutrition in their children. This behavior shows the family's understanding and effort to provide diverse sources of protein, which is essential for addressing protein deficiency. By including different protein-rich foods in their meals, the family is actively working towards improving the nutritional status of their children. This approach aligns with the goal of health education to change knowledge, attitudes, and practices to enhance individual, family, and community health.
A patient presents with petechiae, purpura, and mucosal bleeding. Laboratory tests reveal thrombocytopenia, elevated serum creatinine, and schistocytes on peripheral blood smear. Which of the following conditions is most likely to cause these findings?
- A. Thrombotic thrombocytopenic purpura (TTP)
- B. Idiopathic thrombocytopenic purpura (ITP)
- C. Hemolytic uremic syndrome (HUS)
- D. Disseminated intravascular coagulation (DIC)
Correct Answer: A
Rationale: Thrombotic thrombocytopenic purpura (TTP) is a rare but serious condition characterized by microangiopathic hemolytic anemia, thrombocytopenia, neurological abnormalities, fever, and renal dysfunction. The classic pentad of symptoms includes fever, neurologic changes, renal impairment, thrombocytopenia, and microangiopathic hemolytic anemia. The presence of petechiae, purpura, and mucosal bleeding along with thrombocytopenia, elevated serum creatinine, and schistocytes on peripheral blood smear are consistent with TTP. In TTP, there is usually a deficiency of ADAMTS13 (a von Willebrand factor-cleaving protease) leading to excessive platelet adhesion, aggregation, and microthrombi formation within small blood vessels. Treatment typically
A woman in active labor presents with prolonged second stage, characterized by ineffective pushing efforts and slow fetal descent. What maternal condition should the nurse assess for that may contribute to this abnormal labor pattern?
- A. Pelvic floor dysfunction
- B. Maternal fatigue
- C. Fetal macrosomia
- D. Uterine hyperstimulation
Correct Answer: A
Rationale: Pelvic floor dysfunction can contribute to a prolonged second stage of labor by impairing the ability of the woman to effectively push during contractions. This can result in inefficient pushing efforts and slow fetal descent. The nurse should assess for signs and symptoms of pelvic floor dysfunction, such as difficulty controlling bowel movements or urine leakage, as addressing this issue may help improve the progress of labor. Maternal fatigue, fetal macrosomia (larger than average baby size), and uterine hyperstimulation are other factors that can impact labor but are less likely to specifically contribute to ineffective pushing efforts and slow fetal descent in the second stage of labor.
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