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: A

Rationale: The nurse should monitor serum potassium levels closely during ACE inhibitor therapy because ACE inhibitors can lead to an increase in serum potassium levels, known as hyperkalemia. ACE inhibitors block the conversion of angiotensin I to angiotensin II, which in turn decreases aldosterone secretion. Aldosterone normally acts in the kidneys to reabsorb sodium and water and excrete potassium. Therefore, when aldosterone secretion is decreased due to ACE inhibitor therapy, there can be an increase in potassium retention, potentially leading to hyperkalemia. Monitoring serum potassium levels is essential to prevent complications associated with hyperkalemia, such as cardiac arrhythmias.

Correct Answer: D

Rationale: Failed to generate a rationale of 500+ characters after 5 retries.

Correct Answer: A

Rationale: Patients with COPD are at increased risk for developing ventilator-induced lung injury (VILI) due to their underlying lung pathology. Using a low tidal volume strategy (6-8 ml/kg predicted body weight) has been shown to reduce the risk of VILI in these patients. Additionally, applying high positive end-expiratory pressure (PEEP) helps to recruit collapsed alveoli, improve oxygenation, and decrease the risk of barotrauma by keeping the alveoli open throughout the respiratory cycle. Therefore, the most appropriate ventilator settings to minimize the risk of VILI in a COPD patient with acute exacerbation and respiratory failure requiring mechanical ventilation would be low tidal volume and high PEEP.

Correct Answer: B

Rationale: Encouraging the patient to practice controlled coughing techniques would be the most appropriate intervention to address the symptoms of chronic cough and excessive sputum production in a patient with end-stage COPD receiving palliative care. Controlled coughing techniques can help the patient effectively clear respiratory secretions and improve airway clearance without the need for additional medications or interventions. This approach focuses on optimizing the patient's ability to manage their symptoms and maintain comfort, which aligns with the goals of palliative care. Administering bronchodilator medications, prescribing mucolytic medications, or referring the patient to a respiratory therapist for breathing exercises may have limited effectiveness in this advanced stage of the disease, and controlled coughing techniques would be a more practical and patient-centered approach to symptom management.

Correct Answer: A

Rationale: The parotid gland is the salivary gland that is located superior and anterior to the ear. It mainly produces serous saliva, which is a thin, watery fluid rich in enzymes. The other salivary glands mentioned are the sublingual gland, submandibular gland, and submaxillary gland, all of which have different locations and produce different types of saliva.

Correct Answer: A

Rationale: The Professional Regulation Commission (PRC) in the Philippines requires nurses like Nurse Merle to comply with 45 units of Continuing Professional Development (CPD) in order to renew their license and continually practice nursing. This is a mandatory requirement to ensure that nurses stay updated with the latest advancements, skills, and knowledge in the field of nursing. By completing the required CPD units, Nurse Merle can enhance her competency, maintain her license, and provide quality care to her patients.

Correct Answer: C

Rationale: Anticonvulsant medications, such as phenytoin and phenobarbital, can interfere with pregnancy tests by affecting the levels of human chorionic gonadotropin (hCG) in the body. HCG is the hormone detected in pregnancy tests. These medications may potentially lead to a false-negative result on a pregnancy test for women who are actually pregnant. Therefore, in the case of Almira, who is 6 months pregnant and taking anticonvulsant medication due to the risk of producing a false-negative pregnancy test result, healthcare providers should consider other clinical indicators, such as abdominal cramps and vaginal spotting, to assess her pregnancy status.

Correct Answer: B

Rationale: The primary aim of this law is to regulate the practice of professional nursing within the country. By establishing regulations, standards, and guidelines for nursing practice, the law ensures that nurses provide safe and competent care to patients. It also sets forth licensing requirements, scope of practice, and ethical standards to maintain quality and consistency in nursing care delivery. While enhancing the competence of professional nurses, facilitating mobility of nurses, and promoting the well-being of health workers may be important secondary goals, the main focus of the law is to regulate and govern the practice of nursing within the country.