Nokea
A pregnant woman presents with sudden onset of severe abdominal pain and dark red vaginal bleeding at 28 weeks gestation. On examination, the uterus is tender, and the fundus feels firm. Which of the following conditions is the most likely cause of these symptoms?
- A. Ectopic pregnancy
- B. Threatened abortion
- C. Placenta previa
- D. Abruptio placentae
Correct Answer: D
Rationale: The most likely cause of the sudden onset of severe abdominal pain and dark red vaginal bleeding with a tender, firm uterus at 28 weeks gestation is abruptio placentae. Abruptio placentae, also known as placental abruption, is the premature separation of the placenta from the uterine wall before delivery. This condition can be life-threatening to both the mother and the fetus, as it can lead to severe bleeding and compromise the oxygen and nutrients supply to the fetus. The presentation typically includes severe abdominal pain, dark red or maroon vaginal bleeding, uterine tenderness, and a firm uterus due to the blood accumulation behind the placenta. Prompt recognition and intervention are crucial to prevent adverse maternal and fetal outcomes.
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As Nurse Pedrito prepares for the day's visits, which of the following patients should be seen FIRST? A client with ________.
- A. Parkinson's disease with imbalance gait.
- B. A thoracostomy six months ago.
- C. A history of congestive heart failure with dyspnea.
- D. A stroke with nasogastric tube (NGT).
Correct Answer: C
Rationale: The patient with a history of congestive heart failure and dyspnea should be seen FIRST by Nurse Pedrito. Congestive heart failure is a serious condition that can lead to acute exacerbations and requires prompt assessment and management. Dyspnea (shortness of breath) is a common symptom of heart failure and can indicate worsening cardiac function or fluid overload, which requires immediate attention to prevent further complications. Timely assessment and intervention for heart failure exacerbations can help prevent hospital admissions and improve patient outcomes. Therefore, prioritizing this patient for assessment and intervention is crucial to ensure their safety and well-being.
Which of the following herbal medicines is recommended by the department for cough?
- A. Sambong
- B. Bawang
- C. Guava
- D. Lagundi
Correct Answer: D
Rationale: The herbal medicine recommended by the Department of Health for cough is Lagundi (scientific name: Vitex negundo). Lagundi has been found to have properties that can help relieve cough, asthma, and other respiratory conditions. It has been traditionally used as a natural remedy for these purposes and has gained recognition for its effectiveness in managing cough symptoms. Additionally, Lagundi is also known for its anti-inflammatory and analgesic properties, further supporting its use in addressing respiratory ailments.
Which of the following study designs that uses information on current health status, personal characteristics, and potential risk factors will be appropriate?
- A. Case-control
- B. Cohort
- C. Ecological
- D. Cross-sectional
Correct Answer: B
Rationale: A cohort study design would be appropriate in this scenario. Cohort studies follow a group of individuals over a period of time to assess how their current health status, personal characteristics, and potential risk factors may contribute to the development of certain outcomes or diseases. By collecting data at different time points on the same group of individuals, cohort studies allow researchers to establish associations between exposures and outcomes, providing valuable information on causality. In this case, using a cohort study design would allow for a comprehensive examination of how various factors impact health outcomes over time.
A nurse is preparing to perform a bedside bronchoscopy procedure for a patient. What action should the nurse take to ensure patient safety during the procedure?
- A. Administering sedation to the patient before the bronchoscopy
- B. Obtaining informed consent from the patient or their legal representative
- C. Skipping the use of topical anesthesia to minimize patient discomfort
- D. Allowing the patient to eat or drink up to one hour before the procedure
Correct Answer: B
Rationale: The correct action for the nurse to ensure patient safety during a bedside bronchoscopy procedure is to obtain informed consent from the patient or their legal representative. Informed consent is a vital ethical and legal requirement before any medical procedure. It ensures that the patient understands the risks, benefits, and alternatives of the procedure, as well as gives the patient the authority to make decisions about their healthcare. By obtaining informed consent, the nurse ensures that the patient has been properly informed and agrees to undergo the bronchoscopy, which promotes patient autonomy and safety. Administering sedation, using topical anesthesia, and restricting food intake are also important aspects of bronchoscopy preparation, but obtaining informed consent is the primary action to prioritize patient safety.
A patient with interstitial lung disease (ILD) develops progressive dyspnea, non-productive cough, and fine inspiratory crackles on auscultation. High-resolution computed tomography (HRCT) of the chest reveals diffuse reticular opacities and traction bronchiectasis. Which of the following ILD subtypes is most likely to present with these clinical and radiographic features?
- A. Idiopathic pulmonary fibrosis (IPF)
- B. Sarcoidosis
- C. Hypersensitivity pneumonitis (HP)
- D. Connective tissue disease-associated ILD
Correct Answer: A
Rationale: The clinical presentation of a patient with progressive dyspnea, non-productive cough, fine inspiratory crackles, and HRCT findings of diffuse reticular opacities and traction bronchiectasis is highly suggestive of idiopathic pulmonary fibrosis (IPF). IPF is a specific subtype of ILD characterized by progressive scarring of the lung tissue, leading to the symptoms mentioned above. The presence of reticular opacities and traction bronchiectasis on HRCT is a typical finding in IPF.