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: The appropriate way to correct an error in the Nurses Notes is to draw a single line across the error and initial it. This method is recommended because it indicates that there was an error made, while still preserving the original information for audit and legal purposes. It shows transparency and accountability in documentation, as the original information remains visible. Taking the whole page out and replacing it with a fresh one can lead to discrepancies and potential legal issues if there are inconsistencies in the documentation. Using methods like using the sticky side of the plastic tape or a rubber eraser can make the documentation look unprofessional and raises questions about the accuracy and integrity of the notes.

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: B

Rationale: The responsibility of obtaining informed consent typically falls on the physician or the healthcare provider who is performing the procedure or treatment. Informed consent is a process where the healthcare provider explains the procedure, its risks, benefits, possible alternatives, and potential outcomes to the patient or their legal representative. The patient must have a comprehensive understanding of these aspects before agreeing to the treatment. While nurses, nurse managers, anesthesiologists, midwives, and other healthcare professionals may assist in the consent process by providing information or clarifications, the ultimate responsibility lies with the physician. This is because the physician is usually the one with the expertise and knowledge about the specific procedure or treatment being performed.

Correct Answer: A

Rationale: Failed to generate a rationale of 500+ characters after 5 retries.

Correct Answer: A

Rationale: Grilled chicken breast is a suitable choice for a low-phosphorus diet because poultry is typically lower in phosphorus compared to dairy products (like cheese), nuts (like almonds), and whole grains (like wheat toast). This option indicates an understanding of the need to restrict phosphorus intake, which is important for individuals with chronic kidney disease to prevent complications.

Correct Answer: B

Rationale: A severe headache is a classic sign of a hemorrhagic stroke. Hemorrhagic stroke occurs when a blood vessel in the brain ruptures and causes bleeding. This bleeding can lead to increased pressure within the skull, resulting in a sudden and severe headache. Other symptoms of a hemorrhagic stroke may include nausea, vomiting, sudden weakness or numbness on one side of the body, difficulty speaking or understanding speech, and loss of coordination. It is important to seek immediate medical attention if someone is experiencing symptoms of a stroke, including a severe headache, as prompt treatment is crucial in minimizing damage and improving outcomes.

Correct Answer: C

Rationale: The PRIORITY nursing action of the nurse for Jose due for oxygen therapy is to turn on the oxygen. Ensuring that the oxygen is turned on is the necessary first step before any other actions can be effective in delivering oxygen to the patient. Without oxygen being turned on, all other steps such as attaching the humidifier, connecting tubing, or adjusting the flow rate would be ineffective in providing the necessary oxygen therapy to the patient. Therefore, turning on the oxygen is the most crucial initial step to take in this situation to ensure that the patient receives the needed oxygen promptly and safely.

Correct Answer: D

Rationale: In this scenario, the patient's presentation of a painless thyroid nodule and hoarseness of voice is consistent with papillary thyroid carcinoma, a type of thyroid cancer. While Hashimoto's thyroiditis and Graves' disease are autoimmune thyroid conditions that can lead to thyroid nodules, they typically do not present with hoarseness of voice. Diabetes mellitus does not directly cause these symptoms. Thyroid cancer, particularly papillary thyroid carcinoma, is the most likely cause based on the patient's clinical presentation and the biopsy results.