A patient presents with fever, chills, headache, and myalgia after returning from a trip to sub-Saharan Africa. Laboratory tests reveal intraerythrocytic ring forms and trophozoites on blood smear examination. Which of the following is the most likely causative agent?

Correct Answer: A

Rationale: The patient's symptoms of fever, chills, headache, and myalgia after returning from sub-Saharan Africa are consistent with malaria. Intraerythrocytic ring forms and trophozoites observed on blood smear examination are characteristic of Plasmodium species, particularly Plasmodium falciparum, which is the most common and deadliest species causing malaria in sub-Saharan Africa. Plasmodium falciparum can lead to severe complications, such as cerebral malaria, if not promptly treated. Trypanosoma cruzi causes Chagas disease, not malaria. Borrelia burgdorferi is responsible for Lyme disease, which typically presents with a different set of symptoms like erythema migrans rash. Leishmania donovani causes visceral leishmaniasis, not malaria.

Correct Answer: A

Rationale: The diagnostic examination for osteoporosis typically involves measuring bone density. This is usually done through a dual-energy x-ray absorptiometry (DEXA) scan, which is considered the gold standard for assessing bone density. Osteoporosis is characterized by decreased bone mass and deterioration of bone tissue, leading to increased bone fragility and risk of fractures. Measuring bone density helps in diagnosing osteoporosis by identifying areas of low bone density, assessing the risk of fractures, and monitoring the effectiveness of treatment. Weight, blood volume, and height are not directly used as primary indicators for diagnosing osteoporosis.

Correct Answer: A

Rationale: As a QA nurse, Nurse Jen can adopt concurrent evaluation methods to assess patient outcomes in the unit. The most appropriate options for concurrent evaluation are Face to face interview with nursing staff (III) and Nursing audit from the patient's chart (IV).

Correct Answer: B

Rationale: The constellation of severe lower abdominal pain, fever, and vaginal discharge in a pregnant woman raises suspicion for pelvic inflammatory disease (PID). Cervical motion tenderness and adnexal tenderness are classic physical exam findings for PID. The presence of bilateral adnexal masses further supports the diagnosis, as PID can lead to the formation of tubo-ovarian abscesses. Ectopic pregnancy may present with similar symptoms but is less likely in this case as bilateral adnexal masses suggest a more diffuse inflammatory process. Placenta previa would typically present with painless vaginal bleeding in the third trimester, which is not consistent with the symptoms described. Ovarian torsion would present with sudden severe unilateral lower abdominal pain and is less likely to involve both ovaries simultaneously.

Correct Answer: C

Rationale: Anticonvulsant medications, such as phenytoin and phenobarbital, can interfere with pregnancy tests by affecting the levels of human chorionic gonadotropin (hCG) in the body. HCG is the hormone detected in pregnancy tests. These medications may potentially lead to a false-negative result on a pregnancy test for women who are actually pregnant. Therefore, in the case of Almira, who is 6 months pregnant and taking anticonvulsant medication due to the risk of producing a false-negative pregnancy test result, healthcare providers should consider other clinical indicators, such as abdominal cramps and vaginal spotting, to assess her pregnancy status.

Correct Answer: B

Rationale: The nurse's appropriate response is to provide the requested information clearly and directly. In this case, the client asked for the time, so the best response is to say "It is 10 o'clock" to answer their question promptly. Options A, C, and D do not address the client's question and may be perceived as dismissive or unhelpful.

Correct Answer: D

Rationale: The entry you expect to be written in Mrs. Carpio's progress report should include details related to monitoring her response to the Thiazide diuretics and ensuring her safety. Options A, B, and C all focus on these aspects by monitoring serum electrolytes, intake and output, and weight before drug administration, which are important considerations when a patient is on Thiazide diuretics. However, specifying the time of drug administration (8 o'clock in the evening) is not necessary in the progress report entry. The focus should be on the patient's response to the medication and the associated monitoring parameters. Time of administration is more relevant for nursing care plans or medication schedules.

Correct Answer: A

Rationale: The primary indicator that Nurse Mary observes FIDELITY in the practice of her profession is that she faithfully promotes health and prevents disease. Fidelity in nursing practice refers to being faithful, loyal, and committed to providing the best care and services to patients. By faithfully promoting health and preventing disease, Nurse Mary demonstrates her dedication to her profession, her patients, and the community she serves. This commitment includes following evidence-based practices, upholding ethical standards, being honest and trustworthy, and ensuring the well-being of those under her care. Ultimately, fidelity in nursing practice builds trust and confidence among patients, families, and colleagues, leading to better health outcomes and a stronger healthcare system.

Correct Answer: A

Rationale: The nurse should prioritize screening the patient for contraindications to MRI, such as metal implants or claustrophobia, to ensure procedural safety. Metallic objects can be hazardous in an MRI environment as they can be attracted to the magnet, potentially causing harm to the patient or staff. Claustrophobia can also be a significant issue for patients undergoing an MRI scan, and identifying this beforehand allows for appropriate measures to be taken to address the patient's anxiety or discomfort. Prioritizing this screening step helps ensure the safety and well-being of the patient during the MRI procedure.