Nokea
A patient with a suspected spinal injury is found unconscious. Which of the following actions should be taken first?
- A. Move the patient to a flat surface.
- B. Perform a jaw thrust maneuver.
- C. Apply a cervical collar.
- D. Check for responsiveness.
Correct Answer: B
Rationale: When a patient with a suspected spinal injury is found unconscious, the priority action is to secure the airway without jeopardizing the cervical spine. A jaw thrust maneuver is the appropriate technique to open the airway in this situation because it allows for the maintenance of neutral alignment of the cervical spine while ensuring proper ventilation. Moving the patient to a flat surface or applying a cervical collar could potentially worsen the spinal injury if not done correctly, and checking for responsiveness should only be done after ensuring a patent airway. Therefore, the safest and most effective initial action is to perform a jaw thrust maneuver to establish a clear airway.
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A patient presents with fever, chills, headache, and myalgia after returning from a trip to sub-Saharan Africa. Laboratory tests reveal intraerythrocytic ring forms and trophozoites on blood smear examination. Which of the following is the most likely causative agent?
- A. Plasmodium falciparum
- B. Trypanosoma cruzi
- C. Borrelia burgdorferi
- D. Leishmania donovani
Correct Answer: A
Rationale: The clinical presentation of fever, chills, headache, and myalgia after a trip to sub-Saharan Africa is highly indicative of malaria. Specifically, the presence of intraerythrocytic ring forms and trophozoites on blood smear examination points towards Plasmodium falciparum as the most likely causative agent. Plasmodium falciparum is the most deadly of the Plasmodium species that cause malaria and is responsible for the majority of severe malaria cases worldwide. It is transmitted through the bite of infected Anopheles mosquitoes. Treatment for Plasmodium falciparum infection usually involves antimalarial medications such as artemisinin-based combination therapies.
Which of the following strategies would prove effective in preventing more incidence of dengue infection?
- A. Healthy nutritious food
- B. Burning of leaves and garbage
- C. Destruction of breeding place of vectors
- D. Adequate rest and sleep
Correct Answer: C
Rationale: The most effective strategy in preventing more incidence of dengue infection is to target the breeding places of the Aedes mosquitoes, which are the vectors responsible for transmitting the dengue virus. By eliminating stagnant water sources where these mosquitoes breed, such as uncovered containers, flower pots, and discarded tires, the mosquito population can be significantly reduced. This, in turn, helps to lower the risk of dengue transmission to humans. While healthy nutritious food, burning of leaves and garbage, and adequate rest and sleep are important for overall health and immune function, they do not directly address the primary cause of dengue transmission, which is the Aedes mosquito population.
A postpartum client complains of perineal pain and discomfort. What nursing intervention should be prioritized to provide relief?
- A. Encouraging ambulation
- B. Administering ice packs to the perineum
- C. Providing oral analgesics as needed
- D. Recommending warm sitz baths
Correct Answer: B
Rationale: Administering ice packs to the perineum is the priority nursing intervention to provide relief for perineal pain and discomfort in a postpartum client. Ice packs help to reduce swelling and inflammation in the perineal area, which can help alleviate pain. It is a safe and effective method to provide immediate relief and promote comfort for the client. Other interventions such as encouraging ambulation, administering analgesics, and recommending warm sitz baths can also be beneficial, but in the initial management of perineal pain, ice packs are the most appropriate choice.
A patient presents with recurrent episodes of joint pain, swelling, and limited range of motion in multiple joints. Laboratory tests reveal elevated erythrocyte sedimentation rate (ESR), positive rheumatoid factor (RF), and presence of anti-cyclic citrullinated peptide (anti-CCP) antibodies. Which of the following conditions is most likely to cause these findings?
- A. Rheumatoid arthritis (RA)
- B. Systemic lupus erythematosus (SLE)
- C. Ankylosing spondylitis (AS)
- D. Psoriatic arthritis (PsA)
Correct Answer: A
Rationale: The combination of recurrent joint pain, swelling, and limited range of motion in multiple joints along with elevated ESR, positive RF, and presence of anti-CCP antibodies is classic for rheumatoid arthritis (RA). Elevated ESR indicates inflammation, positive rheumatoid factor (RF) is an autoantibody commonly found in the serum of patients with RA, and the presence of anti-cyclic citrullinated peptide (anti-CCP) antibodies further supports the diagnosis of RA. These laboratory findings along with the clinical presentation are highly suggestive of rheumatoid arthritis. Systemic lupus erythematosus (SLE), ankylosing spondylitis (AS), and psoriatic arthritis (PsA) can have overlapping symptoms with RA, but the specific combination of elevated ESR, positive RF, and anti-CCP antibodies points more towards RA in this scenario.
A patient presents with episodic throbbing headache associated with nausea, vomiting, and sensitivity to light and sound. Symptoms are often preceded by an aura. Which of the following neurological conditions is most likely responsible for these symptoms?
- A. Migraine headache
- B. Cluster headache
- C. Tension-type headache
- D. Chronic daily headache
Correct Answer: A
Rationale: The patient's presentation of episodic throbbing headache associated with nausea, vomiting, sensitivity to light and sound, and aura suggests a diagnosis of migraine headache. Migraines are a common neurological condition characterized by recurrent moderate to severe headaches that are often unilateral, pulsating, and aggravated by physical activity. The presence of premonitory symptoms (aura) before the headache is a key feature commonly seen in migraines. Additionally, nausea, vomiting, and sensitivity to light and sound are also common features associated with migraines.