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A patient presents with fever, headache, myalgia, and a skin lesion resembling a "bull's eye" rash at the site of a tick bite. Which of the following is the most likely causative agent?
- A. Plasmodium falciparum
- B. Trypanosoma cruzi
- C. Borrelia burgdorferi
- D. Leishmania donovani
Correct Answer: C
Rationale: The presentation described in the question, including the skin lesion resembling a "bull's eye" rash at the site of a tick bite, is characteristic of Lyme disease. Lyme disease is caused by the spirochete bacterium Borrelia burgdorferi, which is transmitted to humans through the bite of infected black-legged ticks (Ixodes scapularis). The symptoms of Lyme disease include fever, headache, myalgia, and the erythema migrans rash, which appears as a red circular rash with central clearing resembling a bull's eye.
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A patient with terminal illness expresses a desire to spend quality time with their family but feels guilty for being a burden. How should the palliative nurse respond?
- A. Dismiss the patient's feelings and reassure them that they are not a burden.
- B. Encourage the patient to focus on their own needs rather than worrying about others.
- C. Validate the patient's feelings of guilt and offer support to address their concerns.
- D. Suggest involving family members in caregiving tasks to alleviate the patient's guilt.
Correct Answer: C
Rationale: In this situation, the most appropriate response for the palliative nurse is to validate the patient's feelings of guilt and offer support to address their concerns. It is important to acknowledge the patient's emotions and help them navigate through their guilt in a compassionate and understanding manner. By validating their feelings, the nurse can create a safe space for the patient to express their concerns and work towards finding solutions to alleviate their guilt. This approach fosters trust and a therapeutic relationship between the patient and the nurse, ultimately promoting emotional well-being and facilitating open communication.
A patient presents with chest pain at rest, unrelated to exertion, and not relieved by nitroglycerin. An electrocardiogram (ECG) shows ST-segment depression. Which cardiovascular disorder is most likely responsible for these symptoms?
- A. Stable angina
- B. Unstable angina
- C. Acute myocardial infarction
- D. Prinzmetal's angina
Correct Answer: B
Rationale: Unstable angina is characterized by chest pain at rest, which is not relieved by nitroglycerin. The ECG findings in unstable angina typically show ST-segment depression or T-wave inversion. It is considered a medical emergency as it can progress to a myocardial infarction. Stable angina, on the other hand, is chest pain or discomfort that occurs with exertion and is relieved by rest or medications like nitroglycerin. Acute myocardial infarction would typically present with ST-segment elevation on ECG, while Prinzmetal's angina is characterized by transient ST-segment elevation due to coronary artery vasospasm.
A nurse is caring for a patient with complex healthcare needs. What action by the nurse demonstrates effective care coordination?
- A. Working in isolation without consulting other healthcare providers
- B. Providing fragmented care without considering the patient's preferences
- C. Collaborating with interdisciplinary team members to develop a comprehensive care plan
- D. Focusing solely on completing tasks without addressing the patient's holistic needs
Correct Answer: C
Rationale: Collaborating with interdisciplinary team members to develop a comprehensive care plan demonstrates effective care coordination. In complex healthcare situations, involving various healthcare providers such as physicians, specialists, therapists, social workers, and others is crucial to ensure that all aspects of the patient's care are addressed holistically. By working together, healthcare professionals can share information, expertise, and insights to develop a well-rounded care plan that considers all aspects of the patient's needs. This collaborative approach helps promote better outcomes for the patient and enhances overall care coordination. It also helps to ensure that the patient's preferences and values are taken into account when developing the care plan.
A patient presents with recurrent episodes of vertigo, nausea, and nystagmus, often triggered by head movements. Dix-Hallpike maneuver elicits positional vertigo and rotary nystagmus. Which of the following conditions is most likely responsible for this presentation?
- A. Ménière's disease
- B. Benign paroxysmal positional vertigo (BPPV)
- C. Vestibular neuritis
- D. Labyrinthitis
Correct Answer: B
Rationale: The patient's presentation with recurrent episodes of vertigo, nausea, and nystagmus triggered by head movements, along with a positive Dix-Hallpike maneuver eliciting positional vertigo and rotary nystagmus, is classic for Benign Paroxysmal Positional Vertigo (BPPV). BPPV is the most common cause of vertigo due to a mechanical problem in the inner ear. In BPPV, brief episodes of vertigo are typically triggered by specific head movements, such as rolling over in bed or looking up. The characteristic rotary nystagmus observed in BPPV is consistent with the brief, intense episodes of vertigo that patients experience. The Dix-Hallpike maneuver, commonly used to diagnose BPPV, involves moving the patient from sitting to a supine head-hanging position and can induce vertigo and nystagmus in affected
A patient with a history of peptic ulcer disease is prescribed famotidine (Pepcid) for gastric acid suppression. Which instruction should the nurse include in patient education about famotidine therapy?
- A. "Take famotidine on an empty stomach."
- B. "Avoid taking antacids while on famotidine therapy."
- C. "Increase your intake of spicy foods while taking famotidine."
- D. "Notify your healthcare provider if you develop black, tarry stools."
Correct Answer: B
Rationale: Famotidine belongs to a class of medications known as H2 blockers which work to reduce the production of stomach acid. Antacids, on the other hand, work by neutralizing stomach acid. Taking antacids in conjunction with famotidine can decrease the effectiveness of famotidine as they can interfere with its absorption. Therefore, it is important for the patient to avoid taking antacids while on famotidine therapy to ensure optimal treatment outcomes for gastric acid suppression.