A patient presents with sudden-onset severe lower abdominal pain, nausea, vomiting, and inability to pass urine. On physical examination, there is suprapubic tenderness and a palpable bladder. What is the most likely diagnosis?

Correct Answer: B

Rationale: The patient's presentation with sudden-onset severe lower abdominal pain, nausea, vomiting, inability to pass urine, suprapubic tenderness, and a palpable bladder is classic for acute urinary retention. Acute urinary retention is a urological emergency characterized by the sudden inability to pass urine due to the inability to empty the bladder completely. The palpable bladder on physical examination indicates significant bladder distension. This condition can be caused by multiple factors such as bladder outlet obstruction, neurogenic causes, or medications affecting bladder function. Prompt intervention is necessary to relieve the bladder distension, alleviate symptoms, and prevent complications like bladder rupture.

Correct Answer: A

Rationale: As a nurse manager, the most effective way to let the staff imbibe the culture of quality at the health center is to become a role model. Leading by example is a powerful way to influence behavior and attitudes within a team. By demonstrating a commitment to quality in your own work, behavior, and decision-making, you set a positive example for your staff to follow. This proactive approach creates a culture of quality that is more likely to be embraced by the team as they see it being consistently demonstrated by their leader. This can result in improved staff morale, motivation, and overall performance in delivering quality care to patients. Additionally, being a role model fosters trust and respect among the staff, which is essential for building a strong team dynamic centered around quality healthcare delivery.

Correct Answer: B

Rationale: The independent variable in an experiment is the variable that is manipulated or determined by the researcher. In this hypothesis, the nurse is suggesting that the age of the patient (elderly vs. younger) influences the aggressiveness of treatment received. Therefore, the age of the patient is the independent variable in this scenario. The dependent variable would be the degree of treatment received, as it is expected to be influenced by the independent variable, which is the age of the patient.

Correct Answer: D

Rationale: A subarachnoid hemorrhage is characterized by bleeding within the subarachnoid space, the area between the arachnoid mater and the pia mater surrounding the brain. Patients typically present with a sudden-onset severe headache, altered mental status, and focal neurological deficits due to the mass effect of the blood in the subarachnoid space. Imaging, such as a CT scan, can confirm the presence of the hemorrhagic lesion. Ischemic stroke results from a blockage in the blood vessels supplying the brain, leading to tissue infarction and neurological deficits. Subdural hematoma is a collection of blood between the dura mater and the arachnoid mater, commonly seen following head trauma. Intracerebral hemorrhage involves bleeding within the brain tissue itself, often leading to focal neurological deficits.

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: D

Rationale: Acute respiratory distress syndrome (ARDS) is a severe condition characterized by widespread inflammation in the lungs leading to increased pulmonary vascular permeability, non-cardiogenic pulmonary edema, and respiratory failure. In ARDS, the alveolar-capillary barrier is disrupted, resulting in fluid accumulation in the alveoli and impaired gas exchange.

Correct Answer: D

Rationale: The engagement of the fetus refers to the baby's head moving down into the mother's pelvis in preparation for birth. This factor is not typically used to distinguish between true and false labor because it is a sign of progress in labor rather than a defining characteristic of true labor. In contrast, the factors that are commonly used to differentiate between true and false labor include contractions (e.g., regularity, intensity, duration), cervical changes observed through vaginal examination (e.g., effacement and dilation), and monitoring vital signs.

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: B

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