A patient presents with a pruritic, annular rash with fine scaling and central clearing, affecting the trunk and proximal extremities. The patient reports recent exposure to a new soap and laundry detergent. Which of the following conditions is most likely responsible for this presentation?

Correct Answer: A

Rationale: The patient's presentation of a pruritic, annular rash with fine scaling and central clearing, affecting the trunk and proximal extremities, following exposure to a new soap and laundry detergent is most consistent with tinea corporis, commonly known as ringworm. Ringworm is a superficial fungal infection caused by dermatophytes that can present with circular or annular lesions with central clearing and scaling. The exposure to new soap and laundry detergent may have disrupted the skin's microbiome, making it more vulnerable to fungal infections like tinea corporis. Nummular eczema typically presents as coin-shaped plaques rather than annular lesions, while pityriasis rosea presents with a herald patch followed by smaller similar lesions in a "Christmas tree" distribution. Lichen planus would not typically be associated with exposure to new soap and laundry detergent but can have distinct purple, polygonal papules.

Correct Answer: B

Rationale: The patient's presentation of sudden-onset weakness and sensory loss on one side of the body, along with difficulty speaking and understanding speech that partially resolved within one hour, is consistent with a transient ischemic attack (TIA). TIAs are caused by temporary disruption of blood flow to a part of the brain, leading to transient neurological symptoms. Unlike an ischemic stroke, which results in permanent damage to brain tissue due to prolonged interruption of blood flow, TIAs are transient and resolve within 24 hours. Hemorrhagic strokes and subarachnoid hemorrhages typically present with sudden, severe headaches, and may not improve or resolve quickly as seen in this case.

Correct Answer: C

Rationale: The correct action for the nurse to take when observing signs of distress and discomfort in a patient during assessment is to offer emotional support and actively listen to the patient's concerns. Ignoring the patient's distress may lead to worsening of the patient's condition and can be detrimental to the patient's well-being. Documenting the findings and informing the healthcare provider later is important but should not be the immediate response when a patient is in distress. Administering pain medication without further assessment is also not appropriate as the nurse needs to understand the underlying cause of the distress before providing appropriate interventions. Offering emotional support and actively listening to the patient's concerns can help the nurse understand the patient's needs, provide comfort, and potentially address the root cause of the distress.

Correct Answer: C

Rationale: The described presentation of a yellowish-white spot on the cornea with branching, filamentous opacities is characteristic of fungal keratitis. Fungal keratitis is typically associated with agricultural injuries, trauma involving plant material, or contact lens wear in agricultural environments. Fungal keratitis can be serious and may require intensive antifungal treatment to prevent vision loss. Prompt diagnosis and initiation of appropriate antifungal therapy are essential in managing fungal keratitis.

Correct Answer: A

Rationale: Prolonged rupture of membranes (>24 hours) increases the risk of intrauterine infection for both the mother and the fetus. When the amniotic sac has been ruptured for an extended period, there is a higher likelihood of bacteria entering the uterus, leading to chorioamnionitis (inflammation of the fetal membranes due to infection). Intrauterine infection can be dangerous for both the mother and fetus, potentially causing sepsis, preterm labor, and other complications. Therefore, it is crucial for the nurse to assess for signs and symptoms of infection in both the mother and fetus when managing a woman in active labor with prolonged rupture of membranes.

Correct Answer: A

Rationale: The best response of Nurse Virgo is to explain to Patient Benito that his body needs to function well with his pancreas. The pancreas plays a critical role in the digestive system by producing digestive enzymes and hormones that help regulate blood sugar levels. Removing the pancreas would result in serious health consequences and complications, as the body relies on it for essential functions. It is important for the patient to understand the significance of the pancreas and why its removal is not a viable solution.

Correct Answer: D

Rationale: Nurse Rey can be liable of committing malpractice by performing circumcisions without the proper training, qualifications, and legal authority to do so. Malpractice refers to negligence or failure to provide a standard level of care that results in harm to a patient. In this case, Nurse Rey participating in performing circumcisions may not have the necessary skills and expertise compared to the doctors who are trained to perform such procedures. This can lead to potential harm or complications for the patients, making it a case of malpractice.

Correct Answer: C

Rationale: Incident reports are a crucial tool for capturing data on adverse events, near misses, and other incidents within a healthcare institution. These reports help in analyzing patterns, identifying areas for improvement, and implementing quality and safety measures. Therefore, incident reports themselves are not something that needs to be prevented; instead, they are a critical part of the risk management process to enhance patient safety and quality of care.

Correct Answer: A

Rationale: The primary indicator that Nurse Mary observes FIDELITY in the practice of her profession is that she faithfully promotes health and prevents disease. Fidelity in nursing practice refers to being faithful, loyal, and committed to providing the best care and services to patients. By faithfully promoting health and preventing disease, Nurse Mary demonstrates her dedication to her profession, her patients, and the community she serves. This commitment includes following evidence-based practices, upholding ethical standards, being honest and trustworthy, and ensuring the well-being of those under her care. Ultimately, fidelity in nursing practice builds trust and confidence among patients, families, and colleagues, leading to better health outcomes and a stronger healthcare system.