A patient with a history of chronic kidney disease is prescribed a low-protein diet. Which dietary choice indicates understanding of the prescribed diet?

Correct Answer: D

Rationale: A patient with chronic kidney disease prescribed a low-protein diet should avoid high-protein foods like grilled salmon, lentil soup, and beef stew. Chicken Caesar salad, on the other hand, typically contains a smaller amount of protein compared to the other options. This choice indicates an understanding of the need to limit protein intake while still enjoying a balanced meal. However, it is important to note that the quantity and portion sizes of high-protein ingredients in the salad should also be moderate to comply with a low-protein diet.

Correct Answer: A

Rationale: In terms of social support therapy for a patient with Amyotrophic Lateral Sclerosis (ALS), the most appropriate and therapeutic option would be for the patient to live in the community with appropriate support, either independently or in a supervised setting. This approach allows the individual to maintain a sense of autonomy and independence while still having access to necessary support and care as needed. Living in the community promotes social interaction, engagement, and a sense of normalcy, which can contribute positively to the patient's mental well-being and overall quality of life. This approach also aligns with the principles of person-centered care, focusing on the individual's preferences, needs, and autonomy.

Correct Answer: D

Rationale: The most common symptom of scabies that the family would report to Nurse Emma is itchiness. Scabies is a contagious skin condition caused by the Sarcoptes scabiei mite, which burrows into the skin and lays eggs, leading to intense itching, especially at night. The itching is a result of the body's allergic reaction to the mites and their waste products. While rashes, scaling, and swelling can also occur with scabies, the hallmark and most bothersome symptom experienced by individuals with scabies is the intense itchiness, making it the most common symptom reported by affected individuals or their families during the history-taking process.

Correct Answer: A

Rationale: Macrophages are the primary cells responsible for producing tumor necrosis factor-alpha (TNF-α) during the acute phase response. TNF-α is a pro-inflammatory cytokine that plays a critical role in initiating and propagating the inflammatory response. Macrophages secrete TNF-α in response to infection, injury, or other inflammatory stimuli, contributing to the recruitment of immune cells and the activation of additional inflammatory pathways. In the context of the acute phase response, macrophages are key mediators of the immune response and play a crucial role in host defense mechanisms.

Correct Answer: A

Rationale: The clinical presentation of fever, chills, headache, and myalgia after a trip to sub-Saharan Africa is highly indicative of malaria. Specifically, the presence of intraerythrocytic ring forms and trophozoites on blood smear examination points towards Plasmodium falciparum as the most likely causative agent. Plasmodium falciparum is the most deadly of the Plasmodium species that cause malaria and is responsible for the majority of severe malaria cases worldwide. It is transmitted through the bite of infected Anopheles mosquitoes. Treatment for Plasmodium falciparum infection usually involves antimalarial medications such as artemisinin-based combination therapies.

Correct Answer: A

Rationale: The liver is responsible for secreting bile, which aids in the emulsification and digestion of fats. Bile is produced by the liver and is stored and concentrated in the gallbladder before being released into the small intestine to help with the breakdown of fats during the digestion process. The gallbladder functions as a storage organ for bile produced by the liver. The pancreas secretes digestive enzymes and bicarbonate to aid in the digestion process, while the spleen is mainly involved in immune function and blood storage.

Correct Answer: A

Rationale: ORNAP stands for Operating Room Nurses Association of the Philippines, which is an appropriate professional organization for Merle to actively join after 3 years of experience in the Operating Room. ORNAP is dedicated to promoting professional growth and development, advancing the standards of perioperative nursing practice, and providing a platform for networking and collaboration among operating room nurses in the Philippines. By becoming a member of ORNAP, Merle can stay updated on the latest trends and best practices in perioperative nursing, participate in continuing education opportunities, and connect with colleagues in the same field to enhance her skills and knowledge.

Correct Answer: B

Rationale: Vitamin K is essential for the production of several clotting factors in the liver, including factors II, VII, IX, and X. In a patient with chronic liver disease, impaired liver function can lead to decreased synthesis of these clotting factors. As a result, there is an underlying deficiency of these clotting factors, leading to prolonged PT (prothrombin time) and aPTT (activated partial thromboplastin time). The mixing studies showing correction with normal plasma further support the diagnosis of a factor deficiency rather than an inhibitor, which helps in ruling out conditions like DIC or hemophilia.

Correct Answer: D

Rationale: After childbirth, the uterus undergoes involution, which is the process of returning to its pre-pregnant size and location. Initially, the fundus is firm and located at or just below the level of the umbilicus immediately after delivery. Over the next 24 hours, the fundus should gradually decrease in height as involution progresses. By the day after delivery, the nurse would expect the fundal assessment to be in line with the umbilicus or slightly below it, indicating normal involution of the uterus. If the fundus remains high or deviates from this expected progression, further assessment and intervention may be needed to prevent complications such as postpartum hemorrhage.