A patient presents with unilateral facial paralysis, inability to close the eye on the affected side, and loss of taste sensation on the anterior two-thirds of the tongue. Which of the following conditions is most likely responsible for this presentation?

Correct Answer: B

Rationale: Ramsay Hunt syndrome is caused by the varicella-zoster virus affecting the geniculate ganglion, leading to a triad of symptoms known as the Hunt syndrome: facial paralysis, ear pain, and a vesicular rash in the ear or palate. The facial paralysis in Ramsay Hunt syndrome is usually peripheral, similar to Bell's palsy, but may be more severe. In addition to facial paralysis, the patient may have the inability to close the eye on the affected side (lagophthalmos) and loss of taste sensation on the anterior two-thirds of the tongue due to involvement of the chorda tympani nerve. This differentiation is important to consider in the context of our patient's presentation.

Correct Answer: C

Rationale: The nurse should ask the mother information related to their daughter's menarche. Menarche refers to the first occurrence of menstruation in a girl, which is an important milestone in her development. By inquiring about the daughter's menarche, the nurse can gather essential information about the daughter's reproductive health, growth, and development. This allows the nurse to assess whether the daughter's menstrual cycle is regular and if there are any concerns related to her reproductive health. Understanding the daughter's menarche history is vital in providing appropriate healthcare and support for her.

Correct Answer: C

Rationale: If the nurse observes an unusual odor emanating from the surgical site during surgery, it is important to inform the surgeon immediately and assess for signs of infection. Changes in odor can sometimes be an early sign of infection, which requires prompt attention and intervention. By communicating with the surgeon and conducting a thorough assessment, the nurse can help ensure the timely detection and management of any potential complications, such as infection, that may be affecting the patient's surgical outcome. Prompt action in response to unusual observations is crucial to maintaining patient safety and well-being during surgical procedures.

Correct Answer: A

Rationale: A district hospital is an example of a secondary health facility. Secondary health facilities are the intermediate level of healthcare services, providing a higher level of care compared to primary health facilities like rural health units and barangay health stations. District hospitals typically offer more specialized medical services, diagnostic facilities, and inpatient care that are not available at lower-level health facilities. When Nurse Vince refers a patient to a district hospital, it means that the patient requires more extensive and specialized medical care beyond what can be provided at the primary level of care.

Correct Answer: B

Rationale: CPAP therapy is considered the gold standard treatment for obstructive sleep apnea (OSA) and is the most appropriate intervention for managing OSA and improving symptoms. CPAP therapy involves using a machine that delivers a continuous flow of air through a mask worn over the nose or mouth during sleep. This air pressure helps keep the airway open, preventing the collapse that causes apneas and snoring during sleep.

Correct Answer: C

Rationale: In cases of persistent fetal malpresentation, such as a transverse lie position, a cesarean section is often the safest and most effective intervention to address the abnormal labor presentation. Delivering a baby in a transverse lie position vaginally is associated with high risks, including fetal complications such as umbilical cord prolapse and head entrapment. Therefore, to ensure the safety of both the mother and the baby, a cesarean section is usually the most appropriate and timely intervention to address this situation. It is crucial to prioritize the immediate preparation and facilitation of a cesarean section in cases of persistent fetal malpresentation to prevent potential complications and ensure the best outcome for the mother and the baby.

Correct Answer: C

Rationale: The nurse should prioritize removing the old dressing and applying a new dressing using sterile technique to minimize the risk of infection during a central venous catheter (CVC) dressing change. This is because the most critical step in preventing infection is maintaining a clean and sterile environment around the CVC insertion site. By using sterile technique, the nurse can reduce the introduction of microorganisms that could potentially lead to infection. Wearing sterile gloves and cleaning the insertion site with an alcohol-based antiseptic solution are important steps as well, but the key priority lies in applying the new dressing using sterile technique to prevent contamination and reduce the risk of infection.

Correct Answer: D

Rationale: The Patient's Bill of Rights typically focuses on ensuring patients have the right to certain aspects of their healthcare, such as the right to refuse treatment, the right to informed consent, and the right to receive treatment. Civil commitment, on the other hand, refers to the legal process through which an individual is involuntarily placed in a psychiatric facility for evaluation and treatment. This issue is not typically addressed in the Patient's Bill of Rights, as it involves specific legal procedures rather than general patient rights.

Correct Answer: D

Rationale: In the scenario described, the patient is experiencing severe hypoxemia refractory to conventional oxygen therapy, indicating a need for advanced respiratory support. When a patient with ARDS fails to respond to conservative management, including mechanical ventilation strategies, prone positioning, and recruitment maneuvers, the next step may involve extracorporeal membrane oxygenation (ECMO). ECMO provides a way to bypass the lungs and oxygenate the blood directly, allowing for enhanced gas exchange and support for severely compromised respiratory function. Therefore, in this critical situation, prioritizing the recommendation for ECMO can offer the patient the best chance of improving oxygenation and survival.