A patient presents with acute onset of shoulder pain and limited range of motion after a fall onto an outstretched hand. Physical examination reveals tenderness over the greater tuberosity of the humerus and pain with passive abduction and external rotation of the shoulder. Which of the following conditions is most likely?

Correct Answer: A

Rationale: The correct answer is A: Rotator cuff tear. The presentation of acute shoulder pain and limited range of motion after a fall onto an outstretched hand, along with tenderness over the greater tuberosity and pain with passive abduction and external rotation, is classic for a rotator cuff tear. The mechanism of injury and physical exam findings are consistent with this condition. B: Glenohumeral dislocation typically presents with a visibly deformed shoulder and loss of normal shoulder contour. C: Acromioclavicular joint separation would present with tenderness over the AC joint rather than the greater tuberosity, and typically involves a history of direct trauma to the shoulder. D: Proximal humerus fracture would present with more diffuse shoulder pain and swelling, and not specific tenderness over the greater tuberosity.

Correct Answer: C

Rationale: The correct answer is C: Group A beta-hemolytic Streptococcus (GAS). GAS is the most likely organism responsible for this presentation, known as acute bacterial tonsillitis. GAS commonly causes symptoms such as throat pain, odynophagia, fever, tonsillar enlargement with exudates, and cervical lymphadenopathy. Streptococcal pharyngitis is a common bacterial infection of the throat caused by GAS. The other options are less likely as Streptococcus pneumoniae typically causes pneumonia and Haemophilus influenzae is associated with respiratory tract infections. Epstein-Barr virus (EBV) commonly causes infectious mononucleosis, which presents with different symptoms than those described in the question.

Correct Answer: B

Rationale: The correct answer is B because disclosing a patient's HIV status to family members violates the patient's right to privacy and confidentiality. Patient confidentiality is a fundamental aspect of the Patient's Bill of Rights, ensuring that personal health information is protected. The other choices (A, C, D) do not directly violate the Patient's Bill of Rights. Choice A relates to transparency in billing, choice C is about honesty in communication, and choice D is about timely communication with the physician, all of which are in line with patient rights and quality care.

Correct Answer: A

Rationale: The correct answer is A: Bleeding. Chemotherapy can lead to low platelet counts (thrombocytopenia), increasing the risk of bleeding. The priority goal of the nurse is to prevent bleeding by taking precautions such as avoiding invasive procedures, using soft toothbrushes, and monitoring for signs of bleeding. Infection (B) is important but not the priority as bleeding can be life-threatening. Hypotension (C) is not directly related to thrombocytopenia. Diarrhea (D) is a potential side effect of chemotherapy but is not the priority when considering thrombocytopenia.

Correct Answer: D

Rationale: The correct answer is D: Diabetes insipidus. This condition is characterized by excessive thirst, large volumes of dilute urine, low urine osmolality, hypernatremia, and elevated serum osmolality. The underlying cause is a deficiency in or insensitivity to antidiuretic hormone (ADH), leading to the inability of the kidneys to concentrate urine properly. Hyperthyroidism (choice A) and hypothyroidism (choice B) do not directly affect urine concentration. While diabetes mellitus (choice C) can also present with polyuria and polydipsia, it would typically have high urine osmolality due to the presence of glucose. Therefore, diabetes insipidus is the most likely endocrine disorder responsible for these specific symptoms.

Correct Answer: C

Rationale: Rationale: C is correct as keeping the ulcer covered with a sterile dressing provides a barrier against pathogens, promoting wound healing and preventing infection. A (topical antibiotics) can lead to resistance and disrupt normal flora. B (daily wound debridement) may introduce pathogens and delay healing. D (oral antibiotics prophylactically) is not recommended without evidence of infection.

Correct Answer: C

Rationale: The correct answer is C: Malpractice. Malpractice refers to professional negligence or failure to perform duties according to accepted standards of practice. In this scenario, the surgeon's act of cutting the patient's bladder during an appendectomy could be considered a breach of duty and failure to provide the expected standard of care, which falls under malpractice. Battery (A) involves intentional harmful or offensive contact without consent. Negligence (B) is the failure to exercise reasonable care, but in this case, it was more than just a lack of care. Tort (D) refers to a civil wrong that causes harm, but malpractice is a specific type of tort related to professional negligence.

Correct Answer: B

Rationale: The correct answer is B because an empowered nurse feels in control and valued, leading to job satisfaction. Enthusiasm shows motivation and engagement with their work. Being ethical indicates a commitment to moral principles, contributing to a sense of fulfillment. Choice A is incorrect as competitiveness and self-centeredness do not necessarily equate to job satisfaction. Euphoria may not be a sustainable indicator of satisfaction. Choice C is incorrect because being a loner and egoistic are not traits associated with job satisfaction. Reactivity may suggest a lack of control or frustration. Choice D is incorrect as being outgoing and competitive might not directly translate to job satisfaction. Sensitivity alone does not guarantee satisfaction in the workplace.

Correct Answer: B

Rationale: Step 1: Furosemide is a loop diuretic that works in the ascending loop of Henle to inhibit sodium and chloride reabsorption. Step 2: Inhibition of sodium reabsorption leads to increased water and electrolyte excretion, including potassium. Step 3: Increased potassium excretion can lead to hypokalemia, which is a common side effect of loop diuretics like furosemide. Step 4: Hypokalemia can be dangerous, especially in patients with congestive heart failure, as it can worsen cardiac function and lead to arrhythmias. Step 5: Therefore, patients with a history of congestive heart failure prescribed furosemide are at risk for developing hypokalemia due to increased potassium excretion.