A patient presents with bone pain, fatigue, and frequent infections. Laboratory tests reveal pancytopenia, hypocellular bone marrow, and absence of reticulocytes. Which of the following conditions is most likely to cause these findings?

Correct Answer: A

Rationale: Aplastic anemia is a condition characterized by a reduction in the number of all three blood cell types: red blood cells, white blood cells, and platelets. The patient's presentation of bone pain, fatigue, frequent infections, pancytopenia (decreased counts of all blood cell types), hypocellular bone marrow (reduced cellularity in the bone marrow), and absence of reticulocytes is indicative of aplastic anemia.

Correct Answer: C

Rationale: When a patient is at risk of falls due to an impaired gait, a physical therapist would be the most appropriate member of the multidisciplinary team for the nurse to collaborate with. Physical therapists specialize in improving mobility, balance, and coordination through exercises, gait training, and other interventions. They can assess the patient's gait pattern, strength, and balance, and develop a personalized plan to address the impairments contributing to the fall risk. By working closely with a physical therapist, the nurse can help the patient improve their gait and reduce the risk of falls, ultimately promoting safety and independence.

Correct Answer: C

Rationale: If Jose is complaining of dyspnea despite continuous oxygen therapy, the nurse's initial intervention should be to assess the patency of the tubing delivering the oxygen. A blockage in the tubing could restrict the flow of oxygen to the patient, leading to inadequate oxygen delivery and worsening dyspnea. By ensuring the tubing is clear and functioning properly, the nurse can address a potential issue with oxygen delivery before considering other interventions like giving PRN medication or involving the physician. Re-assessing the patient would also be important after ensuring the tubing's patency to evaluate the effectiveness of the intervention.

Correct Answer: C

Rationale: The described presentation of a yellowish-white spot on the cornea with branching, filamentous opacities is characteristic of fungal keratitis. Fungal keratitis is typically associated with agricultural injuries, trauma involving plant material, or contact lens wear in agricultural environments. Fungal keratitis can be serious and may require intensive antifungal treatment to prevent vision loss. Prompt diagnosis and initiation of appropriate antifungal therapy are essential in managing fungal keratitis.

Correct Answer: B

Rationale: The presentation of knee pain and swelling following a fall onto a flexed knee, along with a palpable effusion and tenderness along the joint line, is highly suggestive of a meniscus injury. The McMurray's test specifically evaluates for meniscal tears. In this case, the presence of pain and clicking with passive knee flexion and internal rotation indicates a medial meniscus tear as the most likely diagnosis. Patellar tendinitis usually presents with anterior knee pain that is worsened by activities such as jumping or running. Lateral collateral ligament (LCL) sprain typically presents with lateral knee pain and instability. Quadriceps tendon rupture would present with significant weakness and inability to fully extend the knee, which is not described in this scenario.

Correct Answer: B

Rationale: Streptococcus pneumoniae is the most common causative organism of bacterial pneumonia in adults. It is responsible for the majority of community-acquired pneumonia cases. Streptococcus pneumoniae is a gram-positive bacteria and is known to cause typical pneumonia characterized by sudden onset of high fever, productive cough with blood-tinged or rust-colored sputum, chest pain, and consolidation on chest imaging. Other organisms like Legionella pneumophila (choice A), Mycoplasma pneumoniae (choice C), and Haemophilus influenzae (choice D) can also cause pneumonia, but Streptococcus pneumoniae is the most likely culprit based on the patient's test results.

Correct Answer: C

Rationale: When a patient with terminal cancer experiences dyspnea (difficulty breathing) and anxiety, opioid medications are often prioritized by palliative care providers for symptom management. Opioids are effective in relieving dyspnea by acting as respiratory depressants and reducing the feeling of air hunger. Additionally, opioids have sedative effects that can help alleviate anxiety and promote relaxation. Therefore, in this situation, prescribing opioid medications would be the most appropriate intervention to address both the dyspnea and anxiety symptoms simultaneously. Oxygen therapy, relaxation techniques, and breathing exercises may also be useful adjunctive interventions, but opioid medications are typically prioritized for immediate symptom relief in this context.

Correct Answer: A

Rationale: The correct practice in this situation would be to have a dedicated fire extinguisher in every strategic location throughout the hospital. Having fire extinguishers readily available in key areas ensures that they can be accessed quickly in case of a fire emergency. Placing one fire extinguisher between two units may not be sufficient as it may not be easily accessible in the event of a fire. Fire extinguishers should not be replaced with fire sensors as these serve different functions. Additionally, borrowing fire extinguishers may not be a safe or reliable practice, as they should be properly maintained and placed according to safety standards. Therefore, having dedicated fire extinguishers in every strategic location is the best practice to ensure the safety and well-being of individuals in the hospital.

Correct Answer: A

Rationale: The most likely causative agent in this scenario is Plasmodium falciparum, which is the parasite that causes malaria. The symptoms of fever, chills, headache, and myalgia following a camping trip are highly suggestive of malaria, especially if the patient has thrombocytopenia and leukopenia. Plasmodium falciparum is known to cause severe malaria with complications such as thrombocytopenia and leukopenia. The other options, Trypanosoma cruzi, Borrelia burgdorferi, and Leishmania donovani, do not typically present with all of the symptoms described and are not associated with the laboratory findings of thrombocytopenia and leukopenia.