Upon data collection he had been failing three times in his math class and Korino was known for substance dependent for three years. What is the MOST APPROPRIATE nursing diagnosis for him?

Correct Answer: B

Rationale: The most appropriate nursing diagnosis for the individual described is "Ineffective individual coping." This is because the individual has been facing challenges in both academic (failing math class) and personal (substance dependence) aspects of his life. The repeated failures in his math class and the substance dependence for three years indicate that he might be struggling to cope with stressors and challenges in his life effectively. By identifying this nursing diagnosis, the nurse can focus on helping the individual develop effective coping strategies to manage and overcome these difficulties.

Correct Answer: A

Rationale: Acute narrow-angle glaucoma is a medical emergency that requires timely intervention to reduce intraocular pressure. Acetazolamide (Diamox) is a medication commonly used to treat this condition as it works as a carbonic anhydrase inhibitor, reducing the production of aqueous humor in the eye. By reducing the production of aqueous humor, acetazolamide helps decrease intraocular pressure rapidly, which is crucial in managing acute narrow-angle glaucoma. Other options listed, such as Furosemide (Lasix), Atropine, and Urokinase (Abbokinase), are not typically used in the treatment of acute narrow-angle glaucoma.

Correct Answer: D

Rationale: The presentation described is characteristic of a parathyroid adenoma. Parathyroid adenomas are benign neoplasms that can present as painless, well-defined nodules usually located in the lower pole of the thyroid gland or in close proximity, such as the lateral aspect of the neck above the clavicle. Fine-needle aspiration cytology of a parathyroid adenoma typically reveals polygonal cells with abundant granular cytoplasm, often referred to as chief cells. This is key in differentiating it from other conditions mentioned in the question.

Correct Answer: B

Rationale: The statement "Multigravida patient has shorter labor" is the best response to Patient Josephine's question about her shorter labor compared to previous deliveries. In obstetrics, it is commonly observed that labor tends to be shorter in patients who have had previous pregnancies (multigravida patients) due to factors such as prior cervical changes and previous stretching of the birth canal. This phenomenon is known as "multigravida cervical efficiency," and it can lead to faster and more efficient labors in subsequent pregnancies for women who have had previous deliveries.

Correct Answer: C

Rationale: In a pregnant patient with suspected pulmonary embolism (PE), the most appropriate imaging modality for evaluation is contrast-enhanced computed tomography (CT) pulmonary angiography. This imaging technique has been shown to be safe for the fetus when necessary, especially if the benefits of making a diagnosis outweigh the minimal risks associated with radiation exposure. It provides quick and accurate detection of PE with high sensitivity and specificity.

Correct Answer: A

Rationale: Magnetic Resonance Imaging (MRI) is a specialized medical imaging technique that uses magnetic fields and radio waves to create detailed images of the organs and tissues within the body. In the context of the scenario provided, an MRI is ordered by the attending physician to validate the medical impression.

Correct Answer: C

Rationale: The presentation described in the question, including the skin lesion resembling a "bull's eye" rash at the site of a tick bite, is characteristic of Lyme disease. Lyme disease is caused by the spirochete bacterium Borrelia burgdorferi, which is transmitted to humans through the bite of infected black-legged ticks (Ixodes scapularis). The symptoms of Lyme disease include fever, headache, myalgia, and the erythema migrans rash, which appears as a red circular rash with central clearing resembling a bull's eye.

Correct Answer: C

Rationale: In clients with ALS (Amyotrophic Lateral Sclerosis), death typically occurs within two to three years of diagnosis. This is often due to progressive weakness and degeneration of the muscles involved in breathing, leading to respiratory failure. As the disease advances, the muscles responsible for breathing become increasingly compromised, eventually resulting in the inability to breathe effectively without mechanical ventilation support. Other complications such as aspiration pneumonia and malnutrition may also contribute to the decline in health. Therefore, respiratory failure is the primary cause of death in clients with ALS.

Correct Answer: A

Rationale: At the concrete operational stage according to Piaget's theory, children typically demonstrate logical thinking abilities and are able to understand and work with concrete objects and events. They can also grasp concepts such as conservation and classification. These children are able to think logically about concrete events but may still struggle with abstract and hypothetical situations. Therefore, Belle, functioning at the concrete operational stage, would exhibit behaviors such as thinking logically and being able to see possibilities, as described in option A.