Which of the following clinical manifestations will NOT be a complaint from Sarah's condition?

Correct Answer: C

Rationale: Sarah's condition seems to be related to growth and wound healing issues, based on the provided clinical manifestations. Decrease libido is typically unrelated to conditions like edema, poor wound healing, and absence of growth in the pubic area. Therefore, it would not be a complaint stemming from Sarah's condition.

Correct Answer: B

Rationale: The presentation described is consistent with nummular eczema, also known as discoid eczema. Nummular eczema typically presents as circular or oval-shaped patches of eczematous rash with fine scaling and central clearing. It is often pruritic and can be triggered by exposure to irritants such as new soaps or laundry detergents. The distribution on the trunk and proximal extremities is also typical for nummular eczema. Tinea corporis (ringworm) would present with a more raised, scaly, and well-defined border with central clearing. Pityriasis rosea presents with a herald patch followed by smaller oval or round lesions in a "Christmas tree" distribution. Lichen planus would present with polygonal, purplish, flat-topped papules typically located on flexural surfaces and extremities.

Correct Answer: D

Rationale: The best time to visit the clinic for the first prenatal care is during the first trimester of pregnancy, ideally before the 12th week. This is because early prenatal care is crucial for monitoring the health of both the mother and the developing baby, identifying any risk factors or complications early on, and initiating important interventions such as prenatal vitamins and screenings. By starting prenatal care early in the first trimester, potential issues can be identified and addressed promptly, leading to better pregnancy outcomes. It is important for pregnant women to seek early prenatal care to ensure a healthy pregnancy and delivery.

Correct Answer: D

Rationale: Late decelerations on the fetal monitor tracing indicate a potential uteroplacental insufficiency, which could be caused by decreased oxygen supply to the fetus. One common cause of late decelerations is uterine hyperstimulation due to excessive use of oxytocin. By discontinuing the oxytocin infusion, the nurse can help alleviate the stress on the fetus and decrease the likelihood of further late decelerations. This action should be prioritized before other interventions such as changing the mother's position or administering oxygen. Immediate delivery may be necessary if the fetus continues to show signs of distress despite discontinuing the oxytocin infusion.

Correct Answer: C

Rationale: The clinical presentation of fever, malaise, maculopapular rash starting on the face and spreading to the trunk and extremities, along with leukopenia and thrombocytopenia, is highly suggestive of Rocky Mountain spotted fever (RMSF) caused by Rickettsia rickettsii. RMSF is a tick-borne illness transmitted by the American dog tick, Rocky Mountain wood tick, and brown dog tick. The constellation of symptoms described aligns well with the typical presentation of RMSF. Borrelia burgdorferi causes Lyme disease, which presents with erythema migrans but does not typically cause leukopenia or thrombocytopenia. Plasmodium falciparum is the causative agent of severe malaria and would present with symptoms such as cyclic fevers, anemia, and jaundice but not the described rash distribution.

Correct Answer: D

Rationale: False imprisonment occurs when a client is physically restrained or confined without legal justification. In this scenario, the nurse restraining the confused and combative client without a physician's order constitutes false imprisonment. Restraints should only be used when necessary to ensure the safety of the client or others, and a physician's order is required to authorize their use. In this case, the nurse acted without proper authorization, making it a violation of the client's rights and false imprisonment. It is essential to follow proper protocols and obtain necessary orders before restraining a client.

Correct Answer: B

Rationale: In patients with Rheumatic fever, typical manifestations include an increase in body temperature, non-pruritic rashes, and migratory joint pains. Voluntary muscle spasm is not a typical manifestation of Rheumatic fever. The main clinical features of Rheumatic fever are related to the inflammation of the heart, joints, skin, and central nervous system. Muscle spasms are not a prominent feature of this condition. It is important for the nurse to be aware of these typical manifestations to effectively monitor and manage the patient's condition.

Correct Answer: C

Rationale: Vocal cord nodules are benign growths on the vocal cords, typically caused by vocal abuse or misuse. The most appropriate intervention for managing vocal cord nodules is voice therapy and vocal hygiene education. Voice therapy aims to correct vocal habits and techniques that contribute to the formation of nodules, while vocal hygiene education focuses on maintaining vocal health through proper hydration, rest, and avoiding behaviors that strain the vocal cords. These interventions have been shown to be effective in reducing and eliminating vocal cord nodules without the need for surgical intervention. Surgery, such as vocal cord polypectomy or injection with corticosteroids, is typically reserved for cases that do not respond to conservative management or if there are significant complications. Partial laryngectomy is a more extensive surgical procedure that is not typically indicated for vocal cord nodules.

Correct Answer: B

Rationale: In this situation, the best way to communicate Marlene's piece of advice would be to inform her about government agencies that provide financial assistance. This option provides a long-term solution for her financial difficulties rather than short-term fixes like asking relatives for help or paying in staggered amounts. By giving her information about available resources, you are empowering her to seek sustainable help for her financial situation. This approach focuses on addressing the root cause of her inability to pay the bill rather than temporary solutions.