A patient presents with acute onset of severe vertigo, nausea, vomiting, and nystagmus. Symptoms are worsened with head movement. Which of the following neurological conditions is most likely responsible for these symptoms?

Correct Answer: B

Rationale: Vestibular neuritis is a condition characterized by the acute onset of severe vertigo, nausea, vomiting, and nystagmus. These symptoms are typically worsened by head movement. Vestibular neuritis is caused by inflammation of the vestibular nerve, which plays a key role in balance and spatial orientation. The classic presentation of these symptoms, along with the absence of hearing loss (which is seen in labyrinthitis), points towards vestibular neuritis as the most likely cause in this scenario. Meniere's disease presents with recurrent episodes of vertigo, hearing loss, tinnitus, and sensation of fullness in the ear. Benign paroxysmal positional vertigo (BPPV) is characterized by brief episodes of vertigo triggered by changes in head position.

Correct Answer: B

Rationale: The nurse's best response to a patient expressing fear of the unknown regarding an upcoming surgical procedure is to provide the patient with accurate information about the surgical procedure and what to expect. This approach empowers the patient with knowledge and helps alleviate anxiety by demystifying the unknown. By educating the patient about the procedure, potential risks, and postoperative care, the nurse can help the patient feel more prepared and in control of the situation. It is crucial for healthcare providers to address patient fears with compassion, understanding, and information to support the patient through the surgical process.

Correct Answer: B

Rationale: Vestibular neuritis is a condition characterized by the acute onset of severe vertigo, nausea, vomiting, and nystagmus. These symptoms are typically worsened by head movement. Vestibular neuritis is caused by inflammation of the vestibular nerve, which plays a key role in balance and spatial orientation. The classic presentation of these symptoms, along with the absence of hearing loss (which is seen in labyrinthitis), points towards vestibular neuritis as the most likely cause in this scenario. Meniere's disease presents with recurrent episodes of vertigo, hearing loss, tinnitus, and sensation of fullness in the ear. Benign paroxysmal positional vertigo (BPPV) is characterized by brief episodes of vertigo triggered by changes in head position.

Correct Answer: A

Rationale: The combination of recurrent joint pain, swelling, and limited range of motion in multiple joints along with elevated ESR, positive RF, and presence of anti-CCP antibodies is classic for rheumatoid arthritis (RA). Elevated ESR indicates inflammation, positive rheumatoid factor (RF) is an autoantibody commonly found in the serum of patients with RA, and the presence of anti-cyclic citrullinated peptide (anti-CCP) antibodies further supports the diagnosis of RA. These laboratory findings along with the clinical presentation are highly suggestive of rheumatoid arthritis. Systemic lupus erythematosus (SLE), ankylosing spondylitis (AS), and psoriatic arthritis (PsA) can have overlapping symptoms with RA, but the specific combination of elevated ESR, positive RF, and anti-CCP antibodies points more towards RA in this scenario.

Correct Answer: C

Rationale: Assessing the mental status of the patient is the PRIORITY nursing action to determine the patient's ability to concentrate and focus. This assessment includes evaluating the patient's level of alertness, orientation, memory, thought processes, and mood. By observing the patient's mental status, the nurse can gain valuable information about the patient's cognitive function, attention span, and ability to concentrate. This assessment will help guide further interventions and care planning for the patient. Asking for academic performance or conducting paper and pencil tests may be useful tools to assess concentration and focus, but they should come after a comprehensive evaluation of the patient's mental status. Referring the patient to a psychiatrist may be necessary based on the assessment findings, but it should not be the first step in determining the patient's ability to concentrate and focus.

Correct Answer: B

Rationale: Mood swings are recognized as a typical part of a normal pregnancy due to the hormonal changes that occur. Pregnant individuals may experience a wide range of emotions, from joy and elation to frustration and irritability. These fluctuations in mood are considered normal and not necessarily indicative of a more serious issue. It is essential for pregnant women to receive support and understanding during this time as they navigate the emotional ups and downs of pregnancy. Feelings being easily hurt by remarks (A) and narcissism (D) are not typically accepted as part of a normal pregnancy and may require further attention or support. While finding a situation amusing or charming (C) can be a positive experience, it is not specifically indicative of a normal emotional reaction during pregnancy.

Correct Answer: C

Rationale: The symptoms described, including progressive weakness, muscle atrophy, fasciculations, dysphagia, and dysarthria primarily involving the upper and lower extremities, are classic features of amyotrophic lateral sclerosis (ALS), also known as Lou Gehrig's disease. ALS is a progressive neurodegenerative disorder that affects the motor neurons in the brain and spinal cord, leading to muscle weakness and atrophy. As the disease progresses, patients may develop difficulty swallowing (dysphagia) and speaking (dysarthria). In contrast, Parkinson's disease primarily involves movement-related symptoms such as tremors, muscle stiffness, and slow movements. Guillain-Barré syndrome (GBS) is an acute inflammatory demyelinating polyneuropathy that typically presents with ascending weakness and sensory abnormalities, often preceded by an infection. Myasthenia gravis is characterized by muscle weakness exacerbated by

Correct Answer: B

Rationale: Vitamin K is essential for the production of several clotting factors in the liver, including factors II, VII, IX, and X. In a patient with chronic liver disease, impaired liver function can lead to decreased synthesis of these clotting factors. As a result, there is an underlying deficiency of these clotting factors, leading to prolonged PT (prothrombin time) and aPTT (activated partial thromboplastin time). The mixing studies showing correction with normal plasma further support the diagnosis of a factor deficiency rather than an inhibitor, which helps in ruling out conditions like DIC or hemophilia.

Correct Answer: D

Rationale: Administering oxygen inhalation is the priority nursing action for a patient presenting with clinical manifestations related to endocrine disorders. Patients with hyperthyroidism, Cushing syndrome, and hypothyroidism can all experience respiratory distress due to various reasons such as thyroid storm, adrenal crisis, or myxedema coma. Oxygen inhalation helps improve oxygenation and tissue perfusion, providing immediate support to the patient's respiratory system. It is crucial to ensure adequate oxygenation before addressing other assessments or interventions. Once the patient's breathing is stabilized, further assessments and treatments can be initiated as necessary.