A patient presents with abdominal pain, fever, and peripheral blood smear showing fragmented red blood cells (schistocytes). Laboratory tests reveal elevated lactate dehydrogenase (LDH), decreased haptoglobin, and increased indirect bilirubin. Which of the following conditions is most likely to cause these findings?

Correct Answer: B

Rationale: Thrombotic thrombocytopenic purpura (TTP) is a rare blood disorder characterized by microangiopathic hemolytic anemia, thrombocytopenia, fever, neurological abnormalities, and renal dysfunction. The peripheral blood smear in TTP typically shows fragmented red blood cells (schistocytes) due to mechanical destruction within small blood vessels. Laboratory findings in TTP commonly include elevated lactate dehydrogenase (LDH), decreased haptoglobin (as it is consumed in the clearance of free hemoglobin), and increased indirect bilirubin due to increased red blood cell breakdown. This combination of clinical presentation and laboratory abnormalities is classic for TTP. Hemolytic uremic syndrome (HUS) may present similarly but is more commonly associated with renal dysfunction and is often triggered by infection with Shiga toxin-producing E. coli.

Correct Answer: C

Rationale: False imprisonment is the act of improperly restraining another individual against their will. In this scenario, the nurse's threat of putting the client into seclusion and administering an injection to restrain them for inappropriate behavior constitutes false imprisonment. The client is being restricted in their movement without valid reason or proper procedure. This type of action is not acceptable in healthcare settings and violates the client's rights. It is important for healthcare professionals to use appropriate de-escalation techniques and interventions to manage challenging behaviors without resorting to threats of physical restraint.

Correct Answer: B

Rationale: The statement "Multigravida patient has shorter labor" is the best response to Patient Josephine's question about her shorter labor compared to previous deliveries. In obstetrics, it is commonly observed that labor tends to be shorter in patients who have had previous pregnancies (multigravida patients) due to factors such as prior cervical changes and previous stretching of the birth canal. This phenomenon is known as "multigravida cervical efficiency," and it can lead to faster and more efficient labors in subsequent pregnancies for women who have had previous deliveries.

Correct Answer: C

Rationale: The description provided is classical for fungal keratitis. Fungal keratitis typically presents with a yellowish-white spot on the cornea, often surrounded by a ring of inflammation. Branching, filamentous opacities extending from the corneal lesion are commonly seen on slit-lamp examination in cases of fungal keratitis. This condition is often associated with risk factors such as trauma with organic material or contact lens wear. Prompt diagnosis and treatment with antifungal agents are crucial in managing fungal keratitis to prevent potential complications.

Correct Answer: C

Rationale: Humoral immunity is primarily responsible for protecting against infections by pathogens like viruses. In the case of the hepatitis B virus (HBV), the individual is exposed to the virus and develops immunity, which is typically mediated by antibodies produced by B cells. These antibodies circulate in the blood and can neutralize the virus, preventing future infections. This type of immunity is known as humoral immunity, as it involves the production of antibodies that target specific antigens, such as those present on the surface of the hepatitis B virus. In contrast, passive immunity is when antibodies are transferred from an external source, innate immunity provides immediate, non-specific defenses against pathogens, and cell-mediated immunity involves the activation of T cells to combat intracellular pathogens.

Correct Answer: B

Rationale: Nurse Florence needs to attain a certain number of continuing Professional Development units in order to renew her Professional License. Continuing Professional Development ensures that nurses stay up-to-date with the latest advancements and best practices in the field, ultimately leading to improved patient care outcomes. Renewing the Professional License is crucial for Nurse Florence to legally practice nursing and demonstrate her commitment to ongoing learning and development in the profession.

Correct Answer: B

Rationale: Radiologic procedures are typically not used as the least screening assessment by nurses in a perinatal unit. The nurse's initial screening assessments usually focus on gathering information through techniques such as physical examination, interviews, and reviewing laboratory results. Radiologic procedures, such as X-rays or CT scans, are usually ordered by physicians once a more specific diagnostic need has been identified, based on the initial screening assessments performed by the nurse. Therefore, in this scenario, the least screening assessment to be used by the nurse would be radiologic procedures.

Correct Answer: C

Rationale: Neuman's adaptation model, also known as the Neuman Systems Model, is a nursing theory that focuses on how individuals respond to stressors in their environment. The model views individuals as being in a constant state of dynamic equilibrium, where they are interacting with stressors that can disrupt their normal functioning. Nursing care, according to this model, is aimed at helping individuals maintain or restore their optimal level of wellness by assisting them in adapting to these stressors. Therefore, Nurse Sandy's selection of a framework that emphasizes the constant relationship between humans and stressors in the environment aligns best with Neuman's adaptation model.

Correct Answer: B

Rationale: The symptoms described - gradual-onset weakness, spasticity, hyperreflexia, positive Babinski sign, and demyelinating plaques in the white matter of the brain and spinal cord - are indicative of multiple sclerosis (MS). MS is an autoimmune disease where the body's immune system attacks the myelin sheath, leading to the formation of plaques in the central nervous system. The characteristic symptoms of MS include weakness, spasticity (stiffness in muscles), hyperreflexia (exaggerated reflex responses), and positive Babinski sign (upward movement of the big toe). While ALS (Amyotrophic lateral sclerosis) presents with progressive muscle weakness and atrophy without sensory involvement and demyelinating plaques, Guillain-Barré syndrome (GBS) is typically an acute inflammatory demyelinating polyneuropathy affecting peripheral nerves rather than the central nervous system, and myast