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: B

Rationale: The most appropriate action for Nurse Pedrito to take at this time is to explore the reason for Mang Emilio's refusal to take his daily medication for hypertension. By understanding the underlying cause of his refusal, Nurse Pedrito can address any concerns or barriers that may be preventing Mang Emilio from adhering to his medication regimen. This approach emphasizes the importance of patient-centered care and communication in promoting medication compliance and overall health outcomes. Additionally, it allows Nurse Pedrito to work collaboratively with Mang Emilio to find a solution that meets his needs and preferences.

Correct Answer: B

Rationale: A priority intervention for a client with multiple myeloma is to include coughing and deep breathing exercises in the plan of care. Multiple myeloma can affect the bone marrow's ability to produce healthy blood cells, including red blood cells, which can lead to anemia. Anemia can cause fatigue and shortness of breath. By encouraging coughing and deep breathing exercises, the nurse can help improve lung function, enhance oxygenation, and prevent potential respiratory complications in the client with multiple myeloma. This intervention is crucial in promoting respiratory health and overall well-being for the client.

Correct Answer: A

Rationale: The most important intervention for managing ventilator-associated pneumonia (VAP) caused by methicillin-resistant Staphylococcus aureus (MRSA) in a patient undergoing mechanical ventilation in the ICU is to start appropriate antimicrobial therapy targeting MRSA. Vancomycin or linezolid are commonly used antibiotics for MRSA infections. These medications are effective against MRSA and can help in treating the infection and preventing further complications. It is crucial to initiate antimicrobial therapy promptly once the diagnosis of VAP caused by MRSA is suspected or confirmed to improve patient outcomes. Other interventions such as bronchoalveolar lavage for diagnostic purposes, contact precautions, or antifungal therapy may be relevant but the priority is to start effective antibiotic therapy to target the specific pathogen causing the infection.

Correct Answer: D

Rationale: Spiral CT angiography is the most appropriate test for confirming the diagnosis of pulmonary embolism (PE) in a patient with suspected PE. It is a non-invasive imaging modality that can detect filling defects within the pulmonary vasculature indicative of a clot. This diagnostic test has high sensitivity and specificity for diagnosing PE, making it a valuable tool in the management of patients with suspected PE.

Correct Answer: B

Rationale: The signs reported by the patient, such as feeling nauseated, restless, sweating excessively, fatigue, and increased hunger, are indicative of hypoglycemia, which is characterized by low blood sugar levels. In individuals with hypoglycemia, these symptoms can occur when the blood glucose levels drop too low, leading to disturbances in the body's energy supply. This is common in individuals who may have experienced episodes of low blood sugar, especially if they have a history of diabetes or are taking medications that lower blood sugar levels. Diabetic nephropathy, hyperglycemia, and diabetic retinopathy are conditions associated with high blood sugar levels and are not consistent with the symptoms described by the patient.

Correct Answer: B

Rationale: In patients with Rheumatic fever, typical manifestations include an increase in body temperature, non-pruritic rashes, and migratory joint pains. Voluntary muscle spasm is not a typical manifestation of Rheumatic fever. The main clinical features of Rheumatic fever are related to the inflammation of the heart, joints, skin, and central nervous system. Muscle spasms are not a prominent feature of this condition. It is important for the nurse to be aware of these typical manifestations to effectively monitor and manage the patient's condition.

Correct Answer: D

Rationale: When managing a patient with a suspected heat stroke, the appropriate action is to remove the patient from the hot environment and start cooling the body. Heat stroke is a medical emergency that can be life-threatening if not promptly treated. Cooling the body is essential to lower the core body temperature as quickly as possible. Ice packs should not be directly applied to the skin as they can cause vasoconstriction and may actually hinder heat dissipation. Administering warm intravenous fluids and encouraging the patient to drink cold water rapidly are also not recommended in the initial management of a heat stroke. The priority is to cool the patient down and seek medical attention immediately.

Correct Answer: B

Rationale: Oxybutynin is a medication commonly used for the management of overactive bladder (OAB) symptoms such as urinary urgency and frequency. It belongs to a class of medications known as anticholinergics, which work by relaxing the bladder muscles and reducing bladder spasms. By doing so, it helps to decrease the symptoms of OAB, including frequent urination, sudden urges to urinate, and leakage. Oxybutynin can be taken orally in tablet form, as a transdermal patch, or as a gel, providing various options for patients based on their preferences and needs. Overall, oxybutynin is an effective treatment option for individuals experiencing overactive bladder symptoms.