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.
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When nurses are projected in a television advertisement as sex symbols, what APPROPRIATE action is expected from a concerned nurse?
- A. Keep your silence, it is the television station 's prerogative.
- B. Go to the street to manifest displeasure of the nurse's portrayal.
- C. Make a position paper to denounce the advertisement
- D. Condemn the issue in the radio program.
Correct Answer: C
Rationale: The most appropriate action for a concerned nurse when nurses are projected as sex symbols in a television advertisement is to make a position paper to denounce the advertisement. This approach allows the nurse to voice their concerns in a formal and professional manner. By creating a position paper, the nurse can clearly outline why the portrayal is inappropriate and advocate for more respectful representations of nursing in the media. This action is constructive, proactive, and focuses on initiating change through advocacy and education. It is a thoughtful and strategic way to address the issue and raise awareness about the importance of respecting the nursing profession.
Nurse Carmi finally decided to make an in depth study of ONLY ONE SUBJECT of domestic violence. What design will she use?
- A. Causality Design
- B. Predictive Correlational Design
- C. Descriptive Correlational Design
- D. Descriptive Case Study Design
Correct Answer: D
Rationale: A descriptive case study design is the most suitable approach when Nurse Carmi decides to make an in-depth study of only one subject of domestic violence. This design involves a comprehensive and detailed exploration of a single individual or a specific situation, allowing for an in-depth analysis of various aspects related to the subject. Since Nurse Carmi is focusing on studying only one subject, a case study design will enable her to gather detailed information, delve deep into the complexities of the individual's experiences, behaviors, and outcomes related to domestic violence. This design will provide a rich and holistic understanding of the single case being studied, offering valuable insights and potential implications for practice and intervention strategies.
A patient is prescribed a proton pump inhibitor (PPI) for the treatment of gastroesophageal reflux disease (GERD). Which instruction should the nurse include in patient education about PPI therapy?
- A. "Take the medication with antacids for enhanced effectiveness."
- B. "Avoid consuming citrus fruits while on PPI therapy."
- C. "Take the medication 30 minutes before meals."
- D. "Report any signs of gastrointestinal bleeding promptly."
Correct Answer: C
Rationale: Patients prescribed proton pump inhibitors (PPIs) for gastroesophageal reflux disease (GERD) should be instructed to take the medication 30 minutes before meals. This is because PPIs work best when taken on an empty stomach, allowing them to inhibit the gastric proton pump effectively and reduce acid production in anticipation of food intake. Taking the medication before meals ensures optimal absorption and effectiveness in controlling symptoms of GERD.
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 woman in active labor presents with a prolonged latent phase, characterized by irregular and infrequent contractions. What maternal condition should the nurse assess for that may contribute to this abnormal labor pattern?
- A. Maternal dehydration
- B. Pelvic outlet obstruction
- C. Maternal exhaustion
- D. Fetal macrosomia
Correct Answer: A
Rationale: Maternal dehydration can contribute to a prolonged latent phase during labor. Dehydration can lead to reduced blood volume and electrolyte imbalances, which can result in ineffective uterine contractions. Without adequate hydration, the uterus may not contract effectively, causing irregular and infrequent contractions. It is important for the nurse to assess the woman's hydration status and encourage her to stay hydrated during labor to help regulate contractions and progress labor.