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A patient presents with sudden onset of severe, unilateral ear pain, diminished hearing, and purulent otorrhea. Otoscopic examination reveals a bulging, erythematous tympanic membrane with obscured landmarks. Which of the following conditions is most likely responsible for this presentation?
- A. Otitis externa
- B. Acute otitis media
- C. Mastoiditis
- D. Chronic suppurative otitis media
Correct Answer: B
Rationale: Acute otitis media is the most likely condition responsible for this presentation. The sudden onset of severe, unilateral ear pain, diminished hearing, and purulent otorrhea are classic symptoms of acute otitis media. Otoscopic examination revealing a bulging, erythematous tympanic membrane with obscured landmarks further supports the diagnosis. The bulging of the tympanic membrane is due to the accumulation of fluid and pus behind it, causing the characteristic appearance. Treatment typically involves antibiotics to help clear the infection and relieve symptoms. If left untreated, acute otitis media can lead to complications such as perforation of the eardrum or mastoiditis.
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The first standard-step-in oxygen therapy that the nurse should do is which of the following?
- A. Prepare the patient for the oxygen treatment
- B. Check the chart for ordered flow rate and oxygen delivery method.
- C. Gather all the equipment and supplies.
- D. Assess patient's condition.
Correct Answer: D
Rationale: Before initiating any oxygen therapy, it is crucial for the nurse to first assess the patient's condition. This step allows the nurse to determine the patient's oxygen saturation levels, respiratory rate, lung sounds, and overall respiratory status. Understanding the patient's baseline condition helps in selecting the appropriate oxygen delivery method and flow rate that will best meet the patient's needs. Additionally, assessing the patient's condition allows the nurse to monitor the effectiveness of the oxygen therapy and make any necessary adjustments throughout the treatment process. Therefore, assessing the patient's condition is the necessary first step in providing safe and effective oxygen therapy.
During the immediate post-operative phase , the PRIMARY goal of the health care team is to maintain ventilation. Which of the following situations should be observed as a result of hypoxemia?
- A. Excess carbon dioxide in the blood
- B. Increasing ammonia in the blood
- C. Decreased oxygen saturation
- D. Reduction of blood Ph
Correct Answer: C
Rationale: One of the main consequences of hypoxemia, which is low oxygen levels in the blood, is decreased oxygen saturation. Oxygen saturation refers to the percentage of hemoglobin molecules in the blood that are bound to oxygen. When there is insufficient oxygen in the blood due to hypoxemia, the oxygen saturation levels will drop. This can lead to symptoms such as shortness of breath, confusion, rapid heart rate, and ultimately can result in tissue damage if not corrected promptly. Monitoring oxygen saturation levels is crucial in the immediate post-operative phase to ensure adequate ventilation and oxygenation for the patient's recovery.
In what way wil1 the nurse handles the situation?
- A. Tell her to trust on God's love and mercy.
- B. Te1l her that death is a reality.
- C. Encourage her to keep calm because the health care team I doing their best to help Ramon recover
- D. Encourage the mother to express more about her thoughts and feelings
Correct Answer: C
Rationale: In this situation, the most appropriate way for the nurse to handle it would be to encourage the mother to keep calm because the health care team is doing their best to help Ramon recover. This response acknowledges the mother's concerns and reassures her that everything possible is being done for her son's well-being. It also helps to foster trust and rapport between the nurse, mother, and the healthcare team, which is important for effective communication and support during a challenging time. Promoting a sense of calm and trust in the healthcare professionals can help alleviate the mother's anxiety and stress, allowing her to focus on being a supportive presence for her son.
A woman in active labor has been diagnosed with placenta previa. What is the priority nursing intervention?
- A. Prepare for immediate cesarean section.
- B. Administer intravenous oxytocin to augment labor.
- C. Insert a Foley catheter to monitor urine output.
- D. Implement bed rest and continuous fetal monitoring.
Correct Answer: A
Rationale: In the case of a woman in active labor with placenta previa, the priority nursing intervention is to prepare for an immediate cesarean section. Placenta previa is a condition in which the placenta covers part or all of the cervix, which can lead to severe bleeding during labor and delivery. The risk of hemorrhage is significant, making a cesarean section the safest option for both the mother and the baby in this situation. It is crucial to act promptly to prevent complications and ensure the well-being of both the mother and the baby. Administering intravenous oxytocin to augment labor or inserting a Foley catheter to monitor urine output would not address the immediate risk of hemorrhage associated with placenta previa. Implementing bed rest and continuous fetal monitoring may be part of the overall care plan but not the priority intervention in this urgent situation.
The patient with diagnosis of schizophrenia who has been taking Clozapine will inform the patients family that the positive effect of this drug is
- A. monthly 1iver function studies change moderately
- B. psychotic symptoms, such as hearing loss are reduced
- C. patient develops leukopenia
- D. patient's energy level and involvement in activities goes up.
Correct Answer: B
Rationale: Clozapine is an atypical antipsychotic medication primarily used in the treatment of schizophrenia. One of the positive effects of Clozapine is the reduction of psychotic symptoms experienced by the patient, such as hallucinations (not hearing loss). Clozapine is effective in managing both positive symptoms (hallucinations, delusions, disorganized thinking) and negative symptoms (apathy, social withdrawal, lack of motivation) of schizophrenia. It is known for its efficacy in reducing hallucinations and other psychotic symptoms, helping the patient to lead a more stable and functional life.