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A pregnant woman presents with recurrent episodes of severe abdominal pain, bloating, and constipation. On examination, an abdominal mass is palpable, and bowel sounds are diminished. Which of the following conditions is the most likely cause of these symptoms?
- A. Ectopic pregnancy
- B. Threatened abortion
- C. Placenta previa
- D. Ovarian torsion
Correct Answer: D
Rationale: Ovarian torsion is the most likely cause of the pregnant woman's symptoms as described. Ovarian torsion occurs when the ovary twists on its pedicle, leading to compromised blood flow to the ovary. This can cause severe abdominal pain, bloating, and constipation. On examination, an abdominal mass may be palpable due to an enlarged, twisted ovary. Bowel sounds may be diminished due to the effect of the torsion on surrounding structures. Ectopic pregnancy, threatened abortion, and placenta previa are less likely to present with an abdominal mass and diminished bowel sounds.
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In CO-PAR, which is the MOST important role of the public health nurse?
- A. Caregiver
- B. Financer
- C. Expert
- D. Adviser
Correct Answer: C
Rationale: In the context of CO-PAR (Community Organizing Participatory Action Research), the most important role of the public health nurse is being an expert. Public health nurses are expected to have specialized knowledge and skills in the field of public health, allowing them to provide evidence-based guidance and interventions to support community health initiatives. As an expert, the public health nurse can assess community needs, develop appropriate interventions, educate community members on health promotion and disease prevention, and evaluate the effectiveness of implemented programs. By utilizing their expertise, public health nurses can effectively contribute to improving the health outcomes and well-being of the community they serve.
A patient presents with well-demarcated, erythematous plaques with silvery scales on the trunk and extensor surfaces of the limbs. The patient reports a family history of similar skin lesions. Which of the following conditions is most likely responsible for this presentation?
- A. Pityriasis rosea
- B. Psoriasis
- C. Erythema multiforme
- D. Lichen planus
Correct Answer: B
Rationale: The patient's presentation of well-demarcated, erythematous plaques with silvery scales on the trunk and extensor surfaces of the limbs is classic for psoriasis. Additionally, the family history of similar skin lesions further supports the diagnosis of psoriasis, as it is a condition with a genetic predisposition. Pityriasis rosea typically presents with a herald patch followed by oval, scaly lesions in a Christmas tree pattern. Erythema multiforme is characterized by target-like lesions. Lichen planus presents as purple, polygonal, flat-topped papules that may have fine white lines on their surface known as Wickham striae.
A 25-year-old woman presents with cyclic pelvic pain, dysmenorrhea, and dyspareunia. On pelvic examination, the uterus is retroverted, and a tender, nodular mass is palpated behind the uterus. Which of the following conditions is most likely to be responsible for these findings?
- A. Endometriosis
- B. Adenomyosis
- C. Leiomyomas (uterine fibroids)
- D. Pelvic inflammatory disease (PID)
Correct Answer: A
Rationale: The scenario described, including cyclic pelvic pain, dysmenorrhea, dyspareunia, retroverted uterus, and a nodular mass behind the uterus, is most indicative of endometriosis. Endometriosis is a gynecological condition in which tissue similar to the endometrium (the tissue that lines the uterus) is found outside the uterus, typically on structures within the pelvis. The presence of endometrial tissue in abnormal locations can lead to symptoms such as pelvic pain, especially during menstruation (dysmenorrhea), painful intercourse (dyspareunia), and the formation of nodular masses (endometriomas) that can be felt on pelvic examination. It is important to note that while adenomyosis and uterine fibroids (leiomyomas) can also cause pelvic pain and dysmenorrhea, the specific findings of retroverted uterus and palpable nodular mass behind
A patient with a history of chronic obstructive pulmonary disease (COPD) presents with increased dyspnea and cough productive of purulent sputum. On auscultation, coarse crackles are heard bilaterally. Which complication of COPD is the patient most likely experiencing?
- A. Acute exacerbation
- B. Pneumothorax
- C. Pulmonary embolism
- D. Pleural effusion
Correct Answer: A
Rationale: The patient with a history of COPD presenting with increased dyspnea, cough productive of purulent sputum, and coarse crackles on auscultation is most likely experiencing an acute exacerbation of COPD. Acute exacerbations in COPD are defined as sustained worsening of the patient's respiratory symptoms beyond normal day-to-day variations, leading to a change in medication. Common triggers for exacerbations include respiratory infections, air pollution, and non-compliance with medications.
What response should the nurse use in dealing with this behavior?
- A. Encourage her to scrub the doorknobs with a strong antiseptic so she does not need to use tissue papers.
- B. Supply her with paper tissue to help her function until her anxiety is reduced .
- C. Force her to touch doorknobs by removing all available paper tissue until she learns to deal with the situation.
- D. Explain to her that ideas about doorknobs with covid 19 are part of the i1lness and is not necessary.
Correct Answer: B
Rationale: Supplying the patient with paper tissues to use when touching doorknobs is the most appropriate response in this situation. This action acknowledges and respects the patient's anxiety while providing a practical solution to help her cope. Forcing her to touch doorknobs or discouraging her concerns would not address the underlying anxiety and may lead to increased distress. Encouraging her to scrub doorknobs with a strong antiseptic is not necessary and may exacerbate her anxiety. Explaining that her concerns are part of her illness may invalidate her feelings and is not a constructive way to address the situation. Supplying her with paper tissues allows her to feel more comfortable while still being able to navigate her daily activities.