A patient presents with recurrent episodes of throat pain, odynophagia, and fever. Physical examination reveals tonsillar enlargement with yellow-white exudates and tender cervical lymphadenopathy. Which of the following organisms is most likely responsible for this presentation?

Correct Answer: C

Rationale: The correct answer is C: Group A beta-hemolytic Streptococcus (GAS). GAS is the most likely organism responsible for this presentation, known as acute bacterial tonsillitis. GAS commonly causes symptoms such as throat pain, odynophagia, fever, tonsillar enlargement with exudates, and cervical lymphadenopathy. Streptococcal pharyngitis is a common bacterial infection of the throat caused by GAS. The other options are less likely as Streptococcus pneumoniae typically causes pneumonia and Haemophilus influenzae is associated with respiratory tract infections. Epstein-Barr virus (EBV) commonly causes infectious mononucleosis, which presents with different symptoms than those described in the question.

Correct Answer: B

Rationale: The correct answer is B: Report any irregular vaginal bleeding. This is important because irregular vaginal bleeding can indicate potential issues such as breakthrough bleeding or hormonal imbalances, which may require adjustments to the contraceptive regimen. Other choices are incorrect because: A) Restricting sexual activity is not necessary with this medication, C) Increasing calcium intake is not directly related to taking biphasic anti-ovulatory medication, and D) Bi-monthly Pap smears are not specifically required due to this type of contraception.

Correct Answer: A

Rationale: The correct answer is A: Loss of self-tolerance. This is because autoimmune diseases result from a breakdown in the immune system's ability to distinguish between self and non-self antigens, leading to the production of antibodies against self-antigens. When self-tolerance is lost, immune cells mistakenly target the body's own tissues, causing tissue damage and inflammation. Choice B (Failure of innate immunity) is incorrect because autoimmune diseases are primarily driven by adaptive immunity rather than innate immunity. Choice C (Defective T cell activation) is incorrect as T cells play a critical role in the immune response to self-antigens in autoimmune diseases. Choice D (Impaired phagocytosis) is incorrect as phagocytosis is a mechanism primarily involved in the removal of pathogens, not in the development of autoimmune diseases.

Correct Answer: A

Rationale: The correct answer is A: Rotator cuff tear. The presentation of acute shoulder pain and limited range of motion after a fall onto an outstretched hand, along with tenderness over the greater tuberosity and pain with passive abduction and external rotation, is classic for a rotator cuff tear. The mechanism of injury and physical exam findings are consistent with this condition. B: Glenohumeral dislocation typically presents with a visibly deformed shoulder and loss of normal shoulder contour. C: Acromioclavicular joint separation would present with tenderness over the AC joint rather than the greater tuberosity, and typically involves a history of direct trauma to the shoulder. D: Proximal humerus fracture would present with more diffuse shoulder pain and swelling, and not specific tenderness over the greater tuberosity.

Correct Answer: C

Rationale: Step 1: Previous pregnancy experience is crucial for understanding the patient's obstetric history and potential risks. Step 2: It helps in identifying any complications or issues that may arise during the current pregnancy. Step 3: Laboratory results, prenatal check-up records, and diagnostic test results provide additional information but do not offer insights into the patient's past pregnancy experiences. Summary: Choice C is the most important as it directly relates to the patient's obstetric history, while the other options focus on current data that may not provide the same level of context.

Correct Answer: C

Rationale: The correct answer is C: unfreezing. Unfreezing is the initial stage in Lewin's planned change model where individuals become open to change by recognizing the need for it. During this stage, the nurse identifies the need for change, plans strategies to implement it, and works on overcoming resistance by ensuring that the driving forces (reasons for change) outweigh the restraining forces (barriers to change). Refreezing (A) is the final stage where the changes are reinforced and integrated into the organization. Movement (B) is the stage where actual change occurs, and in activism (D) is not a recognized stage in Lewin's model.

Correct Answer: D

Rationale: The correct answer is D, Broad opening. Nurse Rica should use this communication technique to encourage the patient to freely express themselves without leading or interrupting. This technique helps build rapport and trust, setting a positive tone for the conversation. A: Clarifying may be too direct and might make the patient feel pressured. B: Challenging can create defensiveness and hinder open communication. C: Restating may not be as effective in initiating a conversation as broad opening. In summary, broad opening allows for a more open and relaxed conversation, fostering a conducive environment for effective communication with the patient.

Correct Answer: B

Rationale: The correct answer is B: Provides reality orientation to patient. Orienting the patient to time, place, date, and events helps them stay connected to reality and improves their awareness of their surroundings. This is crucial in assessing their cognitive functioning and ensuring they are grounded in the present moment. By providing reality orientation, healthcare providers can better understand the patient's current mental state and address any potential confusion or disorientation. This approach aids in establishing a therapeutic environment and enhances the patient's overall well-being. Choices A, C, and D do not capture the essence of reality orientation and its significance in maintaining the patient's mental clarity and connection to the present moment.

Correct Answer: A

Rationale: The correct answer is A: Active artificial immunity. This is because the person's immune system is actively stimulated by the vaccine to produce antibodies against Covid-19. It is considered artificial because it is acquired through vaccination rather than natural exposure to the disease. B: Active natural immunity is incorrect because it refers to immunity acquired through natural exposure to the disease. C: Passive natural immunity is incorrect because it refers to temporary immunity passed from mother to baby through breast milk or placenta. D: Passive artificial immunity is incorrect because it refers to receiving pre-formed antibodies, such as through an injection of antibodies rather than the body producing them itself.