When determining the existence of malpractice, which factor is NOT considered?

Correct Answer: D

Rationale: When determining the existence of malpractice, intent is not considered as a factor. Malpractice typically involves unintentional actions or negligence rather than a deliberate intent to cause harm. The key factors that are usually considered in a malpractice case include duty (a legal obligation to provide a certain standard of care), causation (the link between the provider's actions and the patient's injury), and the existence of an injury resulting from the provider's actions or omissions. Intent does not play a direct role in malpractice cases, as they are focused on the standard of care provided by the healthcare professional and the harm caused as a result.

Correct Answer: A

Rationale: Administering systemic analgesia, such as pain medications or anesthesia, before the wound debridement procedure is the most effective way to minimize patient discomfort. These medications will help manage and reduce the pain experienced by the patient during the procedure, making it more tolerable for them. Topical anesthetic cream may provide some localized relief but may not be sufficient for significant pain management during a wound debridement procedure. Using sharp debridement techniques or performing the procedure quickly may help reduce manipulation or duration, respectively, but these actions alone may not adequately address the patient's pain and discomfort. Administering systemic analgesia ensures that the patient's overall pain is managed, promoting a more comfortable and successful wound debridement procedure.

Correct Answer: C

Rationale: Globulin is the blood protein involved in the immune system. There are different types of globulins, including immunoglobulins (antibodies) that play a crucial role in the body's defense against infections. These antibodies bind to foreign substances, such as bacteria and viruses, helping the immune system to recognize and destroy them. Thrombin is a clotting protein, albumin is a protein responsible for maintaining osmotic balance in the blood, and hemoglobin is a protein found in red blood cells that carries oxygen.

Correct Answer: C

Rationale: Uterine rupture is a serious obstetric emergency that involves a tear or rupture of the uterine wall during pregnancy. In this scenario, the pregnant woman with severe lower abdominal pain, vaginal bleeding, and a tender, distended abdomen is showing signs consistent with uterine rupture. These symptoms are typically not seen with other conditions listed.

Correct Answer: C

Rationale: The symptoms described are classic for amyotrophic lateral sclerosis (ALS), also known as Lou Gehrig's disease. ALS is a progressive neurodegenerative disease that affects nerve cells in the brain and spinal cord, leading to muscle weakness and atrophy. Patients typically present with weakness, muscle atrophy, fasciculations (muscle twitching), and eventually develop difficulty swallowing and breathing due to involvement of the muscles responsible for these functions. Parkinson's disease (Choice A) is a neurodegenerative disorder characterized by tremors, rigidity, and bradykinesia but does not typically present with muscle atrophy or fasciculations as described in the case. Guillain-Barré syndrome (GBS) (Choice B) is an acute inflammatory condition affecting peripheral nerves, leading to ascending paralysis, which is usually reversible. Myasthenia gravis (Choice D) is an autoimmune disorder that affects neu

Correct Answer: D

Rationale: The presentation of sudden-onset severe headache, vomiting, and altered mental status, along with the presence of a berry-shaped aneurysm on imaging, point towards a diagnosis of subarachnoid hemorrhage. The most common cause of a subarachnoid hemorrhage is the rupture of a saccular (berry) aneurysm, which commonly occurs at the junction of the anterior communicating artery and anterior cerebral artery. The sudden headache is often described as the "worst headache of my life" and is typically associated with nausea and vomiting. Altered mental status may be present due to the effects of increased intracranial pressure and possible associated brain injury. It is important to promptly diagnose and manage subarachnoid hemorrhage to prevent complications such as vasospasm, rebleeding, and ischemic deficits.

Correct Answer: B

Rationale: Systematic meta-analysis of the literature typically involves synthesizing research findings from multiple studies on a particular topic. The most common way to gather relevant studies for a meta-analysis is by searching through electronic databases. These databases contain a wide range of peer-reviewed literature such as research articles, reviews, and conference papers. Using electronic databases ensures a comprehensive and systematic approach to finding all relevant studies needed for a meta-analysis. While doctoral dissertations and statistical methods such as those offered by Cochrane can also be valuable sources of information, an electronic database is the primary tool used for conducting a systematic meta-analysis of the literature.

Correct Answer: A

Rationale: In a patient with acute myocardial infarction (MI) complicated by cardiogenic shock, the primary intervention to manage shock is emergent percutaneous coronary intervention (PCI). PCI is a procedure performed to restore blood flow in an occluded coronary artery that is causing the MI. By opening up the blocked artery and restoring blood flow to the heart muscle, PCI can help reduce myocardial damage, improve cardiac function, and stabilize the patient's condition. Prompt reperfusion via PCI is crucial in the setting of cardiogenic shock to improve survival outcomes and reduce the risk of further complications. Administering inotropic medications, initiating therapeutic hypothermia, or recommending anticoagulant therapy may be components of management in specific cases but are not the primary intervention for managing shock in a patient with acute MI and cardiogenic shock.

Correct Answer: B

Rationale: When a patient with chronic kidney disease is prescribed erythropoietin-stimulating agents (ESAs) for anemia management, the parameter that should be monitored closely by the nurse is the hemoglobin levels. Hemoglobin levels indicate the patient's response to ESA therapy and are essential in assessing the effectiveness of the treatment in addressing anemia. Monitoring hemoglobin levels helps ensure that the patient's anemia is controlled within the target range to avoid both the risks of under-treatment (resulting in persistent anemia) and over-treatment (increased risk of adverse outcomes such as hypertension, stroke, or cardiovascular events).