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A patient presents with fever, chills, and costovertebral angle tenderness. Urinalysis reveals pyuria and bacteriuria. Which of the following conditions is most likely?
- A. Acute pyelonephritis
- B. Chronic kidney disease
- C. Urinary tract infection (UTI)
- D. Renal calculi
Correct Answer: A
Rationale: Acute pyelonephritis is the most likely condition based on the patient presentation and urinalysis findings described. Acute pyelonephritis is an infection of the renal parenchyma and pelvis, typically caused by ascending bacteria from the lower urinary tract. The classic symptoms include fever, chills, flank pain, and costovertebral angle tenderness (tenderness over the kidneys). The presence of pyuria (pus in the urine) and bacteriuria (bacteria in the urine) on urinalysis further supports the diagnosis of acute pyelonephritis. It is crucial to diagnose and treat acute pyelonephritis promptly to prevent complications and recurrent infections.
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When a health facility formulates its Vision- Mission to guided Management and health personnel in the work place is what part of quality-standards?
- A. Human resource management
- B. Leadership and management
- C. Patient care standards
- D. Organizational ethics
Correct Answer: B
Rationale: The formulation of a vision and mission statement in a health facility is an essential aspect of leadership and management. A well-crafted vision and mission statement provide the organization with a clear direction and purpose, guiding management and health personnel in their daily activities. It helps in aligning individual goals with organizational objectives, fostering teamwork, and enhancing overall performance. Effective leadership and management ensure that the vision and mission are communicated effectively, understood by all stakeholders, and implemented throughout the organization to achieve quality standards. By setting the tone for organizational culture and values, leadership and management play a crucial role in shaping the quality of care and services provided by the health facility.
A patient with osteoarthritis of the knee experiences persistent pain and functional limitation despite conservative management. Which surgical procedure is commonly performed to alleviate symptoms and improve function in such cases?
- A. Total knee arthroplasty (TKA)
- B. High tibial osteotomy (HTO)
- C. Knee arthroscopy
- D. Meniscectomy
Correct Answer: A
Rationale: Total knee arthroplasty (TKA), also known as total knee replacement, is a surgical procedure commonly performed to alleviate symptoms and improve function in patients with advanced osteoarthritis of the knee that has not responded to conservative management. During TKA, the damaged cartilage and bone in the knee joint are removed and replaced with prosthetic components. This procedure aims to reduce pain, restore function, and improve the quality of life for individuals with severe osteoarthritis of the knee. High tibial osteotomy (HTO) is typically performed in younger patients with unicompartmental osteoarthritis, while knee arthroscopy and meniscectomy are more targeted towards specific knee conditions and may not provide significant relief in cases of advanced osteoarthritis.
Signs such as using tissues to doorknobs develop because the patient is ________.
- A. unconsciously controlling unacceptable impulses or feelings
- B. Listening to voices that tell her that doorknobs are unclean
- C. consciously using this method of punishing herself
- D. fulfilling a need to punish others procedure by carrying out annoying
Correct Answer: A
Rationale: Signs such as using tissues to doorknobs suggest that the patient is unconsciously controlling unacceptable impulses or feelings. This behavior falls under the category of defense mechanisms, specifically displacement, where the individual redirects their emotions from a threatening target to a safer one. In this case, the patient may be experiencing anxiety or fear related to contamination or germs, leading them to use tissues to avoid touching doorknobs directly. It is a way for the patient to manage their underlying emotions, albeit unconsciously, through this compulsive behavior.
A patient with a history of chronic kidney disease presents with pruritus, pale skin, and easy bruising. Laboratory findings reveal anemia, thrombocytopenia, and elevated blood urea nitrogen (BUN) and creatinine levels. Which of the following conditions is most likely?
- A. Uremic encephalopathy
- B. Uremic pericarditis
- C. Uremic bleeding diathesis
- D. Uremic neuropathy
Correct Answer: C
Rationale: The given patient with chronic kidney disease (CKD) is likely experiencing uremic bleeding diathesis. Uremic bleeding diathesis is a complication of CKD characterized by abnormal platelet function, leading to a tendency for bleeding. The presence of anemia, thrombocytopenia (low platelet count), pale skin, easy bruising, and elevated blood urea nitrogen (BUN) and creatinine levels are all consistent with uremic bleeding diathesis.
To remove the ingested poisonous substance, the physician ordered a gastric lavage. What is the role of the nurse immediately prior to the procedure?
- A. Get the right size of the nasogastric tube
- B. Remind parents to be careful next time
- C. Obtain an informed consent immediately
- D. Tell the parent that they are negligent
Correct Answer: A
Rationale: Prior to a gastric lavage procedure, it is essential for the nurse to ensure the correct size of the nasogastric tube is selected. The appropriate size of the tube will allow for effective removal of the ingested poisonous substance during the procedure. Proper sizing also helps in preventing complications such as injury to the gastrointestinal tract or inadequate removal of the substance. This step is crucial for the safe and successful completion of gastric lavage. Reminding parents to be careful, obtaining informed consent immediately, or accusing them of negligence are not immediate responsibilities of the nurse in this context.