A patient presents with sudden onset of severe vertigo, nausea, vomiting, and nystagmus. The patient reports a recent upper respiratory tract infection. Which of the following conditions is most likely responsible for this presentation?

Correct Answer: A

Rationale: The sudden onset of severe vertigo, nausea, vomiting, and nystagmus in a patient with a recent upper respiratory tract infection is highly suggestive of vestibular neuritis. Vestibular neuritis is typically caused by inflammation of the vestibular nerve, often following a viral infection such as an upper respiratory tract infection. This condition presents with acute, severe, continuous vertigo without associated hearing loss. The presence of nystagmus, along with the absence of hearing loss, helps differentiate vestibular neuritis from Meniere's disease (which typically presents with episodic vertigo, hearing loss, and tinnitus) and acoustic neuroma (which presents with gradual onset of symptoms including unilateral hearing loss, tinnitus, and imbalance). Benign paroxysmal positional vertigo (BPPV) typically presents with brief episodes of vertigo triggered by specific head movements, rather than the continuous vertigo seen in this case.

Correct Answer: D

Rationale: Confusion is a potential adverse effect of digoxin therapy. Digoxin toxicity can manifest as various central nervous system symptoms, including confusion, delirium, and disorientation. It is important to monitor for signs of digoxin toxicity in patients taking this medication, especially those with a history of heart failure or renal impairment. Other common signs of digoxin toxicity may include visual disturbances (like halos around lights), gastrointestinal symptoms (like nausea and vomiting), and cardiac arrhythmias. Monitoring serum digoxin levels can help guide therapy and identify toxicity early.

Correct Answer: A

Rationale: The priority nursing intervention for a woman in active labor diagnosed with postpartum hemorrhage (PPH) due to uterine atony is to massage the uterus to promote contraction. Uterine massage helps to stimulate uterine muscle tone and contraction, which can help control bleeding by reducing the size of blood vessels and promoting hemostasis. It is important to address the uterine atony promptly to prevent further blood loss and stabilize the patient's condition. Other interventions such as blood transfusion, administering antibiotics, and elevating the mother's legs can be considered based on the patient's response to the initial intervention of uterine massage.

Correct Answer: D

Rationale: Ella's feeling of joining Lory in heaven is best categorized as suicidal ideation. Suicidal ideation refers to thoughts or fantasies about dying, including thoughts of one's own death or thoughts of wanting to harm oneself. In this scenario, Ella is not explicitly expressing any immediate intent to harm herself or others, nor is she exhibiting paranoia or making a direct threat. Instead, her mention of joining Lory in heaven suggests that she is contemplating the idea of death, which falls under the category of suicidal ideation. It is essential to take such thoughts seriously and seek appropriate help and support for the individual experiencing them.

Correct Answer: A

Rationale: In the scenario described, the patient is experiencing refractory hypotension despite adequate fluid resuscitation, indicating the presence of septic shock. In septic shock, systemic vasodilation and vascular hyporesponsiveness contribute to hypotension. Therefore, the primary management approach is to restore vascular tone and blood pressure to maintain organ perfusion. Administering vasopressor medications (Choice A) is the crucial intervention to achieve this goal. Vasopressors, such as norepinephrine or vasopressin, constrict blood vessels and increase blood pressure, helping to stabilize the patient in septic shock. While options B and C (performing blood cultures and initiating broad-spectrum antibiotics) are important for identifying the causative pathogen and treating the infection, they are secondary to the immediate need for hemodynamic support in septic shock. Prophylactic anticoagulation (Choice D) is not the primary intervention for

Correct Answer: D

Rationale: The aim of pelvic muscle exercises for a patient with urinary incontinence is to strengthen the muscles that control the vagina and urethra. These exercises, known as Kegel exercises, target the pelvic floor muscles that support the pelvic organs and help in controlling urinary function. Strengthening these muscles can help improve bladder control and reduce or eliminate urinary incontinence. Exercises that target the perineal area can also be beneficial in managing urinary incontinence, but the main focus is on strengthening the muscles that control the vagina and urethra.

Correct Answer: A

Rationale: Ariel is likely experiencing the stage of depression in the grieving process. The stages of grief, according to the Kubler-Ross model, are denial, anger, bargaining, depression, and acceptance. In this scenario, Ariel has come to terms with his mother's death and is mourning her loss, which aligns with the stage of depression characterized by feelings of sadness, hopelessness, and intense sorrow. It is a normal part of the grieving process for individuals to experience these emotions as they process their loss.

Correct Answer: D

Rationale: When administering Rilutek (riluzole), the medication should be taken with food. This is because taking Rilutek with food helps to reduce the likelihood of experiencing stomach upset as a side effect. Administering the medication on an empty stomach may increase the risk of gastrointestinal issues such as nausea, vomiting, or stomach pain. Therefore, it is recommended to administer Rilutek with food to ensure better tolerability for the patient.

Correct Answer: B

Rationale: Nurse Crissel likely informed the participants that HIV is not casually transmitted through activities like kissing. HIV transmission primarily occurs through activities that involve the exchange of bodily fluids, such as blood, semen, vaginal fluids, and breast milk. Accidental blood exposure, unprotected sex, and mother to child transmission are known routes of HIV transmission due to the direct exchange of bodily fluids containing the virus. However, the virus is not spread through saliva, including activities like kissing, which do not involve the exchange of significant amounts of bodily fluids.