A patient presents with fever, malaise, and a maculopapular rash that started on the face and spread to the trunk and extremities. Laboratory tests reveal leukopenia and thrombocytopenia. Which of the following is the most likely causative agent?

Correct Answer: C

Rationale: The clinical presentation of fever, malaise, maculopapular rash starting on the face and spreading to the trunk and extremities, along with leukopenia and thrombocytopenia, is highly suggestive of Rocky Mountain spotted fever (RMSF) caused by Rickettsia rickettsii. RMSF is a tick-borne illness transmitted by the American dog tick, Rocky Mountain wood tick, and brown dog tick. The constellation of symptoms described aligns well with the typical presentation of RMSF. Borrelia burgdorferi causes Lyme disease, which presents with erythema migrans but does not typically cause leukopenia or thrombocytopenia. Plasmodium falciparum is the causative agent of severe malaria and would present with symptoms such as cyclic fevers, anemia, and jaundice but not the described rash distribution.

Correct Answer: B

Rationale: The best response for a nurse when a patient expresses dissatisfaction with the care they received during their hospital stay is to listen actively to the patient's concerns, apologize for any shortcomings, and offer to address the issues. It is crucial for healthcare providers to acknowledge the patient's perspective, validate their feelings, and work towards resolving any issues that may have contributed to their dissatisfaction. This approach demonstrates empathy, professionalism, and a commitment to patient-centered care, fostering trust and effective communication between the patient and the healthcare team. Dismissing the patient's concerns (option A), ignoring their dissatisfaction (option C), or telling them that their concerns are unfounded (option D) can further escalate the situation and lead to a breakdown in the patient-provider relationship.

Correct Answer: C

Rationale: The patient is presenting with sudden onset weakness and numbness on one side of the body, along with difficulty speaking and understanding speech, which are typical symptoms of a stroke. Imaging revealing an acute infarction involving the left middle cerebral artery territory is consistent with an ischemic stroke. Ischemic stroke occurs when there is a blockage in a blood vessel supplying blood to the brain, leading to a lack of oxygen and nutrients to the affected area, resulting in neurological deficits. This is in contrast to an intracerebral hemorrhage, which is caused by bleeding into the brain tissue, or a subarachnoid hemorrhage, which involves bleeding into the space surrounding the brain. A transient ischemic attack (TIA) is a temporary episode of neurological dysfunction caused by a brief blockage of blood flow to a part of the brain, usually resolving within 24 hours. In this case, the presentation and imaging findings are most

Correct Answer: A

Rationale: Estrogen exerts negative feedback on the hypothalamus by inhibiting the release of GnRH (Gonadotropin-Releasing Hormone). GnRH plays a crucial role in the regulation of follicle-stimulating hormone (FSH) and luteinizing hormone (LH) production from the pituitary gland. By inhibiting the release of GnRH, estrogen ultimately leads to a decrease in FSH and LH levels. This process helps to suppress the maturation of the egg and ovulation, providing contraceptive effects.

Correct Answer: D

Rationale: Non-maleficence is the ethical principle that emphasizes the obligation to avoid causing harm to patients. In this scenario, the ER nurse clarifies the doctor's prescription to ensure the correct dosage of the pain medication based on the pain scale assessment and the patient's age. By doing so, the nurse is ensuring that the medication is safe and effective for the patient, thus adhering to the principle of non-maleficence. This action demonstrates the nurse's commitment to preventing harm and promoting the well-being of the patient through proper medication management.

Correct Answer: C

Rationale: The priority item that should be placed at the newborn's bedside is a blood pressure cuff. Monitoring the newborn's blood pressure is crucial in the NICU, as it helps assess the baby's cardiovascular function and overall well-being. Blood pressure changes can be an early indication of potential health issues, so having a blood pressure cuff readily available allows for timely monitoring and intervention if necessary. The other items listed (specific gravity urinometer, rectal thermometer, bottle of sterile normal saline) are also important in neonatal care, but monitoring blood pressure takes precedence in this scenario.

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: C

Rationale: Nursing programs that are based on needs assessment and needs analysis are meant to provide education and training to current or aspiring nurses according to specific needs within the healthcare system. These programs are usually foundational education programs that are essential for producing competent and skilled nurses. Offering such programs for free ensures that individuals with a passion for nursing but limited financial resources can access quality education and training opportunities. This helps in bridging the gap in the healthcare workforce and ultimately contributes to the overall health and well-being of the population.

Correct Answer: C

Rationale: When a nurse discovers a discrepancy between the medication order and the patient's medication record, the priority action is to verify the medication order with the prescriber to ensure accuracy and patient safety. Administering the medication without clarification can put the patient at risk. Documenting the discrepancy and informing the charge nurse is important, but it should not delay verifying the order with the prescriber. Contacting the pharmacy for clarification may be necessary in some cases, but the immediate action should be to confirm the prescription with the prescriber to prevent errors and ensure the patient receives the correct medication.