Correct Answer: A

Rationale: The clinical presentation of severe lower abdominal pain and vaginal bleeding in a pregnant woman, along with cervical motion tenderness, unilateral adnexal tenderness, and an adnexal mass on the affected side, is highly concerning for an ectopic pregnancy. Ectopic pregnancy occurs when a fertilized egg implants outside the uterus, most commonly in the fallopian tube. The presence of an adnexal mass and tenderness on one side is indicative of potential tubal involvement and can mimic symptoms of pelvic inflammatory disease. Prompt evaluation and management are crucial in ectopic pregnancy to prevent life-threatening complications associated with rupture of the fallopian tube.

Correct Answer: B

Rationale: Negligence refers to the failure to perform a duty of care that a reasonable person would have exercised in the same situation, resulting in harm or injury to another person. In this scenario, the nurse failed to perform an ordered irrigation of a feeding tube, which is a standard nursing duty. This failure to act according to the orders resulted in harm to the patient, indicating negligence on the part of the nurse. Malpractice is a specific type of negligence that occurs when a professional fails to provide the standard level of care, so in this case, it falls under the broader category of negligence. Harm to the patient is the consequence of the nurse's negligence, and failure to follow the nurse practice act may be a contributing factor to the negligence, but the primary issue is the failure to provide proper care - which is negligence.

Correct Answer: C

Rationale: The patient is presenting with sudden-onset weakness and sensory loss on one side of the body along with difficulty speaking and understanding speech, which are classic symptoms of a stroke. The involvement of the right middle cerebral artery territory on imaging suggests an acute infarction, confirming an ischemic stroke. Ischemic stroke occurs due to a blockage or obstruction within a blood vessel supplying blood to the brain, leading to a lack of oxygen and nutrients reaching brain tissue. This results in neurological deficits corresponding to the affected area of the brain. In contrast, a transient ischemic attack (TIA) would present with similar symptoms but resolve within 24 hours without evidence of acute infarction on imaging. Intracerebral hemorrhage and subarachnoid hemorrhage involve bleeding into the brain tissue or the space surrounding the brain, respectively, resulting in different clinical presentations.

Correct Answer: D

Rationale: The given clinical presentation of chest pain that worsens with swallowing and is relieved by leaning forward along with diffuse ST-segment elevation on an ECG is highly suggestive of pericarditis. Pericarditis is the inflammation of the pericardium, the thin sac surrounding the heart. The symptoms of pericarditis can mimic those of myocardial infarction (heart attack) but can also be differentiated by certain characteristics such as the described positional chest pain, which is worsened by swallowing and relieved by leaning forward.

Correct Answer: A

Rationale: The guiding principle that health is an integral part of the education process is of utmost importance for a school nurse in performing their role and functions. This principle emphasizes the interconnectedness of health and academic success, highlighting that healthy students are better able to learn and succeed in school. As a school nurse, understanding and prioritizing this principle means focusing on promoting health and wellness, providing healthcare services, and implementing health education programs to support the overall well-being and academic achievement of students. By recognizing the significance of this principle, school nurses can effectively contribute to creating a healthy and supportive school environment that fosters student growth and development.