A patient with suspected community-acquired pneumonia (CAP) is empirically started on antibiotic therapy pending culture results. Which of the following antibiotic regimens provides appropriate coverage for typical bacterial pathogens commonly implicated in CAP?

Correct Answer: A

Rationale: The correct answer is A: Ceftriaxone and azithromycin. Ceftriaxone covers Streptococcus pneumoniae, the most common pathogen in CAP, while azithromycin covers atypical pathogens like Mycoplasma pneumoniae. Vancomycin and piperacillin/tazobactam (choice B) are not first-line treatments for CAP. Ampicillin-sulbactam and levofloxacin (choice C) cover some pathogens but not as comprehensively as ceftriaxone and azithromycin. Clindamycin and cefepime (choice D) do not provide adequate coverage for typical CAP pathogens.

Correct Answer: B

Rationale: The correct answer is B: Herpes simplex virus infection. The presentation of a painful, vesicular rash following a linear pattern on the left forearm is characteristic of herpes simplex virus infection, specifically herpes zoster (shingles). The linear pattern is due to the virus following a specific nerve pathway. This is different from the other choices - A: Allergic contact dermatitis typically presents as a diffuse rash at the site of contact with an allergen, not a linear pattern. C: Scabies presents with burrows and papules, not vesicles in a linear pattern. D: Poison ivy dermatitis causes a diffuse rash, not a linear vesicular rash.

Correct Answer: A

Rationale: The correct answer is A: Administering proton pump inhibitors (PPIs) concomitantly. Aspirin and clopidogrel can increase the risk of gastrointestinal bleeding. PPIs help reduce this risk by decreasing gastric acid production. Therefore, administering PPIs with dual antiplatelet therapy is essential for preventing bleeding complications. Encouraging increased fluid intake (B) may not directly address the risk of bleeding. Monitoring for signs of thrombocytopenia (C) is important but may not directly prevent bleeding in this case. Providing education on fall prevention measures (D) is important for overall safety but does not directly address bleeding risks associated with dual antiplatelet therapy.

Correct Answer: B

Rationale: Plantar fasciitis is the correct answer. It is characterized by inflammation of the plantar fascia, leading to heel pain, especially in the morning. The plantar fascia is a band of tissue that connects the heel bone to the toes. The pain is usually worse with the first steps after resting. Achilles tendinitis involves inflammation of the Achilles tendon, which connects the calf muscles to the heel bone, causing pain at the back of the heel and ankle. Morton's neuroma is a condition involving a thickening of tissue around a nerve in the ball of the foot, leading to sharp, burning pain in the toes. Stress fracture of the calcaneus refers to a small crack in the heel bone due to repetitive stress or overuse, resulting in heel pain that may worsen with activity, but not specifically with the first steps in the morning.

Correct Answer: C

Rationale: The correct answer is C: Primary prevention. In this scenario, the clinic focuses on preventing disease before it occurs through health education and immunization. Primary prevention aims to promote general health and prevent the onset of diseases. It targets the entire population to reduce the risk of disease occurrence. Incorrect Choices: A: Diagnosis and treatment - This choice involves identifying and treating existing health conditions, which is not the primary focus of a clinic designed for health education and immunization. B: Secondary prevention - This choice involves early detection and treatment of diseases to prevent complications, which is more focused on individuals who already have risk factors or symptoms, not on the general population. D: Tertiary prevention - This choice involves managing and treating complications of diseases to prevent further deterioration, which is not the primary goal of a clinic focused on health education and immunization.

Correct Answer: D

Rationale: The correct answer is D: advocacy. Advocacy involves actively supporting and promoting the welfare and rights of the patient. Nurses advocate for their patients by ensuring their health, safety, and personal rights are upheld. This ethical principle goes beyond just fulfilling responsibilities or being accountable for one's actions. Responsibility (A) focuses on duties and tasks, accountability (B) is about being answerable for one's actions, and confidentiality (C) pertains to maintaining patient privacy. In this context, advocacy is the most appropriate choice as it encompasses actively working to protect and promote the best interests of the patient.

Correct Answer: B

Rationale: When a woman in active labor exhibits signs of prolonged second stage, such as ineffective pushing efforts and slow fetal descent, one of the maternal conditions that should be considered is pelvic floor dysfunction. The pelvic floor muscles play a crucial role in supporting the uterus, bladder, and rectum. If these muscles are weak or dysfunctional, it can lead to difficulty in pushing effectively and impede the descent of the fetus through the birth canal. This can result in prolonged labor and increase the risk of complications for both the mother and the baby. Therefore, assessing for pelvic floor dysfunction is important in addressing the abnormal labor pattern and providing appropriate interventions to support the progress of labor.

Correct Answer: B

Rationale: The correct answer is B: Provides reality orientation to patient. Orienting the patient to time, place, date, and events helps them stay connected to reality and improves their awareness of their surroundings. This is crucial in assessing their cognitive functioning and ensuring they are grounded in the present moment. By providing reality orientation, healthcare providers can better understand the patient's current mental state and address any potential confusion or disorientation. This approach aids in establishing a therapeutic environment and enhances the patient's overall well-being. Choices A, C, and D do not capture the essence of reality orientation and its significance in maintaining the patient's mental clarity and connection to the present moment.

Correct Answer: C

Rationale: The correct answer is C: Cells die. In Alzheimer's disease, there is a progressive degeneration of brain cells, leading to cell death. This results in a loss of important brain functions such as memory, cognition, and eventually, bodily functions. The atrophy of the brain stem (choice A) is not a characteristic feature of Alzheimer's. Fluid buildup (choice B) is not a primary mechanism of the disease. Tissue swelling (choice D) is not typically associated with the progression of Alzheimer's; rather, there is a gradual loss of brain tissue due to cell death.