A patient presents with crushing chest pain that lasts longer than 20 minutes, diaphoresis, and dyspnea. An electrocardiogram (ECG) shows ST-segment elevation in the anterior leads. Which cardiovascular disorder is most likely responsible for these symptoms?

Correct Answer: C

Rationale: The patient is most likely experiencing an acute myocardial infarction (MI) based on the presentation of crushing chest pain lasting longer than 20 minutes, diaphoresis, dyspnea, and ST-segment elevation on the ECG. These symptoms are consistent with the classic presentation of an ST-segment elevation myocardial infarction (STEMI), which is a type of acute MI that is characterized by prolonged ischemia leading to myocardial cell death. In this case, the ST-segment elevation in the anterior leads indicates myocardial damage in the corresponding area of the heart supplied by the affected coronary artery. This is a medical emergency that requires urgent intervention to restore blood flow to the affected myocardium and prevent further complications.

Correct Answer: C

Rationale: The presentation of persistent, severe headache, visual disturbances, and epigastric pain in a postpartum client could indicate the development of postpartum preeclampsia or eclampsia, which are serious conditions that require immediate medical attention. Prompt notification of the healthcare provider is essential to ensure timely assessment, diagnosis, and treatment to prevent potential complications for both the mother and baby. Encouraging rest, providing acetaminophen, or offering a massage are not appropriate interventions for addressing these symptoms, as they do not address the underlying cause and urgency of the situation.

Correct Answer: A

Rationale: The ethical principle that should guide the nurse's decision-making in this situation is beneficence, which emphasizes the nurse's obligation to act in the best interest of the patient. In this scenario, the nurse must balance the patient's request for pain medication with considerations related to the patient's history of substance abuse. The nurse should prioritize providing effective pain relief for the patient while also considering the potential risks of administering medication to someone with a history of substance abuse. By focusing on beneficence, the nurse can make decisions that promote the well-being and best interests of the patient, taking into account both the immediate need for pain relief and the patient's history of substance abuse.

Correct Answer: B

Rationale: To assess the strengths and weaknesses of the organization, the nurse should employ a strategic plan. A strategic plan involves setting overall goals, objectives, and strategies for the organization. It provides a comprehensive framework for evaluating the current state of the organization, identifying areas of improvement, and aligning resources to achieve long-term success. By using a strategic plan, the nurse can conduct a thorough analysis of the organization's internal and external factors, including its strengths and weaknesses, to determine the most effective course of action for the future.

Correct Answer: B

Rationale: Guava leaves are recommended by the Department of Health as a remedy for cough due to their natural expectorant properties. The leaves contain compounds that help to loosen mucus and make it easier to expel, providing relief from cough and congestion. Guava leaves are commonly used in traditional medicine for respiratory conditions such as cough, bronchitis, and asthma. They help soothe the throat, reduce inflammation, and promote overall respiratory health. It is important to note that while guava leaves can be a helpful remedy for cough, they should be used in conjunction with other treatments as advised by healthcare professionals for best results.

Correct Answer: D

Rationale: In a 55-year-old postmenopausal woman presenting with vaginal bleeding and a healthy cervix on examination, the most likely cause would be a cervical polyp. Cervical polyps are benign growths that can occur on the cervix and are often asymptomatic but can occasionally cause postmenopausal bleeding. Their appearance on examination would typically be a non-malignant finding with no cervical motion tenderness. Cervical cancer, endometrial cancer, and vaginal cancer would typically present with different examination findings and risk factors.

Correct Answer: A

Rationale: Quality improvement measures are most effective when everyone within an organization is involved. This includes not only professional and management staff but also consumers or customers who are directly impacted by the products or services being provided. By involving everyone, a more comprehensive and diverse perspective can be gained, leading to better identification of areas for improvement and more successful implementation of quality improvement initiatives. Additionally, by involving all stakeholders, there is a greater buy-in and commitment to the process, increasing the likelihood of sustainable improvements being made.

Correct Answer: D

Rationale: The presentation described in the question – sudden-onset unilateral headache along with ipsilateral ptosis, miosis, and anhidrosis – is characteristic of Horner syndrome. Horner syndrome is caused by disruption of the sympathetic nerve pathway and can occur in trigeminal neuralgia. Trigeminal neuralgia is a painful condition affecting the trigeminal nerve commonly characterized by sudden and severe facial pain that can be triggered by various stimuli. The involvement of the sympathetic pathway in trigeminal neuralgia can lead to Horner syndrome symptoms such as ptosis (drooping eyelid), miosis (constricted pupil), and anhidrosis (lack of sweating) on the affected side of the face. Cluster headaches usually involve severe unilateral pain around the eye, but they do not typically present with Horner syndrome symptoms. Migraine and tension-type headaches also do not typically present with Horner syndrome symptoms.

Correct Answer: C

Rationale: The first action the nurse should take when a patient post-thyroidectomy develops signs of hypocalcemia is to assess the patient's calcium level. By assessing the patient's calcium level through laboratory testing, the nurse can confirm the presence of hypocalcemia and determine the severity of the condition. This information will guide further interventions, such as administering calcium supplements or notifying the healthcare provider for additional management. It is important to confirm the diagnosis before proceeding with treatment to ensure appropriate and safe care for the patient.