A patient presents with recurrent episodes of deep vein thrombosis (DVT) and pulmonary embolism (PE). Laboratory tests reveal elevated levels of antiphospholipid antibodies (anticardiolipin and lupus anticoagulant). Which of the following conditions is most likely to cause these findings?

Correct Answer: D

Rationale: Antiphospholipid syndrome is characterized by abnormal antiphospholipid antibodies, which can lead to an increased risk of blood clots such as deep vein thrombosis (DVT) and pulmonary embolism (PE). The two most common antiphospholipid antibodies are anticardiolipin and lupus anticoagulant. Patients with antiphospholipid syndrome can present with recurrent thrombotic events, such as DVT and PE, due to the pro-thrombotic effects of these antibodies. Protein C deficiency, Protein S deficiency, and Antithrombin III deficiency are other causes of hypercoagulability but would not typically present with elevated antiphospholipid antibodies.

Correct Answer: C

Rationale: The most appropriate nursing action in this situation is to assess the client's blood pressure and other vital signs. The client's symptoms of severe headache, visual disturbances, and epigastric pain could be indicative of preeclampsia or eclampsia, which are serious conditions that require immediate medical attention. Checking the blood pressure and other vital signs will help determine if the client's symptoms are related to abnormal blood pressure levels, which is critical in identifying and managing hypertensive disorders in postpartum clients. Once the assessment is completed, appropriate medical interventions can be initiated promptly if necessary.

Correct Answer: A

Rationale: The healthcare team should prioritize administering lactulose or other ammonia-lowering agents to manage hepatic encephalopathy in a patient with acute liver failure. Hepatic encephalopathy is a neuropsychiatric syndrome that occurs in patients with liver dysfunction, leading to the accumulation of ammonia and other neurotoxic metabolites in the bloodstream. Lactulose works by acidifying the colon, which promotes the conversion of ammonia to ammonium, a less toxic form that can be excreted in the stool. By reducing the levels of ammonia, lactulose helps improve the neurological symptoms associated with hepatic encephalopathy.

Correct Answer: A

Rationale: Bulimia nervosa is an eating disorder characterized by binge eating followed by compensatory behaviors such as self-induced vomiting, fasting, or excessive exercise. The repeated purging in bulimia can lead to electrolyte imbalances, such as hypokalemia (low potassium levels). Hypokalemia is a serious condition that can affect the function of the heart's electrical system, potentially leading to the development of cardiac arrhythmias (irregular heartbeats) and even cardiac arrest, which can result in death. Therefore, in a bulimic patient like Sherry, the risk of death is most likely due to the combination of hypokalemia and its complications, such as cardiac arrhythmias and arrest.

Correct Answer: C

Rationale: In this scenario, the action that violates a psychiatric patient's rights is option C, where staff members confiscated written letters done by patients addressed to the local newspaper. Patients have the right to communicate freely and express their thoughts and feelings through various means, such as letter-writing. Confiscating these letters is a violation of their rights to free expression and communication. It is essential to respect and uphold the rights of psychiatric patients, including their right to communicate with others.

Correct Answer: A

Rationale: The clinical presentation of urinary urgency, frequency, and nocturia along with prostate enlargement with a smooth, firm consistency on digital rectal examination (DRE) is classic for benign prostatic hyperplasia (BPH). BPH is a common condition in aging men characterized by non-malignant growth of the prostate gland, which can cause varying degrees of lower urinary tract symptoms due to obstruction of the urethra. In contrast, prostate cancer typically presents with findings like an asymmetric, hard, or nodular prostate on DRE, while prostatitis presents with symptoms like fever, perineal pain, and systemic symptoms. Urinary tract infection (UTI) may present with dysuria, frequency, urgency, and suprapubic pain, but it does not usually cause prostate enlargement.

Correct Answer: A

Rationale: The patient's presentation of recurrent episodes of postnasal drip, chronic cough, halitosis, and foul-smelling, yellowish discharge from the middle meatus is highly suggestive of chronic rhinosinusitis. The presence of nasal polyps further supports this diagnosis. Chronic rhinosinusitis with nasal polyps is characterized by inflammation of the paranasal sinuses, leading to symptoms such as nasal congestion, postnasal drip, cough, and a reduced sense of smell. The yellowish discharge and foul odor are typical findings in cases of chronic rhinosinusitis with secondary bacterial infection. Nasal endoscopy may reveal edematous nasal mucosa and polyps obstructing the middle meatus, contributing to the symptoms described by the patient. Management typically involves a combination of medical therapies such as intranasal corticosteroids, saline irrigation, and antibiotics, and in some cases, surgical intervention

Correct Answer: A

Rationale: The best thing to do next is to turn off the fan immediately. The fact that the electric fan is stopping every now and then and sparking at intervals indicates a potential electrical issue or malfunction. This situation poses a safety hazard as it increases the risk of an electrical fire or damage to the fan. Turning off the fan immediately will help prevent any further damage or potential danger. After turning off the fan, it would be advisable to call for maintenance to inspect and repair the fan to ensure it is safe to use again.

Correct Answer: A

Rationale: The patient is most likely experiencing autonomic dysreflexia. Autonomic dysreflexia is a potentially life-threatening condition that can occur in individuals with spinal cord injuries at the level of T6 or above. It is characterized by a sudden onset of severe hypertension, bradycardia, diaphoresis, flushing, and headache in response to a noxious stimulus below the level of injury. The sudden change in position from supine to sitting likely triggered autonomic dysreflexia in this patient.