Nokea
A patient presents with a yellowish-white spot on the cornea, surrounded by a ring of inflammation. Slit-lamp examination reveals branching, filamentous opacities extending from the corneal lesion. Which of the following conditions is most likely responsible for this presentation?
- A. Herpes simplex keratitis
- B. Bacterial keratitis
- C. Fungal keratitis
- D. Acanthamoeba keratitis Dental, Alimentary, and Biliary
Correct Answer: C
Rationale: The presentation described is consistent with fungal keratitis. Fungal keratitis typically presents with a yellowish-white spot on the cornea, surrounded by a ring of inflammation. The filamentous opacities seen on slit-lamp examination are characteristic of fungal hyphae extending from the corneal lesion. This condition is often associated with risk factors such as trauma with vegetable matter, contact lens wear, or topical corticosteroid use. Prompt diagnosis and treatment with antifungal medications are essential to prevent complications and preserve vision.
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A patient expresses religious beliefs that conflict with a recommended treatment plan. What is the nurse's best approach?
- A. Disregard the patient's religious beliefs and insist on the recommended treatment.
- B. Listen actively to the patient's religious beliefs, respect their autonomy, and explore alternative options.
- C. Ignore the patient's religious beliefs and proceed with implementing the recommended treatment.
- D. Tell the patient that their religious beliefs are irrelevant to their medical care.
Correct Answer: B
Rationale: The best approach for the nurse in this situation is to listen actively to the patient's religious beliefs, respect their autonomy, and explore alternative treatment options. It is important for the nurse to understand and acknowledge the patient's perspective, even if it conflicts with the recommended treatment plan. By showing respect for the patient's beliefs and involving them in the decision-making process, the nurse can work collaboratively with the patient to find a solution that aligns with their religious beliefs while also addressing their medical needs. This approach promotes patient-centered care and helps build a trusting and therapeutic relationship between the nurse and the patient.
A 70- year-old has been rushed to the hospital due to bradycardia and palpitation. The physician suggested that a pacemaker be inserted to correct the symptoms. The patient voluntarily decides not to have the pacemaker Inserted. This is respected by the family. This is an example of what ethical principles
- A. Beneficence
- B. Justice
- C. Autonomy
- D. Justice
Correct Answer: C
Rationale: Autonomy is the ethical principle that upholds an individual's right to make decisions about their own medical treatment, free from coercion or undue influence. In this scenario, the 70-year-old patient has voluntarily decided not to have the pacemaker inserted despite the physician's recommendation. The fact that the decision is respected by the family further highlights the importance of autonomy in this situation. Respecting the patient's right to make choices regarding their own healthcare, even if it goes against medical advice, demonstrates a commitment to autonomy as an ethical principle.
Which of the following is not a characteristic of quality improvement that the medical director is interested in?
- A. The leader is the empowerer
- B. Problem-solving is by everyone
- C. The employees are treated as customers
- D. Reacts to correct or bad situation
Correct Answer: D
Rationale: Quality improvement focuses on proactive measures rather than reactive responses. The medical director would be more interested in establishing processes and systems that prevent issues from occurring in the first place, rather than just reacting to problems as they arise. Continuous improvement involves identifying problems, analyzing root causes, and implementing long-term solutions to prevent the issues from recurring. Therefore, reacting to correct or bad situations is not a characteristic of quality improvement that the medical director would prioritize.
A patient presents with recurrent episodes of deep vein thrombosis (DVT) and pulmonary embolism (PE). Laboratory tests reveal elevated levels of antiphospholipid antibodies (anticardiolipin and lupus anticoagulant). Which of the following conditions is most likely to cause these findings?
- A. Protein C deficiency
- B. Protein S deficiency
- C. Antithrombin III deficiency
- D. Antiphospholipid syndrome
Correct Answer: D
Rationale: Antiphospholipid syndrome is characterized by abnormal antiphospholipid antibodies, which can lead to an increased risk of blood clots such as deep vein thrombosis (DVT) and pulmonary embolism (PE). The two most common antiphospholipid antibodies are anticardiolipin and lupus anticoagulant. Patients with antiphospholipid syndrome can present with recurrent thrombotic events, such as DVT and PE, due to the pro-thrombotic effects of these antibodies. Protein C deficiency, Protein S deficiency, and Antithrombin III deficiency are other causes of hypercoagulability but would not typically present with elevated antiphospholipid antibodies.
A patient presents with recurrent episodes of fever, sore throat, and cervical lymphadenopathy. Laboratory tests reveal leukocytosis with atypical lymphocytes on peripheral blood smear and positive heterophile antibody test (Monospot test). Which of the following conditions is most likely to cause these findings?
- A. Infectious mononucleosis (Epstein-Barr virus infection)
- B. Cytomegalovirus (CMV) infection
- C. HIV/AIDS
- D. Toxoplasmosis
Correct Answer: A
Rationale: The clinical presentation of recurrent fever, sore throat, cervical lymphadenopathy, leukocytosis with atypical lymphocytes, and positive heterophile antibody test (Monospot test) is highly indicative of infectious mononucleosis caused by the Epstein-Barr virus (EBV). EBV is a member of the herpesvirus family and is a common cause of infectious mononucleosis. The atypical lymphocytes seen on peripheral blood smear are reactive T lymphocytes responding to the EBV infection. The Monospot test detects heterophile antibodies produced in response to EBV infection.