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?

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Question 1 of 9

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?

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.

Question 2 of 9

For the past 6 months, several nurses are resigning. Some have verbalized in the exit interview that there are not happy anymore. Which of the following descriptions manifest BEST, a nurse who has job satisfaction?

Correct Answer: B

Rationale: The correct answer is B because an empowered nurse feels in control and valued, leading to job satisfaction. Enthusiasm shows motivation and engagement with their work. Being ethical indicates a commitment to moral principles, contributing to a sense of fulfillment. Choice A is incorrect as competitiveness and self-centeredness do not necessarily equate to job satisfaction. Euphoria may not be a sustainable indicator of satisfaction. Choice C is incorrect because being a loner and egoistic are not traits associated with job satisfaction. Reactivity may suggest a lack of control or frustration. Choice D is incorrect as being outgoing and competitive might not directly translate to job satisfaction. Sensitivity alone does not guarantee satisfaction in the workplace.

Question 3 of 9

Mr. M is receiving hospice care for a terminal illness. He wants to make sure his daughter is allowed to make any decisions regarding his care should he become unable to do so. What document would permit his daughter to do this?

Correct Answer: C

Rationale: The correct answer is C: Durable power of attorney. This legal document allows Mr. M to appoint his daughter as his healthcare proxy, granting her the authority to make medical decisions on his behalf if he becomes incapacitated. A: Expressed contract involves clear terms agreed upon by both parties, not relevant here. B: Implied contract arises from actions rather than explicit agreement, not applicable in this situation. D: A living will outlines an individual's medical treatment preferences, but does not grant decision-making authority to another person.

Question 4 of 9

Which diagnostic procedure is commonly used to establish the diagnosis of lung cancer which provides a detailed description of the tracheobronchial tree and allows for biopsies of suspicious areas?

Correct Answer: B

Rationale: The correct answer is B: Bronchoscopy. This procedure involves inserting a thin, flexible tube with a camera through the mouth or nose to examine the tracheobronchial tree. It allows direct visualization of the airways, collection of tissue samples for biopsy, and detection of abnormalities like tumors. A: CT scan provides detailed images of the lungs but does not allow for direct tissue sampling. C: Sputum cytology involves examining sputum for cancer cells but may not provide accurate results. D: PET scan is used to detect metabolic activity in tissues, including tumors, but does not provide detailed visualization of the airways or allow for biopsies.

Question 5 of 9

Which of the following structures is responsible for the production of digestive enzymes and bicarbonate-rich pancreatic juice?

Correct Answer: C

Rationale: The correct answer is C: Pancreas. The pancreas is responsible for producing digestive enzymes and bicarbonate-rich pancreatic juice. It secretes enzymes like amylase, lipase, and protease to break down carbohydrates, fats, and proteins in the small intestine. The bicarbonate-rich juice helps neutralize stomach acid. The liver (A) produces bile stored in the gallbladder (B), which aids in fat digestion. The spleen (D) is involved in immune function and blood filtration, not digestive enzyme production.

Question 6 of 9

A patient presents with pruritic, erythematous patches with silvery scales on the elbows, knees, and scalp. Which of the following conditions is most likely responsible for this presentation?

Correct Answer: B

Rationale: The correct answer is B: Psoriasis. Psoriasis is characterized by pruritic, erythematous patches with silvery scales, commonly found on the elbows, knees, and scalp. This presentation matches the patient's symptoms. Eczema (choice A) typically presents with red, inflamed, and itchy skin patches. Pityriasis rosea (choice C) manifests as a herald patch followed by smaller scaly patches in a "Christmas tree" distribution. Seborrheic dermatitis (choice D) involves oily, yellowish, scaly patches mainly on the scalp, face, and ears, and does not typically present with silvery scales.

Question 7 of 9

A patient is prescribed a selective serotonin reuptake inhibitor (SSRI) for the treatment of depression. Which adverse effect should the nurse monitor closely in the patient?

Correct Answer: C

Rationale: The correct answer is C: Hyponatremia. SSRI medications can lead to the syndrome of inappropriate antidiuretic hormone secretion (SIADH), causing hyponatremia. This occurs due to increased levels of serotonin affecting the hypothalamus, leading to excessive ADH release. Hyponatremia can result in neurological symptoms and must be closely monitored. A: Bradycardia is not a common adverse effect of SSRIs. B: Hyperkalemia is not typically associated with SSRIs. D: Hypertension is not a common adverse effect of SSRIs; they may actually lower blood pressure.

Question 8 of 9

Nurse Florence was asked by her Headnurse why she requested permission to enroll in the Graduate Program for the second semester. Her reply should be, EXCEPT:

Correct Answer: D

Rationale: The correct answer is D because Nurse Florence was asked why she requested permission to enroll in the Graduate Program for the second semester, not about her interest in Pediatric Nursing. A: Having an impressive resume to be competitive aligns with career advancement. B: Connecting with people professionally can lead to networking opportunities. C: Investing for the future implies long-term career growth. Therefore, D is the least relevant response to the question asked.

Question 9 of 9

A pregnant woman presents with fever, chills, and abdominal pain localized to the right upper quadrant. On examination, she has tenderness in the right upper abdomen and a positive Murphy's sign. Which of the following conditions is the most likely cause of these symptoms?

Correct Answer: C

Rationale: The scenario described in the question is consistent with acute cholecystitis, which is inflammation of the gallbladder usually caused by an impacted gallstone in the cystic duct. The key clinical features of acute cholecystitis include fever, chills, right upper quadrant abdominal pain (which can be localized to the right upper quadrant), tenderness in the right upper abdomen, and a positive Murphy's sign (pain and inspiratory arrest upon palpation of the right upper quadrant). This condition is more common in pregnant women due to hormonal changes that can lead to gallstone formation and subsequent inflammation of the gallbladder. Ectopic pregnancy, pelvic inflammatory disease, and ovarian torsion typically present with different clinical features compared to those described in acute cholecystitis.

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