Nokea
Which of the following should be AVOIDED by patient Sonia while she is being treated for hypothyroidism?
- A. Use of warm blankets
- B. Taking foods low in fiber
- C. Light activities done at home
- D. Exposure to cold temperature
Correct Answer: D
Rationale: Patients with hypothyroidism have a decreased ability to regulate their body temperature due to the reduced hormone levels. Exposure to cold temperatures can exacerbate this issue and lead to symptoms such as cold intolerance, feeling cold all the time, and potentially even hypothermia. It is important for patients with hypothyroidism to avoid prolonged exposure to cold temperatures to prevent any negative impact on their health.
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A patient undergoing mechanical ventilation in the ICU develops ventilator-associated pneumonia (VAP) caused by methicillin-resistant Staphylococcus aureus (MRSA). What intervention should the healthcare team prioritize to manage the patient's infection?
- A. Administer vancomycin or linezolid for MRSA coverage.
- B. Perform bronchoalveolar lavage for diagnostic purposes.
- C. Implement contact precautions to prevent transmission.
- D. Recommend prophylactic antifungal therapy to prevent candidiasis.
Correct Answer: A
Rationale: The most important intervention for managing ventilator-associated pneumonia (VAP) caused by methicillin-resistant Staphylococcus aureus (MRSA) in a patient undergoing mechanical ventilation in the ICU is to start appropriate antimicrobial therapy targeting MRSA. Vancomycin or linezolid are commonly used antibiotics for MRSA infections. These medications are effective against MRSA and can help in treating the infection and preventing further complications. It is crucial to initiate antimicrobial therapy promptly once the diagnosis of VAP caused by MRSA is suspected or confirmed to improve patient outcomes. Other interventions such as bronchoalveolar lavage for diagnostic purposes, contact precautions, or antifungal therapy may be relevant but the priority is to start effective antibiotic therapy to target the specific pathogen causing the infection.
A 55-year-old postmenopausal woman presents with vaginal bleeding. On pelvic examination, the cervix appears healthy, and there is no cervical motion tenderness. Which of the following conditions is most likely to be responsible for these findings?
- A. Cervical cancer
- B. Endometrial cancer
- C. Vaginal cancer
- D. Cervical polyp
Correct Answer: D
Rationale: In a 55-year-old postmenopausal woman presenting with vaginal bleeding and a healthy cervix on examination, the most likely cause would be a cervical polyp. Cervical polyps are benign growths that can occur on the cervix and are often asymptomatic but can occasionally cause postmenopausal bleeding. Their appearance on examination would typically be a non-malignant finding with no cervical motion tenderness. Cervical cancer, endometrial cancer, and vaginal cancer would typically present with different examination findings and risk factors.
The NICU nurse prepares for the arrival of the newborn. Which of the following PRIORITY item should be placed at the newborn's bedside? A _____________.
- A. Specific gravity urinometer
- B. Rectal thermometer
- C. Blood pressure cuff
- D. Bottle of sterile normal saline
Correct Answer: C
Rationale: The priority item that should be placed at the newborn's bedside is a blood pressure cuff. Monitoring the newborn's blood pressure is crucial in the NICU, as it helps assess the baby's cardiovascular function and overall well-being. Blood pressure changes can be an early indication of potential health issues, so having a blood pressure cuff readily available allows for timely monitoring and intervention if necessary. The other items listed (specific gravity urinometer, rectal thermometer, bottle of sterile normal saline) are also important in neonatal care, but monitoring blood pressure takes precedence in this scenario.
A patient presents with a target-like rash with concentric erythematous rings and central clearing on the trunk and extremities. The patient reports recent exposure to a new medication. Which of the following conditions is most likely responsible for this presentation?
- A. Erythema multiforme
- B. Pityriasis rosea
- C. Urticaria (hives)
- D. Seborrheic dermatitis
Correct Answer: A
Rationale: Erythema multiforme is a skin condition characterized by the sudden onset of a target-like rash with concentric erythematous rings and central clearing on the trunk and extremities. It typically presents with a distinctive "iris" or "bull's eye" pattern. Erythema multiforme is often triggered by exposure to certain medications, such as antibiotics, anticonvulsants, and other drugs. The rash is usually accompanied by symptoms like fever, malaise, and joint pain. It is important to identify and discontinue the offending medication causing the reaction in cases of drug-induced erythema multiforme.
A patient with terminal cancer is experiencing dyspnea due to pleural effusion. What intervention should the palliative nurse prioritize to manage the patient's symptoms?
- A. Administer bronchodilator medications to improve airway clearance.
- B. Perform thoracentesis to drain the pleural fluid and relieve dyspnea.
- C. Recommend non-invasive positive pressure ventilation for respiratory support.
- D. Encourage the patient to practice relaxation techniques to reduce anxiety.
Correct Answer: B
Rationale: The palliative nurse should prioritize performing thoracentesis to drain the pleural fluid and relieve dyspnea in a patient with terminal cancer experiencing pleural effusion. Pleural effusion is a common complication in patients with advanced cancer and can cause significant respiratory distress. Drainage of the pleural fluid through thoracentesis can provide immediate relief by easing the pressure on the lungs and improving the patient's ability to breathe. This intervention is essential in managing dyspnea for comfort and quality of life in palliative care settings. Administering bronchodilator medications (option A) or recommending non-invasive positive pressure ventilation (option C) may not directly address the underlying cause of dyspnea in this case. While relaxation techniques (option D) can help with anxiety and overall well-being, they may not be sufficient in managing the physical symptom of dyspnea caused by pleural effusion.