While taking nursing history on Annie, what will be the response of the patient that indicates her present condition?

Correct Answer: A

Rationale: The response indicating Annie's present condition would be option A. This is because the symptoms mentioned in option A, such as experiencing vertigo, nausea, and nystagmus when sitting, point towards a vestibular disorder. These are symptoms commonly associated with conditions like Meniere's disease or vestibular neuritis, which can cause balance issues and feelings of dizziness. These symptoms are more indicative of Annie's current health status compared to the other options which focus on past or unrelated issues, such as ear pain during travel or impaired hearing since birth. The information provided in option A gives a more direct insight into Annie's present condition, making it the most appropriate response.

Correct Answer: C

Rationale: The description provided is classical for fungal keratitis. Fungal keratitis typically presents with a yellowish-white spot on the cornea, often surrounded by a ring of inflammation. Branching, filamentous opacities extending from the corneal lesion are commonly seen on slit-lamp examination in cases of fungal keratitis. This condition is often associated with risk factors such as trauma with organic material or contact lens wear. Prompt diagnosis and treatment with antifungal agents are crucial in managing fungal keratitis to prevent potential complications.

Correct Answer: A

Rationale: A grieving individual may show a range of cues across different aspects of their life. Thoughts may include constant preoccupation with the loss, difficulties in concentrating, or intrusive thoughts. Feelings may involve sadness, anger, guilt, confusion, or relief. Behavioral cues may include changes in sleep patterns, appetite, energy levels, social withdrawal, or the use of substances. Physiologic complaints can manifest as headaches, stomach issues, fatigue, or other physical symptoms. Therefore, when a nurse observes cues related to thoughts, feelings, behavior, and physiologic complaints in a patient, it can suggest that the patient is grieving for a loss.

Correct Answer: B

Rationale: Thrombotic thrombocytopenic purpura (TTP) is a rare blood disorder characterized by microangiopathic hemolytic anemia, thrombocytopenia, fever, neurological abnormalities, and renal dysfunction. The peripheral blood smear in TTP typically shows fragmented red blood cells (schistocytes) due to mechanical destruction within small blood vessels. Laboratory findings in TTP commonly include elevated lactate dehydrogenase (LDH), decreased haptoglobin (as it is consumed in the clearance of free hemoglobin), and increased indirect bilirubin due to increased red blood cell breakdown. This combination of clinical presentation and laboratory abnormalities is classic for TTP. Hemolytic uremic syndrome (HUS) may present similarly but is more commonly associated with renal dysfunction and is often triggered by infection with Shiga toxin-producing E. coli.

Correct Answer: C

Rationale: Feces, urine, blood, and other body fluids are considered as vehicles of transmission in the context of communicable diseases. These substances can carry and transmit disease-causing microorganisms such as bacteria, viruses, and parasites from infected individuals to others. Through close contact or exposure to these contaminated body fluids, the pathogens can enter the body of another person and cause infection. Nurses like Nurse Keena must exercise caution and use appropriate infection control measures to prevent transmission of communicable diseases through these vehicles.

Correct Answer: C

Rationale: In pneumothorax, air enters the normally negative pressure space between the lung and chest wall, leading to loss of negative intra-pleural pressure. However, this loss of negative pressure typically does not directly result in lung collapse. Instead, the accumulation of air in the pleural space can lead to a pressure imbalance, causing the lung to collapse partially or completely, which is known as atelectasis. Therefore, it is more accurate to state that the loss of negative intra-pleural pressure can result in lung collapse due to the presence of air in the pleural space, rather than the loss of negative pressure itself causing the collapse.

Correct Answer: C

Rationale: Intracerebral hemorrhage is characterized by bleeding directly into the brain parenchyma, leading to the sudden onset of severe headache, vomiting, altered mental status, and neurological deficits. The hyperdense lesion seen on imaging is caused by the presence of blood within the brain tissue. This condition is often associated with hypertension and can be life-threatening if not promptly diagnosed and managed. Subdural hematoma is an accumulation of blood between the brain and its outermost covering (dura mater), typically presenting with a slower onset of symptoms compared to intracerebral hemorrhage. Subarachnoid hemorrhage involves bleeding into the space between the arachnoid membrane and the pia mater (subarachnoid space), commonly caused by the rupture of an aneurysm. Ischemic stroke results from the blockage of a blood vessel supplying the brain, leading to a lack of oxygen and nutrients to

Correct Answer: C

Rationale: The diagnosis of contact latex allergy is primarily based on the patient's history of exposure to latex-containing products and the development of symptoms upon contact with latex. To confirm the diagnosis, skin patch testing is performed. Skin patch testing exposes the skin to small amounts of latex allergens to observe for any localized allergic reaction, such as redness, swelling, or itchiness. This test helps determine if the individual has developed a delayed-type hypersensitivity reaction to latex. Latex-specific IgE testing (choice A) and finding IgE in serum (choice B) are methods used in diagnosing immediate-type latex allergy but are not sufficient for confirming contact latex allergy specifically. ELISA (choice D) is a type of laboratory technique used for various purposes, including measuring the levels of specific substances in the blood, but it is not typically used as a diagnostic tool for contact latex allergy.

Correct Answer: D

Rationale: In research involving adults who are capable of providing informed consent, such as a 21-year-old subject, the absolute way to ensure autonomy and respect for the individual's rights is to obtain informed and written consent directly from the subject herself. The subject's autonomy and right to self-determination should be respected, and obtaining consent directly from the subject ensures that they are fully informed about the research, its risks, benefits, and their rights regarding anonymity and confidentiality. In this case, Nurse Carmi must explain the research process clearly to the 21-year-old subject, obtain her informed consent in writing, and ensure that her anonymity, confidentiality, and human rights are protected throughout the study.