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What is the appropriate sequence of steps in the assessment of a conscious trauma patient?
- A. Airway, breathing, circulation, disability, exposure (ABCDE).
- B. Circulation, airway, breathing, disability, exposure (CABDE).
- C. Breathing, airway, circulation, disability, exposure (BACDE).
- D. Exposure, disability, circulation, airway, breathing (EDCAB).
Correct Answer: A
Rationale: The appropriate sequence of steps in the assessment of a conscious trauma patient is the ABCDE approach, which stands for Airway, Breathing, Circulation, Disability, and Exposure.
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A patient presents with a thyroid nodule and signs of compression such as difficulty swallowing and breathing. Fine-needle aspiration biopsy reveals a follicular pattern and colloid-filled spaces. Which endocrine disorder is most likely responsible for these symptoms?
- A. Hashimoto's thyroiditis
- B. Graves' disease
- C. Follicular adenoma
- D. Thyroid nodules
Correct Answer: C
Rationale: The patient's presentation of thyroid nodule with compression symptoms like difficulty swallowing and breathing, along with fine-needle aspiration biopsy showing a follicular pattern and colloid-filled spaces, is highly suggestive of a follicular adenoma. Follicular adenomas are benign thyroid tumors that can cause compression symptoms due to their growth and size, leading to pressure on surrounding structures in the neck area. The presence of colloid-filled spaces in the biopsy is characteristic of follicular adenomas.
A patient presents with sudden-onset, painless vision loss in the right eye. Fundoscopic examination reveals a cherry-red spot at the macula and attenuated retinal vessels. Which of the following conditions is most likely responsible for this presentation?
- A. Central retinal artery occlusion
- B. Central retinal vein occlusion
- C. Retinal detachment
- D. Acute angle-closure glaucoma
Correct Answer: A
Rationale: The presentation of sudden-onset, painless vision loss in the right eye with a cherry-red spot at the macula and attenuated retinal vessels is classic for central retinal artery occlusion (CRAO). In this condition, the blockage of the central retinal artery results in severe ischemia of the retina, leading to rapid and profound vision loss. The cherry-red spot at the macula is a result of preserved choroidal circulation contrasting with the pale, ischemic retina. Attenuated retinal vessels are also commonly observed due to decreased blood flow. Prompt evaluation and management are critical in CRAO to potentially restore some vision and prevent further ischemic damage to the retina.
Which of the following is a common complication associated with Dupuytren's contracture?
- A. Trigger finger
- B. Swan-neck deformity
- C. Boutonniere deformity
- D. Mallet finger
Correct Answer: B
Rationale: Dupuytren's contracture is a condition characterized by the thickening and tightening of the tissue beneath the skin of the hand, leading to the fingers being pulled into a bent position. One of the common complications associated with Dupuytren's contracture is the development of a Swan-neck deformity. This deformity is characterized by hyperextension of the proximal interphalangeal joint and flexion of the distal interphalangeal joint. It is important to recognize and address complications like Swan-neck deformity in individuals with Dupuytren's contracture to prevent further functional impairment and disability.
Three hours postpartum, a primiparous patient's fundus is firm and midline. On perineal inspection by Nurse Kayla, she observes a small constant trickle of blood. What will thee nurse suspect for the patient to have?
- A. Uterine inversion
- B. Retained placenta
- C. Perineal lacerations
- D. Bladder distention
Correct Answer: B
Rationale: In this scenario, the firm and midline fundus at three hours postpartum indicates that the uterus is contracting well. The presence of a small constant trickle of blood on perineal inspection suggests ongoing bleeding. This combination of findings is concerning for retained placenta, where a portion of the placenta remains attached to the uterine wall and prevents proper contraction and closure of the blood vessels at the placental site. Retained placenta can lead to postpartum hemorrhage and requires prompt evaluation and intervention to prevent complications. Nurse Kayla should escalate this finding to the healthcare provider for further assessment and management.
The positive practice environment PPE is part of the quality standards of every health facility in the country today. Which of the following is NOT a component of the PPE in the work setting?
- A. waste management
- B. electrical wires
- C. peer review
- D. infection control
Correct Answer: B
Rationale: The positive practice environment (PPE) in a health care setting typically includes components such as waste management, infection control, and peer review. However, electrical wires are not a standard component of the PPE in a work setting. Electrical safety is important in a healthcare facility, but it is usually addressed in a separate set of guidelines and protocols focusing specifically on electrical safety and maintenance. Therefore, among the given options, electrical wires are not considered a component of the positive practice environment in the work setting.