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
Correct Answer: C
Rationale: The description provided is classical for fungal keratitis. Fungal keratitis typically presents with a yellowish-white spot on the cornea, often surrounded by a ring of inflammation. Branching, filamentous opacities extending from the corneal lesion are commonly seen on slit-lamp examination in cases of fungal keratitis. This condition is often associated with risk factors such as trauma with organic material or contact lens wear. Prompt diagnosis and treatment with antifungal agents are crucial in managing fungal keratitis to prevent potential complications.
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After administering anesthesia to the patient, the nurse notices a sudden drop in blood pressure. What is the nurse's priority action?
- A. Administer vasopressors to increase blood pressure
- B. Assess the patient's airway, breathing, and circulation
- C. Document the blood pressure readings in the anesthesia record
- D. Notify the anesthesiologist immediately
Correct Answer: B
Rationale: The nurse's priority action after noticing a sudden drop in blood pressure after administering anesthesia is to assess the patient's airway, breathing, and circulation (ABCs). This is crucial to determine the immediate cause of the sudden drop in blood pressure and to ensure the patient's safety and stability. Assessment of the ABCs will help identify any potential airway obstruction, respiratory distress, or circulatory issues that may be contributing to the drop in blood pressure. Once the assessment is done, appropriate interventions can be initiated to stabilize the patient's condition. Administering vasopressors, documenting the blood pressure readings, and notifying the anesthesiologist are important actions but assessing the ABCs takes precedence in this situation to ensure the patient's immediate needs are addressed.
A woman in active labor demonstrates persistent posterior fetal position, contributing to prolonged labor and severe back pain. What nursing intervention should be implemented to facilitate fetal rotation and optimize labor progress?
- A. Encourage frequent position changes, including hands-and-knees position.
- B. Administer intravenous analgesics to manage maternal discomfort.
- C. Prepare for immediate instrumental delivery.
- D. Initiate continuous fetal monitoring to assess fetal well-being.
Correct Answer: A
Rationale: Encouraging frequent position changes, including the hands-and-knees position, is the most appropriate nursing intervention in this scenario. This position is known to help rotate the baby from a persistent posterior position to an optimal anterior position for delivery. The hands-and-knees position can help take pressure off the mother's back, alleviate back pain, and facilitate the rotation of the baby's head to engage in the mother's pelvis, thus promoting labor progress. It is a non-invasive and effective way to promote fetal rotation without the need for immediate instrumental delivery or intravenous analgesics. Continuous fetal monitoring is important for assessing fetal well-being but would not directly address the issue of posterior fetal position and the associated prolonged labor.
In as much as the research may have some risks on the part of the subject who is 21 years old, Nurse Carmi must assure the subject of her anonymity, confidentiality and respect for her human rights. ONE ABSOLUTE WAY is to get an informed and written consent from whom?
- A. Parents
- B. Husband
- C. Guardians
- D. Subject herself Situation
Correct Answer: D
Rationale: In research involving adults who are capable of providing informed consent, such as a 21-year-old subject, the absolute way to ensure autonomy and respect for the individual's rights is to obtain informed and written consent directly from the subject herself. The subject's autonomy and right to self-determination should be respected, and obtaining consent directly from the subject ensures that they are fully informed about the research, its risks, benefits, and their rights regarding anonymity and confidentiality. In this case, Nurse Carmi must explain the research process clearly to the 21-year-old subject, obtain her informed consent in writing, and ensure that her anonymity, confidentiality, and human rights are protected throughout the study.
Which of the following cell types is primarily responsible for the production of antibodies during the humoral immune response?
- A. Plasma cells
- B. T helper cells (Th cells)
- C. Memory B cells
- D. Macrophages
Correct Answer: A
Rationale: Plasma cells are the primary type of cells responsible for the production of antibodies during the humoral immune response. When activated by antigens, B cells differentiate into plasma cells, which are specialized in producing large quantities of antibodies. These antibodies are essential in fighting off infections by binding to antigens and marking them for destruction by other immune cells. T helper cells assist in activating B cells, but the actual production of antibodies is mainly carried out by plasma cells. Memory B cells are involved in mounting a rapid and specific secondary response upon re-exposure to the same antigen. Macrophages play a role in phagocytosis and antigen presentation, but they are not the primary cells responsible for producing antibodies during the humoral immune response.
Leukemia is a chronic illness and it is expected that the patient will be in and out of the hospital. To maintain communication, the nurse will _________.
- A. ask the patient to call the hospital number listed in the yellow pages
- B. ask for the phone number where the patient can be easily contacted
- C. read the information sheet of the patient in the chart
- D. tell patient to write the number in a piece of paper and give it to the ward clerk
Correct Answer: B
Rationale: It is important for the nurse to have a direct and easily accessible means of communication with the patient who is expected to be in and out of the hospital due to their chronic illness like leukemia. By asking for the patient's phone number, the nurse can quickly reach out to them for updates, clarification, or any urgent matters that may arise. This direct communication line helps in ensuring continuity of care and addressing the patient's needs promptly. This approach is more practical and efficient compared to options such as asking the patient to call the hospital number listed in the yellow pages or relying on chart information which may not always be up to date. Writing down the number and giving it to the ward clerk may cause unnecessary delays in communication.