A patient presents with watery diarrhea, abdominal cramps, and nausea after consuming contaminated water from a stream during a camping trip. Laboratory tests reveal oocysts in the stool sample. Which of the following parasites is most likely responsible for this infection?

Correct Answer: C

Rationale: The patient is likely infected with Cryptosporidium parvum based on the symptoms of watery diarrhea, abdominal cramps, and nausea after consuming contaminated water. Cryptosporidium is a protozoan parasite that can be transmitted through contaminated water sources, such as streams. Laboratory tests revealing oocysts in the stool sample further support the diagnosis of Cryptosporidium infection, as these oocysts are characteristic of this parasite. Giardia lamblia is another common protozoan parasite that can cause similar symptoms but is usually associated with more foul-smelling, greasy diarrhea. Entamoeba histolytica causes amoebic dysentery, which presents with bloody diarrhea and abdominal pain. Cyclospora cayetanensis also causes watery diarrhea, but it is usually associated with foodborne outbreaks rather than waterborne transmission.

Correct Answer: B

Rationale: Malpractice is a type of tort that involves professional negligence or misconduct by a professional such as a nurse that results in harm to a patient. In this scenario, failing to obtain informed consent before performing a procedure is considered a breach of the standard of care expected from a healthcare professional, which falls under malpractice. This failure to obtain informed consent deprives the patient of the right to make an informed decision about their treatment and can lead to legal consequences for the nurse.

Correct Answer: A

Rationale: The nurse should prioritize adjusting the irrigation flow rate based on the patient's urine output to prevent complications during continuous bladder irrigation (CBI). Proper adjustment of the irrigation flow rate helps maintain adequate bladder drainage while preventing bladder distention, clot formation, and potential irrigation fluid overload. Monitoring the patient's urine output and adjusting the flow rate accordingly ensures optimal functioning of the CBI system and enhances patient safety. This proactive approach minimizes the risk of complications and promotes effective postoperative care following urological surgery.

Correct Answer: C

Rationale: The nurse's primary responsibility in responding to a patient's questions about their diagnosis and treatment options is to listen actively and provide accurate, honest, and comprehensive answers. This approach helps build trust between the patient and the healthcare team, allows the patient to make informed decisions about their care, and ensures that the patient understands their condition and the recommended treatment plan. Providing vague answers or ignoring the patient's questions can lead to confusion, anxiety, and mistrust, which can hinder the patient's overall care and recovery. Referring the patient to the physician for all questions may be appropriate for certain medical inquiries, but the nurse plays a crucial role in educating and supporting the patient throughout their healthcare journey.

Correct Answer: C

Rationale: Subacute thyroiditis is an inflammatory disorder of the thyroid gland that causes gland destruction and release of pre-formed thyroid hormone leading to hyperthyroidism. The fine-needle aspiration biopsy findings of granulomatous inflammation and multinucleated giant cells are characteristic of subacute thyroiditis. This condition typically presents with a painful, tender thyroid gland and may be preceded by a viral illness. Unlike Graves' disease, which is an autoimmune disorder resulting in hyperthyroidism with diffuse goiter and positive thyroid stimulating immunoglobulins, subacute thyroiditis is typically self-limited and resolves spontaneously without the need for long-term treatment.

Correct Answer: C

Rationale: Acute appendicitis is the most likely cause of the symptoms described in the pregnant woman. The classic presentation of acute appendicitis includes fever, chills, abdominal pain localized to the right lower quadrant, rebound tenderness, and guarding. Pregnant women are at a slightly higher risk of developing appendicitis due to anatomic changes and increased abdominal pressure during pregnancy, which can lead to an atypical presentation of symptoms. Prompt diagnosis and surgical intervention are crucial to prevent complications such as perforation, which can be detrimental for both the mother and the fetus.

Correct Answer: B

Rationale: The most appropriate nursing diagnosis for the individual described is "Ineffective individual coping." This is because the individual has been facing challenges in both academic (failing math class) and personal (substance dependence) aspects of his life. The repeated failures in his math class and the substance dependence for three years indicate that he might be struggling to cope with stressors and challenges in his life effectively. By identifying this nursing diagnosis, the nurse can focus on helping the individual develop effective coping strategies to manage and overcome these difficulties.

Correct Answer: A

Rationale: Difficulty of speaking and chewing is an indicator of cranial nerve involvement. Cranial nerves are responsible for controlling various functions of the head and neck, including speech and mastication. Impairment of cranial nerve function can lead to difficulty in these activities. In the context of the question, with the patient in the stroke unit, cranial nerve involvement can occur due to the stroke affecting the brain regions responsible for cranial nerve function. Loss of pain sensation, spastic paralysis of the extremities, and forgetfulness with syncope are not specific indicators of cranial nerve involvement in this scenario.

Correct Answer: B

Rationale: The statement "Multigravida patient has shorter labor" is the best response to Patient Josephine's question about her shorter labor compared to previous deliveries. In obstetrics, it is commonly observed that labor tends to be shorter in patients who have had previous pregnancies (multigravida patients) due to factors such as prior cervical changes and previous stretching of the birth canal. This phenomenon is known as "multigravida cervical efficiency," and it can lead to faster and more efficient labors in subsequent pregnancies for women who have had previous deliveries.