A patient with renal failure presents with confusion, seizures, asterixis, and a sweet odor to the breath. Laboratory findings reveal severe metabolic acidosis, hyperkalemia, and elevated blood urea nitrogen (BUN) and creatinine levels. What is the most likely diagnosis?

Correct Answer: B

Rationale: The patient's presentation with renal failure, confusion, seizures, asterixis, and a sweet odor to the breath, along with laboratory findings of severe metabolic acidosis, hyperkalemia, and elevated BUN and creatinine levels, is consistent with uremic encephalopathy. Uremic encephalopathy is a neurological complication of acute or chronic renal failure resulting from the buildup of uremic toxins in the blood, leading to various neurological symptoms such as confusion and seizures. The sweet odor to the breath can be attributed to the presence of urea, a waste product that accumulates in renal failure. Other metabolic abnormalities like hyperkalemia and severe metabolic acidosis are also common in renal failure. It is crucial to promptly recognize and manage uremic encephalopathy to prevent further neurological complications.

Correct Answer: D

Rationale: Postpartum hemorrhage is defined as a blood loss of more than 500 ml within the first 24 hours after vaginal delivery or more than 1000 ml following a cesarean delivery. Excessive bleeding can lead to hypovolemic shock and can be life-threatening if not promptly addressed. Therefore, a blood loss of more than 500 ml/24 hours would lead the nurse to suspect a postpartum hemorrhage and prompt further assessment and intervention.

Correct Answer: A

Rationale: Nurse Adalynn explains to the mothers that early indication for hypovolemia caused by postpartum hemorrhage is an increasing pulse and decreasing blood pressure. Hypovolemia is a condition where there is a decreased volume of circulating blood in the body, often characterized by fluid loss such as through bleeding. As blood volume decreases, the heart rate increases in an attempt to maintain adequate perfusion to organs and tissues. This results in an elevated pulse rate. Additionally, as the blood volume decreases, the blood pressure may drop due to the reduced amount of blood being pumped around the body. Therefore, monitoring for an increasing pulse and decreasing blood pressure is crucial in detecting hypovolemia early, allowing for prompt intervention to prevent further complications.

Correct Answer: C

Rationale: Uterine rupture is a serious obstetric emergency that involves a tear or rupture of the uterine wall during pregnancy. In this scenario, the pregnant woman with severe lower abdominal pain, vaginal bleeding, and a tender, distended abdomen is showing signs consistent with uterine rupture. These symptoms are typically not seen with other conditions listed.

Correct Answer: D

Rationale: Nephrolithiasis refers to the formation of stones within the kidney or urinary tract. The most common types of kidney stones are either composed of calcium oxalate or calcium phosphate. When these stones form within the renal collecting system, they can lead to symptoms such as flank pain, hematuria, and urinary obstruction. Ureteropelvic junction (UPJ) obstruction and ureterovesical junction (UVJ) obstruction are specific types of blockages within the urinary system that can be caused by kidney stones but are not characteristic of the stone formation itself. Renal colic is the term used to describe the severe pain associated with the passage of a kidney stone through the ureter.

Correct Answer: C

Rationale: In this situation, the most appropriate way for the nurse to handle it would be to encourage the mother to keep calm because the health care team is doing their best to help Ramon recover. This response acknowledges the mother's concerns and reassures her that everything possible is being done for her son's well-being. It also helps to foster trust and rapport between the nurse, mother, and the healthcare team, which is important for effective communication and support during a challenging time. Promoting a sense of calm and trust in the healthcare professionals can help alleviate the mother's anxiety and stress, allowing her to focus on being a supportive presence for her son.

Correct Answer: A

Rationale: Endometriosis is a condition characterized by the abnormal growth of endometrial tissue outside the uterus. One common symptom of endometriosis is excessive menstrual bleeding, known as menorrhagia. This excessive bleeding is due to the presence of endometrial tissue in abnormal locations, leading to inflammation, scarring, and blood accumulation. In severe cases, endometriosis can lead to the formation of adhesions, cysts, and scar tissue, causing significant pain and fertility issues for affected individuals. Endometrial hyperplasia, leiomyomas (uterine fibroids), and adenomyosis are other gynecological conditions, but they do not involve the abnormal proliferation of endometrial tissue outside the uterus like endometriosis does.

Correct Answer: C

Rationale: Normal saline solution is the best choice for cleaning Claudia's eyes with drainage. It is a sterile solution that closely matches the natural pH of the eyes, making it gentle and safe for ocular use. Normal saline can help flush out any debris or discharge in the eye without causing further irritation or complications. On the other hand, hydrochloric acid is a corrosive substance that can cause significant harm if it comes into contact with the eyes. Mineral water may contain impurities that could further irritate the eyes. Soapsuds solution is not recommended for eye cleaning as it can cause irritation and damage to the delicate eye tissues. Therefore, normal saline solution is the most appropriate and safe option for cleaning Claudia's eyes in this situation.

Correct Answer: A

Rationale: In a community clinic providing primary care for patients, the most common healthcare professional who manages patient care is a physician. Physicians, also known as doctors, are trained and licensed to diagnose and treat a wide range of medical conditions. They are responsible for conducting exams, prescribing medications, ordering tests, and developing treatment plans for patients. While other healthcare professionals such as nurses, midwives, and barangay health workers also play important roles in providing care, physicians typically lead the team, make critical decisions, and provide overall management of patient care in a primary care setting like a community clinic.