Which of the ff. conditions places a patient at risk for respiratory complications following his splenectomy?

Correct Answer: C

Rationale: The correct answer is C: An incision near the diaphragm. Following a splenectomy, an incision near the diaphragm can lead to respiratory complications due to potential irritation or injury to the diaphragm. This can result in impaired breathing and increased risk of respiratory issues such as pneumonia. A: A low platelet count is not directly related to respiratory complications following a splenectomy. B: Early ambulation is generally encouraged to prevent complications such as blood clots but does not specifically impact respiratory complications. D: Early discharge may not directly lead to respiratory complications, as long as the patient is adequately monitored postoperatively.

Correct Answer: D

Rationale: The correct answer is D: All of the above. Malignant melanoma, basal cell epithelioma, and squamous cell carcinoma are all forms of skin cancer associated with prolonged sun exposure. Melanoma is the deadliest form, originating in melanocytes; basal cell and squamous cell carcinomas are more common but less aggressive. All three types can develop due to cumulative UV radiation exposure. Therefore, all options are correct in this context.

Correct Answer: D

Rationale: The correct answer is D: Ankylosing spondylitis. This disease process is characterized by chronic progressive inflammation of the sacroiliac and costovertebral joints and adjacent soft tissue. Ankylosing spondylitis specifically affects the spine and large joints. Rheumatoid arthritis (A) is characterized by joint inflammation and primarily affects small joints. Scoliosis (B) is a condition characterized by an abnormal lateral curvature of the spine, not inflammation of the sacroiliac and costovertebral joints. Kyphosis (C) is an excessive outward curvature of the spine, not related to inflammation of the sacroiliac and costovertebral joints.

Correct Answer: D

Rationale: The correct answer is D: Aphasia. Aphasia is a language disorder that affects a person's ability to communicate and understand speech. In this case, Mr. Dela Isla's difficulty in comprehending what the nurse was saying indicates a problem with language processing, which aligns with the symptoms of aphasia. Insomnia (A) is a sleep disorder, not related to language comprehension. Agnosia (B) is a perception disorder where someone cannot recognize objects or people, not related to language. Apraxia (C) is a motor disorder affecting the ability to perform purposeful movements, not related to language comprehension.

Correct Answer: A

Rationale: The correct answer is A: Avoiding using soap on the irradiated areas. Soap can irritate the skin and exacerbate the risk for impaired skin integrity in a client receiving radiation therapy. By avoiding soap, we minimize the risk of skin breakdown and promote skin healing. B: Applying talcum powder can actually worsen skin irritation and should be avoided. C: Wearing a lead apron is not relevant to the nursing diagnosis of risk for impaired skin integrity. D: Removing thoracic skin markings is not necessary for skin integrity and may disrupt the treatment plan.

Correct Answer: C

Rationale: The correct answer is C: To rule out cholinergic crisis caused by Neostigmine. Edrophonium HCL is a fast-acting cholinesterase inhibitor used to differentiate between myasthenic crisis and cholinergic crisis. If the patient's weakness improves after administration of edrophonium, it indicates that the weakness was due to myasthenia gravis and not cholinergic crisis caused by excessive neostigmine. Choice A is incorrect because there is no synergestic effect between neostigmine and edrophonium. Choice B is incorrect as resistance to neostigmine is not a valid reason for ordering edrophonium. Choice D is incorrect because edrophonium is used for differential diagnosis, not for confirming the diagnosis of myasthenia gravis.

Correct Answer: C

Rationale: Step-by-step rationale for choice C being correct: 1. Restlessness: Indicates increased work of breathing and hypoxia. 2. Suprasternal retractions: Sign of respiratory distress. 3. paO2 of 62: Indicates severe hypoxemia, common in ARDS. Summary: A: Enlarged heart on x-ray does not directly indicate ARDS. B: Thick green sputum suggests infection, not specific to ARDS. D: Wheezes and slow respirations are not typical of ARDS, and pCO2 is normal in ARDS.

Correct Answer: E

Rationale: I'm sorry, but it seems like the correct answer (E) is missing from the question. Could you please provide the correct answer so that I can provide you with a detailed explanation of why it is correct and summarize why the other choices are incorrect?

Correct Answer: B

Rationale: The correct answer is B: Tachycardia. Levothyroxine is a synthetic form of thyroid hormone used to treat hypothyroidism. If the dose is too high, it can lead to symptoms of hyperthyroidism, including tachycardia (rapid heartbeat). This is because an excess of thyroid hormone can increase the heart rate. Dysuria (choice A) is not a common adverse effect of levothyroxine. Leg cramps (choice C) are more commonly associated with electrolyte imbalances. Blurred vision (choice D) is not a typical adverse effect of levothyroxine.