Nokea
A newly diagnosed HIV patient is in your care. The patient has a positive PPD result of 5 mm induration and a normal CXR.
Which of the following represents preferred treatment of this patient?
- A. INH and pyridoxine
- B. IHN and Rifampin
- C. Rifampin and Streptomycin
- D. No pharmacotherapeutic regimen necessary.
Correct Answer: A
Rationale: INH with pyridoxine is the standard treatment for latent TB in HIV patients with a positive PPD.
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During the assessment of a laboring client, the nurse notes that the FHT are loudest in the upper-left quadrant. The infant is most likely in which position?
- A. Left mentum anterior
- B. Left occipital anterior
- C. Left sacral anterior
- D. Left occipital transverse
Correct Answer: B
Rationale: Fetal heart tones loudest in the upper-left quadrant suggest a left occipital anterior position, where the fetus's back is aligned with the mother's left side. Other positions` positions are less likely.
The incidence of spinal cord defects/ neural tube defects such as meningomyelocele
The incidence of spinal cord defects/ neural tube defects such as meningomyelocele has decreased because
- A. prenatal diagnosis by ultrasound and treatment in the uterus.
- B. maternal ingestion of folic acid prior and during pregnancy.
- C. decreased incidence of smoking and alcohol use during pregnancy.
- D. genetic testing prior to pregnancy.
Correct Answer: B
Rationale: Folic acid supplementation reduces neural tube defects by supporting neural tube closure.
While assessing an Rh positive newborn whose mother is Rh negative, the nurse recognizes the risk for hyperbilirubinemia. Which of the following should be reported immediately?
- A. Jaundice evident at 26 hours
- B. Hematocrit of 55%
- C. Serum bilirubin of 12 mg
- D. Positive Coombs' test
Correct Answer: C
Rationale: The elevated bilirubin is in the range that requires immediate intervention, such as phototherapy. At a serum bilirubin of 12 mg, the neonate is at risk for the development of kernicterus, or bilirubin encephalopathy. The provider determines the therapy appropriate after reviewing all laboratory findings.
What is the appropriate ratio of cardiac compressions to ventilations in an adult client for one-person CPR?
- A. 5:01
- B. 1:05
- C. 15:02
- D. 2:15
Correct Answer: C
Rationale: The appropriate ratio for adult CPR is 15 compressions to 2 ventilations.
Mr. Smith is 67-year-old black male brought to the hospital by his wife, who stated that he fell down 20 minutes ago and has been unable to speak or move his right side since then, Mr. Smith has no significant past medical history. On exam, Mr. Smith is conscious, very anxious, his speech is garbed and unintelligible, he has a left facial droop, and he is completely right hemiphlegic.
The most likely etiology for his symptoms is:
- A. CVA
- B. Traumatic brain injury
- C. Brain tumor
- D. Alzheimer's disease
Correct Answer: A
Rationale: Symptoms of sudden speech loss, facial droop, and hemiplegia strongly suggest a cerebrovascular accident (stroke).