During a patient consultation, the nurse notices the patient seems anxious and is avoiding eye contact. What is the most appropriate action for the nurse to take?

Correct Answer: B

Rationale: The most appropriate action for the nurse to take when noticing that the patient seems anxious and is avoiding eye contact is to ask the patient if they are feeling anxious and if they would like to talk about it. This approach shows empathy, concern, and openness to addressing the patient's emotional state. By directly acknowledging the patient's behavior and giving them the opportunity to express their feelings, the nurse can create a supportive and caring environment that promotes effective communication and trust between the patient and healthcare provider. It is important to consider the patient's emotional well-being alongside their physical health during consultations.

Correct Answer: D

Rationale: Scabies is caused by an infestation of the microscopic mite Sarcoptes scabiei. This parasitic mite burrows into the upper layer of the skin, where it lays eggs and causes intense itching and skin irritation. The transmission of scabies usually occurs through close and prolonged skin-to-skin contact with an infested person. Unlike viruses, bacteria, and fungi, which are microorganisms that can also cause skin infections, scabies specifically refers to an infestation by a parasitic mite.

Correct Answer: A

Rationale: Albuterol (salbutamol) is a short-acting beta agonist bronchodilator commonly used for quick relief of bronchoconstriction in patients with COPD. It works by relaxing the smooth muscles in the airways, allowing for easier breathing and improved airflow. The patient's increased dyspnea, wheezing, and productive cough are indicative of bronchoconstriction, and albuterol is the most appropriate medication to provide rapid bronchodilation and symptom relief in this situation. Diphenhydramine (Benadryl) is an antihistamine and not typically used for bronchodilation in COPD. Montelukast (Singulair) is a leukotriene receptor antagonist that may be used in the maintenance treatment of COPD but is not the initial choice for acute symptom relief. Prednisone is a cortic

Correct Answer: A

Rationale: The nurse recommends regular monitoring of the patient's blood cholesterol levels to prevent complications from their heart disease. High levels of cholesterol can lead to the buildup of plaque in the arteries, increasing the risk of heart problems such as heart attacks and strokes. Monitoring cholesterol levels allows healthcare providers to assess the patient's risk and make appropriate recommendations for managing their heart disease. Regular monitoring can help track the effectiveness of lifestyle changes or medications in lowering cholesterol levels and reducing the risk of complications.

Correct Answer: B

Rationale: When a medication is unavailable and therefore not given to the patient, it is important to document this in the Nurses Notes along with an explanation. Leaving it blank (Option A) may lead to confusion or errors as the reason for not administering the medication would not be clear. Using an asterisk or mark as per hospital protocol (Option C) may not provide enough information about why the medication was missed. Writing the letter (Option D) without any explanation would not suffice in terms of documentation and accountability. Therefore, signing and making an explanation in the Nurses Notes (Option B) is the correct way to chart when a medication is unavailable. This ensures proper documentation of the situation and helps in maintaining the continuity of care for the patient.

Correct Answer: C

Rationale: Ménière's disease is characterized by the triad of symptoms including progressive sensorineural hearing loss, tinnitus, and vertigo. The audiometric testing in Ménière's disease often shows a "carrot-shaped" configuration, which refers to low-frequency hearing loss initially and eventually spreading to involve higher frequencies. This distinctive pattern of hearing loss helps differentiate Ménière's disease from other causes like Presbycusis (age-related hearing loss) or Noise-induced hearing loss. Acoustic neuroma can present with unilateral sensorineural hearing loss but typically does not exhibit the specific "carrot-shaped" configuration seen in Ménière's disease.

Correct Answer: B

Rationale: In a pregnant woman presenting with severe abdominal pain and vaginal bleeding at 8 weeks gestation with a closed cervix, the most likely cause of these symptoms is a threatened abortion. A threatened abortion is a common complication of early pregnancy characterized by vaginal bleeding and lower abdominal pain without cervical dilation. The cervix remains closed, indicating that the pregnancy is still intact but at risk of potential miscarriage. Placenta previa typically presents with painless vaginal bleeding in the second or third trimester, whereas ectopic pregnancy usually presents with abdominal pain and vaginal bleeding in the setting of a closed cervix but is less likely at 8 weeks gestation. Gestational trophoblastic disease is a rare cause of vaginal bleeding in pregnancy and typically presents in the first trimester with signs of hyperemesis gravidarum, uterine enlargement, and elevated β-hCG levels.

Correct Answer: A

Rationale: The patient is most likely experiencing autonomic dysreflexia. Autonomic dysreflexia is a potentially life-threatening condition that can occur in individuals with spinal cord injuries at the level of T6 or above. It is characterized by a sudden onset of severe hypertension, bradycardia, diaphoresis, flushing, and headache in response to a noxious stimulus below the level of injury. The sudden change in position from supine to sitting likely triggered autonomic dysreflexia in this patient.

Correct Answer: D

Rationale: Takotsubo cardiomyopathy, also known as stress-induced cardiomyopathy or broken heart syndrome, presents with symptoms similar to acute coronary syndrome, such as chest pain and ECG changes. In Takotsubo cardiomyopathy, chest pain typically occurs during emotional stress and resolves spontaneously, similar to the scenario described in the question. The ECG may show transient ST-segment elevation. This condition is characterized by a reversible left ventricular dysfunction that can mimic a myocardial infarction. Unlike stable angina (Choice A) and unstable angina (Choice B), Takotsubo cardiomyopathy is not related to coronary artery disease. Acute myocardial infarction (Choice C) typically presents with persistent ST-segment elevation on ECG and is caused by atherosclerotic plaque rupture leading to myocardial infarction, which is not consistent with the transient ST-segment elevation seen in