A patient with a history of chronic liver disease presents with easy bruising and prolonged bleeding from minor cuts. Laboratory tests reveal prolonged PT and aPTT, and mixing studies show correction of coagulation times with normal plasma. Which of the following conditions is most likely to cause these findings?

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: B

Rationale: Vestibular neuritis is a condition characterized by the acute onset of severe vertigo, nausea, vomiting, and nystagmus. These symptoms are typically worsened by head movement. Vestibular neuritis is caused by inflammation of the vestibular nerve, which plays a key role in balance and spatial orientation. The classic presentation of these symptoms, along with the absence of hearing loss (which is seen in labyrinthitis), points towards vestibular neuritis as the most likely cause in this scenario. Meniere's disease presents with recurrent episodes of vertigo, hearing loss, tinnitus, and sensation of fullness in the ear. Benign paroxysmal positional vertigo (BPPV) is characterized by brief episodes of vertigo triggered by changes in head position.

Correct Answer: C

Rationale: The symptoms described, including progressive weakness, muscle atrophy, fasciculations, dysphagia, and dysarthria primarily involving the upper and lower extremities, are classic features of amyotrophic lateral sclerosis (ALS), also known as Lou Gehrig's disease. ALS is a progressive neurodegenerative disorder that affects the motor neurons in the brain and spinal cord, leading to muscle weakness and atrophy. As the disease progresses, patients may develop difficulty swallowing (dysphagia) and speaking (dysarthria). In contrast, Parkinson's disease primarily involves movement-related symptoms such as tremors, muscle stiffness, and slow movements. Guillain-Barré syndrome (GBS) is an acute inflammatory demyelinating polyneuropathy that typically presents with ascending weakness and sensory abnormalities, often preceded by an infection. Myasthenia gravis is characterized by muscle weakness exacerbated by

Correct Answer: A

Rationale: The patient's presentation of episodic throbbing headache associated with nausea, vomiting, sensitivity to light and sound, and aura suggests a diagnosis of migraine headache. Migraines are a common neurological condition characterized by recurrent moderate to severe headaches that are often unilateral, pulsating, and aggravated by physical activity. The presence of premonitory symptoms (aura) before the headache is a key feature commonly seen in migraines. Additionally, nausea, vomiting, and sensitivity to light and sound are also common features associated with migraines.

Correct Answer: B

Rationale: Acknowledging the patient's emotions and offering empathy and support is the most appropriate response in this situation. It is important for the nurse to show understanding and compassion towards the patient, especially when they are feeling emotional about a recent diagnosis. By acknowledging the patient's emotions, the nurse can create a supportive environment that facilitates open communication and helps the patient feel heard and valued. This approach can also help build trust between the patient and the nurse, leading to better outcomes in terms of patient care and overall well-being. Ignoring the patient's emotions, telling them to stop being emotional, or changing the subject may make the patient feel dismissed or isolated, which could negatively impact their mental and emotional state. Thus, offering empathy and support is key in helping the patient cope with their emotions and navigate through their diagnosis.