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Which of the following organisms is the MOST common causative agent of urinary tract infection (UTI)?
- A. Staphylococcus
- B. Pseudomonas
- C. Klebsiella
- D. Escherichia coli
Correct Answer: D
Rationale: Escherichia coli (E. coli) is the MOST common causative agent of urinary tract infection (UTI), accounting for approximately 80-85% of all cases. E. coli is a type of bacteria that naturally resides in the gastrointestinal tract and can easily migrate to the urinary tract, causing infection. Its prevalence in UTIs is due to various factors such as its ability to adhere to the uroepithelial cells and form biofilms, leading to persistent infections. Therefore, E. coli is the most common organism responsible for UTIs in both community and healthcare settings.
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A woman in active labor experiences frequent and intense uterine contractions with minimal rest intervals, leading to maternal fatigue and decreased fetal oxygenation. What maternal condition should the nurse assess for that may contribute to this abnormal labor pattern?
- A. Maternal dehydration
- B. Uterine hyperstimulation
- C. Pelvic outlet obstruction
- D. Maternal exhaustion
Correct Answer: B
Rationale: Uterine hyperstimulation, also known as tachysystole, is a condition characterized by frequent and intense uterine contractions with minimal rest intervals. This can lead to maternal fatigue and decreased fetal oxygenation due to the insufficient time for the uterus to relax and refill with oxygenated blood between contractions. Uterine hyperstimulation can be caused by various factors such as excessive use of uterotonics (oxytocin or prostaglandins), improper labor induction techniques, or maternal conditions like previous uterine surgery. It is essential for the nurse to assess for signs of uterine hyperstimulation and take appropriate interventions to prevent potential complications for both the mother and the baby.
A patient presents with a thyroid nodule and signs of hyperthyroidism. Fine-needle aspiration biopsy reveals Hurthle cells and cellular atypia. Which endocrine disorder is most likely responsible for these symptoms?
- A. Hashimoto's thyroiditis
- B. Graves' disease
- C. Hurthle cell carcinoma
- D. Papillary thyroid carcinoma
Correct Answer: C
Rationale: Hurthle cell carcinoma is a type of thyroid cancer that arises from the Hurthle cells of the thyroid gland. Patients with Hurthle cell carcinoma may present with a thyroid nodule and signs of hyperthyroidism, which can mimic other thyroid disorders such as Graves' disease. Fine-needle aspiration biopsy revealing Hurthle cells and cellular atypia is suggestive of a Hurthle cell neoplasm, particularly Hurthle cell carcinoma. It is important to differentiate Hurthle cell carcinoma from benign Hurthle cell adenomas or other thyroid conditions to guide appropriate management and treatment.
Nurse Harper provides health instruction to the patient experiencing heartburn, which statement by the patient indicates a NEED or further Instructions? I have to drink milk between meals it
- A. Drink milk between meals
- B. Eat small, frequent meals
- C. avoid fatty or spicy foods
- D. lie down after eating
Correct Answer: A
Rationale: This statement indicates a need for further instructions because drinking milk between meals may worsen heartburn for some individuals. Milk can temporarily neutralize stomach acid, but it can also stimulate acid production in the stomach leading to increased heartburn symptoms. Therefore, Nurse Harper should provide more guidance on appropriate dietary choices for managing heartburn, such as avoiding trigger foods like fatty or spicy foods, eating small, frequent meals, and not lying down immediately after eating.
Which of the following can be a MAJOR PROBLEM for a patient with tracheostomy?
- A. Breathing
- B. Swallowing
- C. Ingesting
- D. Singing
Correct Answer: A
Rationale: Having a tracheostomy means that a patient has an artificial opening in their neck to help them breathe. Therefore, any issues related to breathing, such as blockages in the tracheostomy tube or difficulty in clearing secretions, can pose a major problem for a patient with a tracheostomy. It is crucial to monitor the patient's respiratory status closely and intervene promptly if any breathing difficulties arise to prevent potential respiratory distress or complications.
A patient with a history of rheumatoid arthritis presents with acute pain and swelling of the wrist joint. Physical examination reveals ulnar deviation of the fingers and swan-neck deformity of the digits. Which imaging modality is most appropriate for further evaluation of wrist involvement in rheumatoid arthritis?
- A. X-ray
- B. Magnetic resonance imaging (MRI)
- C. Ultrasound
- D. Dual-energy X-ray absorptiometry (DEXA) scan
Correct Answer: A
Rationale: X-ray is the most appropriate imaging modality for evaluating wrist involvement in rheumatoid arthritis. It can show joint space narrowing, erosions, soft tissue swelling, and periarticular osteopenia. X-rays are readily available, cost-effective, and provide valuable information about joint damage and disease progression in rheumatoid arthritis. In this case, X-ray would be able to confirm the presence of erosions, joint deformities, and assess the severity of the disease in the wrist joint. While MRI and ultrasound can also be helpful in evaluating rheumatoid arthritis, X-ray remains the initial imaging modality of choice due to its convenience and ability to assess bony changes. Dual-energy X-ray absorptiometry (DEXA) scan is not indicated for evaluating wrist involvement in rheumatoid arthritis.