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A pregnant woman presents with a history of recurrent pregnancy losses in the second trimester. On examination, the cervix is dilated, and uterine contractions are absent. Which of the following conditions is the most likely cause of these symptoms?
- A. Ectopic pregnancy
- B. Threatened abortion
- C. Placenta previa
- D. Incompetent cervix
Correct Answer: D
Rationale: Incompetent cervix refers to a weakened cervix that is unable to support the weight of the growing fetus, leading to painless cervical dilation and second-trimester pregnancy loss. In this condition, the cervix may dilate prematurely without contractions, resulting in a painless cervical dilation. The history of recurrent second-trimester losses, along with cervical dilation and absence of uterine contractions in the presenting pregnant woman, are characteristic of incompetent cervix. Prompt recognition and management with cerclage placement can help prevent further pregnancy losses in women with incompetent cervix.
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While preparing the surgical site, the nurse notices that the skin preparation solution has expired. What should the nurse do?
- A. Use the expired solution as it is still effective
- B. Document the expiration date in the patient's chart
- C. Discard the expired solution and obtain a new one
- D. Dilute the solution with sterile water to extend its shelf life
Correct Answer: C
Rationale: Using an expired skin preparation solution can compromise the safety and effectiveness of the surgical site cleansing. Expired solutions may have reduced efficacy or could cause adverse reactions due to chemical breakdown over time. Therefore, it is essential for the nurse to discard the expired solution and obtain a new one to ensure proper sanitation and reduce the risk of complications during the surgical procedure. It is important to adhere to proper protocols and guidelines in healthcare settings to maintain patient safety and optimal outcomes.
A patient presents with a Colles' fracture. What is the characteristic deformity associated with this type of fracture?
- A. Dorsal displacement of the distal fragment
- B. Ventral displacement of the distal fragment
- C. Lateral displacement of the distal fragment
- D. Medial displacement of the distal fragment
Correct Answer: A
Rationale: Colles' fracture is a type of distal radius fracture characterized by a break of the radius bone in the forearm close to the wrist. In a Colles' fracture, the distal fragment of the fractured radius bone gets displaced dorsally, meaning it shifts upwards towards the back of the hand, creating a characteristic "dinner fork" deformity when viewed from the side. This dorsal displacement results in a visible bump on the back of the wrist and a noticeable deformity when compared to the uninjured side.
Identify the causative agent of dengue fever.
- A. Fomite
- B. Bacteria
- C. Vector
- D. Virus
Correct Answer: D
Rationale: The causative agent of dengue fever is a virus. Dengue fever is primarily transmitted to humans by the bite of infected Aedes mosquitoes, particularly Aedes aegypti and Aedes albopictus. These mosquitoes act as vectors, carrying and transmitting the dengue virus (specifically four closely related but antigenically different serotypes: DEN-1, DEN-2, DEN-3, and DEN-4) to humans during the feeding process. The virus then replicates in the human body, causing symptoms of dengue fever. Therefore, the correct answer is D. Virus.
A patient presents with recurrent episodes of sudden, severe vertigo lasting hours, accompanied by nausea, vomiting, and nystagmus. Vestibular function tests demonstrate unilateral weakness. Which of the following conditions is most likely responsible for this presentation?
- A. Vestibular neuritis
- B. Benign paroxysmal positional vertigo (BPPV)
- C. Ménière's disease
- D. Acoustic neuroma Ophthalmology
Correct Answer: A
Rationale: The patient's presentation of recurrent episodes of sudden, severe vertigo lasting hours with nausea, vomiting, and nystagmus, along with unilateral weakness on vestibular function tests, is most consistent with vestibular neuritis. Vestibular neuritis is characterized by inflammation of the vestibular nerve leading to sudden onset vertigo that can last for hours to days. It is often associated with nausea, vomiting, and nystagmus. Unilateral weakness on vestibular function tests indicates dysfunction of one vestibular system. Differential diagnosis for this type of presentation includes other conditions such as Meniere's disease, BPPV, and acoustic neuroma. However, the combination of symptoms and unilateral vestibular weakness makes vestibular neuritis the most likely diagnosis in this case.
What drug should the nurse prepare for administration to reverse all signs of toxicity?
- A. Digibind (Digoxin)
- B. Atropine sulfate
- C. Naloxone (Narcan)
- D. Diazepam (Valium)
Correct Answer: C
Rationale: Naloxone, also known by the brand name Narcan, is used to reverse the effects of opioid overdose. Opioids can cause respiratory depression, sedation, and other signs of toxicity. Administering naloxone can quickly reverse these effects, restoring the patient's breathing and consciousness. This makes it the appropriate choice for reversing all signs of toxicity related to opioids. Digibind (Digoxin) is used to reverse toxicity from digoxin specifically. Atropine sulfate is used for bradycardia. Diazepam (Valium) is a benzodiazepine used for anxiety, seizures, and muscle relaxation, not for reversing toxicity.