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: The diagnosis of contact latex allergy is primarily based on the patient's history of exposure to latex-containing products and the development of symptoms upon contact with latex. To confirm the diagnosis, skin patch testing is performed. Skin patch testing exposes the skin to small amounts of latex allergens to observe for any localized allergic reaction, such as redness, swelling, or itchiness. This test helps determine if the individual has developed a delayed-type hypersensitivity reaction to latex. Latex-specific IgE testing (choice A) and finding IgE in serum (choice B) are methods used in diagnosing immediate-type latex allergy but are not sufficient for confirming contact latex allergy specifically. ELISA (choice D) is a type of laboratory technique used for various purposes, including measuring the levels of specific substances in the blood, but it is not typically used as a diagnostic tool for contact latex allergy.

Correct Answer: C

Rationale: A dental abscess is characterized by a localized collection of pus that results from a bacterial infection of the tooth pulp, leading to swelling, pain, and inflammation. The infection typically occurs when bacteria enter the tooth through a cavity, crack, or other dental injury. The abscess can cause significant pain and discomfort and must be treated promptly by a dentist to prevent further complications. Dental caries refer to tooth decay or cavities that result from the breakdown of tooth structure by acids produced by bacteria. Periodontitis is a severe gum infection that damages the soft tissue and destroys the bone that supports the teeth. Oral candidiasis is a fungal infection that affects the mouth and throat.

Correct Answer: A

Rationale: A strong team is cohesive, meaning its members work well together, communicate effectively, and support each other. Cohesion helps the team to function smoothly and achieve its goals efficiently. While being driven, having shared goals, and a sense of mission are important characteristics of a strong team, cohesion is the foundation that holds the team together and allows these other factors to thrive.

Correct Answer: B

Rationale: Malpractice is a type of tort that involves professional negligence or misconduct by a professional such as a nurse that results in harm to a patient. In this scenario, failing to obtain informed consent before performing a procedure is considered a breach of the standard of care expected from a healthcare professional, which falls under malpractice. This failure to obtain informed consent deprives the patient of the right to make an informed decision about their treatment and can lead to legal consequences for the nurse.

Correct Answer: A

Rationale: Multiple myeloma is a type of cancer that develops in plasma cells, which are a type of white blood cells involved in the body's immune response. As a result, multiple myeloma primarily affects the hematologic system, which includes the blood and blood-forming tissues. This cancer typically arises in the bone marrow and can lead to an overproduction of abnormal plasma cells, which can crowd out healthy blood cells. Symptoms of multiple myeloma can include anemia, bone pain, recurrent infections, fatigue, and kidney problems, all of which are related to the hematologic system.

Correct Answer: A

Rationale: Difficulty of speaking and chewing is an indicator of cranial nerve involvement. Cranial nerves are responsible for controlling various functions of the head and neck, including speech and mastication. Impairment of cranial nerve function can lead to difficulty in these activities. In the context of the question, with the patient in the stroke unit, cranial nerve involvement can occur due to the stroke affecting the brain regions responsible for cranial nerve function. Loss of pain sensation, spastic paralysis of the extremities, and forgetfulness with syncope are not specific indicators of cranial nerve involvement in this scenario.

Correct Answer: C

Rationale: Periodontitis is the dental condition characterized by inflammation and destruction of the supporting structures of the teeth, including the gingiva (gums), periodontal ligament, and alveolar bone. It is usually caused by untreated gingivitis, where plaque buildup along the gumline leads to bacterial infection and inflammation, resulting in destruction of the tissues that support the teeth. If left untreated, periodontitis can lead to tooth loss and other complications. Gingivitis, on the other hand, is inflammation of the gums without involvement of the supporting structures, while dental caries refer to tooth decay or cavities in the enamel. Dental abscess is a localized collection of pus caused by a bacterial infection.

Correct Answer: B

Rationale: Guillain-Barré Syndrome (GBS) is characterized by ascending motor weakness, starting typically in the lower extremities and progressing upwards. Patients with GBS often verbalize the early onset of symptoms as weakness starting in the legs and potentially spreading to involve the arms and sometimes the face. Therefore, the common verbalization of the patient with GBS regarding the early onset of symptoms is ascending motor weakness. Acute hemiplegia (choice A) and acute hemiparesis (choice D) involve weakness or paralysis typically limited to one side of the body, which is not a characteristic presentation of GBS. Weakness of the four lower extremities (choice C) is also not a typical description in GBS as the weakness usually starts distally and progresses proximally.