A patient in the ICU develops acute exacerbation of chronic obstructive pulmonary disease (COPD) characterized by worsening dyspnea and increased sputum production. What intervention should the healthcare team prioritize to manage the patient's exacerbation?

Correct Answer: B

Rationale: The correct answer is B: Initiate non-invasive positive pressure ventilation (NIPPV) for respiratory support. In acute exacerbations of COPD, NIPPV helps improve ventilation and oxygenation, reducing the work of breathing and preventing the need for intubation. This intervention is a priority as it can rapidly stabilize the patient's respiratory status. A: Administering bronchodilator medications is important in COPD management, but in severe exacerbations, NIPPV takes precedence. C: Arterial blood gas analysis is important for assessing oxygenation and ventilation status, but it does not directly address the acute respiratory distress. D: Chest physiotherapy can help with airway clearance in COPD, but in acute exacerbations, respiratory support with NIPPV is more urgent.

Correct Answer: C

Rationale: The correct answer is C: Nasal polyps. Nasal polyps are benign growths that form in the nasal cavity and sinuses, leading to symptoms such as chronic nasal congestion, hyposmia, and anosmia. The presence of polypoid masses seen on nasal endoscopy is characteristic of nasal polyps. Rationale: 1. Chronic nasal congestion, hyposmia, and anosmia are common symptoms of nasal polyps. 2. Nasal endoscopy revealing polypoid masses confirms the presence of nasal polyps. 3. Allergic rhinitis may cause nasal congestion but does not typically present with polypoid masses. 4. Chronic sinusitis can cause nasal congestion but is usually associated with inflammation of the sinuses, not just polypoid masses. 5. A deviated nasal septum can lead to nasal congestion but does not typically cause polypoid masses obstructing the nasal cavity and sinuses.

Correct Answer: A

Rationale: The correct answer is A: Pulmonary embolism. This is the most likely cause of the symptoms based on the presentation of chest pain, dyspnea, hemoptysis, and a mismatched defect on the V/Q scan. A pulmonary embolism occurs when a blood clot travels to the lungs, causing a blockage in the pulmonary artery. This can lead to symptoms like chest pain, shortness of breath, and coughing up blood. The V/Q scan showing a mismatched defect indicates a ventilation-perfusion mismatch, which is a classic finding in pulmonary embolism. Pericarditis (B), acute myocardial infarction (C), and aortic dissection (D) typically present with different sets of symptoms and do not match the V/Q scan findings in this case.

Correct Answer: C

Rationale: The correct answer is C because communicating with the patient's primary care provider and community resources demonstrates continuity of care. This action ensures a seamless transition from the hospital to home by keeping all involved parties informed and involved in the patient's care. Option A (written discharge instructions only) may provide information but lacks coordination with other healthcare providers. Option B (discharging without follow-up care coordination) can lead to gaps in care. Option D (disregarding patient concerns) goes against patient-centered care and can disrupt the continuity of care.

Correct Answer: C

Rationale: Step 1: Previous pregnancy experience is crucial for understanding the patient's obstetric history and potential risks. Step 2: It helps in identifying any complications or issues that may arise during the current pregnancy. Step 3: Laboratory results, prenatal check-up records, and diagnostic test results provide additional information but do not offer insights into the patient's past pregnancy experiences. Summary: Choice C is the most important as it directly relates to the patient's obstetric history, while the other options focus on current data that may not provide the same level of context.

Correct Answer: C

Rationale: The correct answer is C: Primary prevention. In this scenario, the clinic focuses on preventing disease before it occurs through health education and immunization. Primary prevention aims to promote general health and prevent the onset of diseases. It targets the entire population to reduce the risk of disease occurrence. Incorrect Choices: A: Diagnosis and treatment - This choice involves identifying and treating existing health conditions, which is not the primary focus of a clinic designed for health education and immunization. B: Secondary prevention - This choice involves early detection and treatment of diseases to prevent complications, which is more focused on individuals who already have risk factors or symptoms, not on the general population. D: Tertiary prevention - This choice involves managing and treating complications of diseases to prevent further deterioration, which is not the primary goal of a clinic focused on health education and immunization.

Correct Answer: C

Rationale: Step 1: Job description is crucial for clarifying roles and responsibilities, ensuring staff understand their duties. Step 2: Regular review of job descriptions helps align staff performance with organizational goals and expectations. Step 3: It allows for identifying areas of improvement and providing necessary support and resources. Step 4: Academic performance in college, family dynamics, and number of incident reports are not directly related to work performance. Summary: Regularly reviewing staff job descriptions is essential for enhancing performance by clarifying roles, aligning expectations, and identifying areas for improvement. Other choices lack direct relevance to work performance.

Correct Answer: C

Rationale: The correct answer is C: Acquired von Willebrand syndrome. This condition is characterized by a defect in von Willebrand factor function, leading to prolonged bleeding time and mucocutaneous bleeding. Normal platelet count rules out Glanzmann thrombasthenia and Bernard-Soulier syndrome which are platelet disorders. Normal PT and aPTT rule out Hemophilia A, a coagulation factor deficiency. Acquired von Willebrand syndrome is the most likely cause based on the clinical presentation and laboratory findings.

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.