Nokea
Which of the following directly VIOLATES the Patient's Bill of Rights?
- A. Informing patients about the billing policies of the hospital.
- B. Disclosing the HIV result to members of the patient's family.
- C. Honestly telling the patient about his current condition.
- D. Immediately referring results of laboratory to the physician.
Correct Answer: B
Rationale: The correct answer is B because disclosing a patient's HIV status to family members violates the patient's right to privacy and confidentiality. Patient confidentiality is a fundamental aspect of the Patient's Bill of Rights, ensuring that personal health information is protected. The other choices (A, C, D) do not directly violate the Patient's Bill of Rights. Choice A relates to transparency in billing, choice C is about honesty in communication, and choice D is about timely communication with the physician, all of which are in line with patient rights and quality care.
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During a surgical procedure, the nurse notices a sudden decrease in the patient's oxygen saturation on the monitor. What immediate action should the nurse take?
- A. Inform the surgeon and anesthesiologist
- B. Increase the flow rate of oxygen
- C. Check the endotracheal tube placement
- D. Assess the patient's respiratory status
Correct Answer: A
Rationale: The correct immediate action is to inform the surgeon and anesthesiologist (Choice A) because a sudden decrease in oxygen saturation during surgery is a critical situation that requires prompt attention from the entire surgical team. The surgeon and anesthesiologist need to be made aware of the situation so that they can assess the patient's condition and make any necessary adjustments to the surgical procedure or anesthesia delivery. Increasing the flow rate of oxygen (Choice B) may help temporarily but does not address the underlying cause of the oxygen desaturation. Checking the endotracheal tube placement (Choice C) is important but may not be the immediate priority in this critical situation. Assessing the patient's respiratory status (Choice D) is important but should be done after informing the surgeon and anesthesiologist to ensure coordinated and timely interventions.
A 20-year-old woman presents with sudden onset of severe lower abdominal pain and missed menstrual periods for the past two months. She has a positive urine pregnancy test. On transvaginal ultrasound, an empty uterus is visualized, and there is fluid in the cul-de-sac. Which condition is most likely to be responsible for these findings?
- A. Ovarian cyst rupture
- B. Ectopic pregnancy
- C. Septic abortion
- D. Ovarian torsion
Correct Answer: B
Rationale: The correct answer is B: Ectopic pregnancy. In this scenario, the combination of missed periods, positive pregnancy test, and empty uterus on ultrasound with fluid in the cul-de-sac is highly suggestive of an ectopic pregnancy. Ectopic pregnancy occurs when the fertilized egg implants outside the uterus, commonly in the fallopian tube. The presence of fluid in the cul-de-sac indicates possible blood from a ruptured ectopic pregnancy, causing the severe lower abdominal pain. Ovarian cyst rupture (A) typically presents with less severe pain. Septic abortion (C) would present with signs of infection and products of conception in the uterus. Ovarian torsion (D) would present with acute onset of unilateral lower abdominal pain and a palpable adnexal mass, not fluid in the cul-de-sac.
You should check the patient for suspect disturbed thought processes related to depressed metabolism and altered cardiovascular and respiratory status. What is the rationale for orienting the patient to time, place, date, and events?
- A. Shows improved cognitive functioning
- B. Provides reality orientation to patient
- C. Permits evaluation of effectiveness of treatment
- D. Let the patient identify the time, place, date, and events correctly
Correct Answer: B
Rationale: The correct answer is B: Provides reality orientation to patient. Orienting the patient to time, place, date, and events helps them stay connected to reality and improves their awareness of their surroundings. This is crucial in assessing their cognitive functioning and ensuring they are grounded in the present moment. By providing reality orientation, healthcare providers can better understand the patient's current mental state and address any potential confusion or disorientation. This approach aids in establishing a therapeutic environment and enhances the patient's overall well-being. Choices A, C, and D do not capture the essence of reality orientation and its significance in maintaining the patient's mental clarity and connection to the present moment.
Which of the following actions is recommended for managing a patient with a suspected snakebite?
- A. Applying a tourniquet proximal to the bite site.
- B. Immobilizing the affected limb at the level of the heart.
- C. Making an incision over the bite site to facilitate venom extraction.
- D. Transporting the patient to a medical facility for antivenom administration.
Correct Answer: D
Rationale: The correct answer is D: Transporting the patient to a medical facility for antivenom administration. This is recommended because antivenom is the definitive treatment for snakebites. Tourniquets (choice A) can worsen tissue damage and should be avoided. Elevating the limb (choice B) may not prevent venom spread. Making an incision (choice C) can lead to infection and increased venom absorption. Antivenom administration at a medical facility is crucial for proper management of snakebites.
A patient presents with recurrent episodes of brief, severe, stabbing pain in the distribution of the trigeminal nerve. Episodes are triggered by touch, chewing, or cold exposure. Which of the following neurological conditions is most likely responsible for these symptoms?
- A. Migraine headache
- B. Cluster headache
- C. Tension-type headache
- D. Trigeminal neuralgia
Correct Answer: D
Rationale: The correct answer is D: Trigeminal neuralgia. This condition is characterized by recurrent, severe, stabbing pain in the trigeminal nerve distribution triggered by touch, chewing, or cold exposure. The key feature is the characteristic lancinating pain, which is not typical of migraine (choice A), cluster headache (choice B), or tension-type headache (choice C). Migraine typically presents with pulsating, moderate to severe headache associated with nausea and sensitivity to light and sound. Cluster headache is characterized by severe, unilateral pain around the eye associated with autonomic symptoms. Tension-type headache presents with bilateral, pressing or tightening pain without specific triggers. Therefore, based on the description of the symptoms in the question, trigeminal neuralgia is the most likely diagnosis.