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 clinical presentation of fever, chills, headache, and myalgia after a trip to sub-Saharan Africa is highly indicative of malaria. Specifically, the presence of intraerythrocytic ring forms and trophozoites on blood smear examination points towards Plasmodium falciparum as the most likely causative agent. Plasmodium falciparum is the most deadly of the Plasmodium species that cause malaria and is responsible for the majority of severe malaria cases worldwide. It is transmitted through the bite of infected Anopheles mosquitoes. Treatment for Plasmodium falciparum infection usually involves antimalarial medications such as artemisinin-based combination therapies.

Correct Answer: A

Rationale: When handling information about families in the community, the nurse should consider the principle of confidentiality as ethical. Confidentiality refers to the obligation of healthcare providers to safeguard the privacy of patient information. By maintaining confidentiality, the nurse upholds trust and respect in the nurse-family relationship. This principle ensures that sensitive information shared by families is kept secure and not disclosed without permission, thus respecting their autonomy and promoting open communication in healthcare settings.

Correct Answer: A

Rationale: The right to considerate and respectful care irrespective of socio-economic status is applicable in this case because Mr. Steve is facing financial difficulties in paying for his medical bills. This right ensures that all patients receive proper treatment and care regardless of their ability to pay. It emphasizes that every individual deserves to be treated with dignity and respect, regardless of their financial situation. In Mr. Steve's case, being referred to a social worker due to inability to pay should not impact the quality of care and respect he receives from healthcare providers.

Correct Answer: C

Rationale: Chest pain, dyspnea, hypotension, and ST-segment elevation on an ECG in the inferior leads are classic signs of an acute myocardial infarction (MI). An acute MI occurs when there is a sudden blockage of blood flow to a part of the heart muscle, leading to tissue damage. This causes symptoms such as chest pain due to ischemia, dyspnea due to heart failure, and hypotension due to poor cardiac output. The ST-segment elevation seen on the ECG is indicative of significant myocardial injury. Prompt diagnosis and management are crucial in acute MI to prevent further complications and to minimize damage to the heart muscle. It is important to differentiate an acute MI from stable or unstable angina or other cardiovascular disorders, as the management and prognosis vary significantly.

Correct Answer: B

Rationale: The patient's presenting symptoms of chest pain worsened by inspiration and relieved by sitting forward, with associated DVT in the lower extremity, suggest a high likelihood of pulmonary embolism. Chest pain that worsens with inspiration due to pleuritic involvement is a classic symptom of pulmonary embolism. Additionally, the presence of DVT in the lower extremity represents a risk factor for the development of pulmonary embolism, as clots originating in the deep veins can travel to the pulmonary circulation to cause an obstruction. Patients with pulmonary embolism may also exhibit signs of right heart strain, such as tachycardia, tachypnea, and sometimes hemoptysis.

Correct Answer: B

Rationale: In this scenario, the firm and midline fundus at three hours postpartum indicates that the uterus is contracting well. The presence of a small constant trickle of blood on perineal inspection suggests ongoing bleeding. This combination of findings is concerning for retained placenta, where a portion of the placenta remains attached to the uterine wall and prevents proper contraction and closure of the blood vessels at the placental site. Retained placenta can lead to postpartum hemorrhage and requires prompt evaluation and intervention to prevent complications. Nurse Kayla should escalate this finding to the healthcare provider for further assessment and management.

Correct Answer: A

Rationale: The patient is exhibiting signs and symptoms of alcohol withdrawal, such as tremors, diaphoresis, hyperactivity, elevated blood pressure, and tachycardia. Lorazepam, which is a benzodiazepine, is commonly used to manage alcohol withdrawal symptoms. It helps alleviate symptoms such as anxiety, agitation, tremors, and seizures by acting on the same brain receptors affected by alcohol. It has sedative, anxiolytic, and anticonvulsant properties which can help stabilize the patient and prevent potential complications of alcohol withdrawal, such as seizures. Haloperidol is an antipsychotic medication used for conditions like schizophrenia and acute psychosis; therefore, it would not be appropriate for alcohol withdrawal. Naloxone is used to reverse opioid overdose, and Benztropin is used to treat Parkinson's disease and extrapyramidal symptoms, so they are not indicated for alcohol

Correct Answer: B

Rationale: When a patient receiving palliative care for end-stage cancer experiences severe nausea and vomiting despite current antiemetic therapy, the palliative nurse should consider switching to a different antiemetic medication with a different mechanism of action. This approach is based on the concept of individual variability in response to medications, as well as the potential development of tolerance to a particular drug. Switching to a different antiemetic with a new mechanism of action can provide the patient with a fresh chance at better symptom control by targeting different receptors or pathways involved in nausea and vomiting. It is important to consult the healthcare team and consider the patient's overall condition and medication history before making any changes in the treatment plan.

Correct Answer: A

Rationale: Beta-blockers are medications commonly used in the management of heart failure. One of the therapeutic effects of beta-blockers is to decrease the heart rate. By blocking the action of adrenaline on the heart, beta-blockers help to slow down the heart rate, reduce the workload on the heart, and improve overall heart function. In patients with heart failure, a decreased heart rate is a favorable outcome as it can help improve cardiac output and reduce symptoms of heart failure such as fatigue and shortness of breath. Monitoring the heart rate is an important assessment parameter to evaluate the effectiveness of beta-blocker therapy in patients with heart failure. Therefore, a decreased heart rate would indicate a therapeutic effect of beta-blocker therapy in this patient.