Nokea
Upon further assessment, you notices that she had any scratches on her right ankle, a resulting infection, and cellulitis. When you asked her about the scratches, the patient states, "Oh, my cat might have been using my leg as a scratiching post again and I did not even feel it." Which diabetic complicatons suspect the patient to have?
- A. Neuropathy
- B. Retinopathy
- C. Macroangiopathy
- D. Nephropathy
Correct Answer: A
Rationale: The patient's lack of sensation in her right leg, allowing her cat to scratch her without her noticing, is indicative of neuropathy. Neuropathy is a common diabetic complication characterized by nerve damage that can result in loss of sensation or altered sensation in different parts of the body, including the extremities. In this case, neuropathy has likely affected the patient's right lower extremity, leading to her inability to feel the cat scratching her leg and resulting in the unnoticed scratches, infection, and subsequent cellulitis.
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Which of the following imaging modalities is most appropriate for evaluating suspected pulmonary embolism (PE) in a pregnant patient?
- A. Chest X-ray
- B. Ventilation-perfusion (V/Q) scan
- C. Contrast-enhanced computed tomography (CT) pulmonary angiography
- D. Transthoracic echocardiography
Correct Answer: C
Rationale: In a pregnant patient with suspected pulmonary embolism (PE), the most appropriate imaging modality for evaluation is contrast-enhanced computed tomography (CT) pulmonary angiography. This imaging technique has been shown to be safe for the fetus when necessary, especially if the benefits of making a diagnosis outweigh the minimal risks associated with radiation exposure. It provides quick and accurate detection of PE with high sensitivity and specificity.
A pregnant woman presents with fever, chills, and abdominal pain localized to the right lower quadrant. On examination, she has rebound tenderness and guarding. Which of the following conditions is the most likely cause of these symptoms?
- A. Ectopic pregnancy
- B. Pelvic inflammatory disease
- C. Acute appendicitis
- D. Ovarian torsion
Correct Answer: C
Rationale: Acute appendicitis is the most likely cause of the symptoms described in the pregnant woman. The classic presentation of acute appendicitis includes fever, chills, abdominal pain localized to the right lower quadrant, rebound tenderness, and guarding. Pregnant women are at a slightly higher risk of developing appendicitis due to anatomic changes and increased abdominal pressure during pregnancy, which can lead to an atypical presentation of symptoms. Prompt diagnosis and surgical intervention are crucial to prevent complications such as perforation, which can be detrimental for both the mother and the fetus.
A patient presents with sudden-onset severe headache, vomiting, and altered mental status. Imaging reveals a hyperdense lesion within the brain parenchyma, suggestive of acute bleeding. Which of the following neurological conditions is most likely responsible for these symptoms?
- A. Ischemic stroke
- B. Subdural hematoma
- C. Intracerebral hemorrhage
- D. Subarachnoid hemorrhage
Correct Answer: C
Rationale: Intracerebral hemorrhage is characterized by bleeding directly into the brain parenchyma, leading to the sudden onset of severe headache, vomiting, altered mental status, and neurological deficits. The hyperdense lesion seen on imaging is caused by the presence of blood within the brain tissue. This condition is often associated with hypertension and can be life-threatening if not promptly diagnosed and managed. Subdural hematoma is an accumulation of blood between the brain and its outermost covering (dura mater), typically presenting with a slower onset of symptoms compared to intracerebral hemorrhage. Subarachnoid hemorrhage involves bleeding into the space between the arachnoid membrane and the pia mater (subarachnoid space), commonly caused by the rupture of an aneurysm. Ischemic stroke results from the blockage of a blood vessel supplying the brain, leading to a lack of oxygen and nutrients to
The client has been "pesky," seeking the attention of nurses in the nurses' station much of the day. Now the nurse escorts the client to the room and tells the client to stay there or be put into seclusion. The nurse is threatening to give the client an injection in order to restrain the client for inappropriate behavior. This is an example of
- A. Abuse
- B. Assault
- C. False imprisonment
- D. Battery
Correct Answer: C
Rationale: False imprisonment is the act of improperly restraining another individual against their will. In this scenario, the nurse's threat of putting the client into seclusion and administering an injection to restrain them for inappropriate behavior constitutes false imprisonment. The client is being restricted in their movement without valid reason or proper procedure. This type of action is not acceptable in healthcare settings and violates the client's rights. It is important for healthcare professionals to use appropriate de-escalation techniques and interventions to manage challenging behaviors without resorting to threats of physical restraint.
While taking nursing history on Annie, what will be the response of the patient that indicates her present condition?
- A. She frequently experiences vertigo nausea and nystagmus when sitting.
- B. She has ear pain and discharge from the left ear when travelling.
- C. She has had impaired hearing since birth.
- D. Her hearing loss has become worse with each succeeding pregnancy
Correct Answer: A
Rationale: The response indicating Annie's present condition would be option A. This is because the symptoms mentioned in option A, such as experiencing vertigo, nausea, and nystagmus when sitting, point towards a vestibular disorder. These are symptoms commonly associated with conditions like Meniere's disease or vestibular neuritis, which can cause balance issues and feelings of dizziness. These symptoms are more indicative of Annie's current health status compared to the other options which focus on past or unrelated issues, such as ear pain during travel or impaired hearing since birth. The information provided in option A gives a more direct insight into Annie's present condition, making it the most appropriate response.