Correct Answer: B

Rationale: Pelvic inflammatory disease (PID) is the most likely cause of the symptoms described in the pregnant woman. PID is an infection of the female reproductive organs, typically caused by sexually transmitted bacteria like Chlamydia or Gonorrhea. The classic presentation includes lower abdominal pain, fever, vaginal discharge, cervical motion tenderness, and bilateral adnexal tenderness on examination. This condition can lead to serious complications if not promptly treated, including infertility, ectopic pregnancy, and chronic pelvic pain. Therefore, it is crucial to diagnose and manage PID promptly, especially in pregnant women, to prevent adverse outcomes.

Correct Answer: A

Rationale: The symptoms described - sudden-onset severe headache, nausea, vomiting, photophobia, neck stiffness, and positive Kernig and Brudzinski signs - are classic manifestations of meningitis. Meningitis is an inflammation of the meninges, the protective membranes covering the brain and spinal cord, often caused by infection. The sudden onset of these symptoms and signs, along with neck stiffness and positive Kernig and Brudzinski signs (indicative of meningeal irritation), strongly suggest meningitis as the most likely diagnosis in this scenario.

Correct Answer: B

Rationale: The most critical action to prioritize for ensuring patient safety during a cardiopulmonary exercise stress test is to monitor the patient's electrocardiogram (ECG) rhythm continuously during the test (Option B). This monitoring allows the healthcare team to promptly detect any abnormal heart rhythms or signs of cardiac distress, enabling timely intervention if necessary. Continuous ECG monitoring is essential during exercise testing as it helps in assessing the heart's response to physical activity and identifying any potential cardiac abnormalities or complications that may arise during the test. By closely monitoring the ECG rhythm, the nurse can ensure the patient's safety and well-being throughout the procedure. Administering a beta-blocker medication before the test (Option A) may be indicated in some cases but is not as crucial as continuous ECG monitoring during the test. Encouraging the patient to consume a heavy meal before the test (Option C) is contraindicated as it can interfere with the accuracy of the results

Correct Answer: C

Rationale: In a critically ill patient admitted to the ICU with acute renal failure requiring renal replacement therapy (RRT), the healthcare team should prioritize the initiation of continuous renal replacement therapy (CRRT). CRRT is preferred in critically ill patients with hemodynamic instability as it allows for slow and continuous removal of solutes and fluids, making it a safer option compared to intermittent hemodialysis. CRRT can also provide better control of volume status and electrolyte imbalances over a longer period, which is beneficial in critically ill patients who are hemodynamically unstable. Peritoneal dialysis is not commonly used in the ICU setting for acute renal failure requiring RRT, and loop diuretics are not effective in treating acute renal failure. Temporary hemodialysis catheters may also be used, but CRRT is generally preferred in critically ill patients for better hemodynamic tolerance and control of solute and fluid removal.

Correct Answer: D

Rationale: For a diagnostic pelvic ultrasound, one important preparation is to have the patient void or empty their bladder before the procedure. This allows for better visualization of the pelvic organs and structures during the ultrasound scan. A full bladder can obstruct the view and make it difficult to obtain accurate images. Therefore, it is essential for the patient to follow instructions to empty their bladder before the pelvic ultrasound to ensure the best results.