Nokea
A patient presents with fever, headache, 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 described with fever, headache, maculopapular rash starting on the face and spreading to the trunk and extremities, along with leukopenia and thrombocytopenia suggests a likely diagnosis of Rocky Mountain spotted fever (RMSF), which is caused by the bacterium Rickettsia rickettsii.
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Romy is diagnosed with small cell lung cancer (SCLC) a rapidly growing type of cancer. He and his family were shocked when told by the doctor that the patient will just undergo palliative treatment. Which nursing action is MOST APPROPRIATE?
- A. Providing relief from symptoms.
- B. Reducing fatigue
- C. Providing psychological support.
- D. Advising treatment options
Correct Answer: A
Rationale: In the case of Romy being diagnosed with small cell lung cancer (SCLC) and undergoing palliative treatment, the most appropriate nursing action is to focus on providing relief from symptoms. Palliative care aims to improve the quality of life for patients with serious illnesses by managing their symptoms, such as pain, shortness of breath, nausea, and other side effects of treatment. As the cancer is advanced and the goal is not curative treatment but rather to keep the patient comfortable, symptom management becomes a priority to ensure Romy's physical comfort and well-being during this difficult time. Providing relief from symptoms is crucial in palliative care to help enhance the patient's quality of life and ensure they are as comfortable as possible.
Whose responsibility is it to obtain informed consent?
- A. Nurse Manager
- B. Physician
- C. Anesthesiologist
- D. Midwife
Correct Answer: B
Rationale: Obtaining informed consent is primarily the responsibility of the physician. Informed consent is a crucial ethical and legal concept in healthcare that requires the healthcare provider, usually the physician, to ensure that the patient understands the proposed treatment, including the risks, benefits, alternatives, and potential outcomes, before agreeing to proceed with the treatment. While other healthcare professionals, such as nurses, nurse managers, anesthesiologists, and midwives, may also play a role in the informed consent process by providing information and clarifying details, it is ultimately the physician who must obtain the patient's informed consent before any treatment or procedure is performed.
A 22-year-old woman presents with cyclic pelvic pain, dysmenorrhea, and infertility. On pelvic examination, the uterus is retroverted and enlarged. Which of the following conditions is most likely to be responsible for these findings?
- A. Endometriosis
- B. Adenomyosis
- C. Leiomyomas (uterine fibroids)
- D. Pelvic inflammatory disease (PID)
Correct Answer: B
Rationale: Adenomyosis is a condition characterized by the presence of endometrial tissue within the myometrium (muscle wall) of the uterus. It can present with symptoms such as cyclic pelvic pain, dysmenorrhea (painful periods), and infertility. On pelvic examination, the uterus may be retroverted (tilted backward) and enlarged due to the presence of adenomyotic nodules within the uterine muscle. Adenomyosis can also cause heavy menstrual bleeding (menorrhagia). Endometriosis, on the other hand, involves the presence of endometrial tissue outside the uterus and can cause similar symptoms but is less likely to result in uterine enlargement or retroversion. Leiomyomas (uterine fibroids) are benign tumors of the uterine muscle and can also cause pelvic pain and abnormal uterine enlargement but are less likely to be associated with dysmenorrhea and infertility
A 35-year-old woman presents with irregular menstrual cycles, hirsutism, and acne. Which of the following conditions is most likely to be associated with these symptoms?
- A. Polycystic ovary syndrome (PCOS)
- B. Endometriosis
- C. Ovarian cancer
- D. Uterine fibroids
Correct Answer: A
Rationale: Polycystic ovary syndrome (PCOS) is a common hormonal disorder in women of reproductive age. The classic symptoms of PCOS include irregular menstrual cycles, hirsutism (excess hair growth in a male pattern), and acne. Women with PCOS often have enlarged ovaries with multiple small cysts. Other common features include obesity, insulin resistance, and infertility. Endometriosis is characterized by the presence and growth of endometrial-like tissue outside the uterus, leading to symptoms such as pelvic pain and infertility. Ovarian cancer usually presents with nonspecific symptoms and is less likely in a young woman with these specific symptoms. Uterine fibroids are benign tumors that can cause heavy menstrual bleeding and pelvic pressure but are less likely to be associated with hirsutism and acne.
A postpartum client exhibits signs of wound infection, including erythema, warmth, and purulent drainage from a cesarean incision. Which nursing action is most appropriate?
- A. Applying a sterile dressing to the incision
- B. Irrigating the wound with saline solution
- C. Notifying the healthcare provider immediately
- D. Administering oral antibiotics as prescribed
Correct Answer: C
Rationale: When a postpartum client exhibits signs of wound infection, such as erythema, warmth, and purulent drainage from a cesarean incision, it is essential to notify the healthcare provider immediately. Wound infections can lead to serious complications if not promptly addressed. The healthcare provider will assess the infection, possibly order further diagnostic tests, and determine the appropriate course of treatment, which may include antibiotics or additional wound care measures. Applying a dressing or irrigating the wound may be part of the treatment plan prescribed by the healthcare provider, but the first step is always to seek guidance from the provider.