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: 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: B

Rationale: Metformin is a commonly prescribed medication for the treatment of type 2 diabetes mellitus. One of the rare but serious adverse effects associated with metformin use is lactic acidosis. Lactic acidosis results from the buildup of lactic acid in the bloodstream, leading to symptoms such as weakness, rapid breathing, abdominal pain, and muscle pain. Lactic acidosis can be life-threatening and requires immediate medical attention. It is important for patients taking metformin to be aware of the signs and symptoms of lactic acidosis and seek immediate medical help if they experience any of these symptoms. Regular monitoring of kidney function is crucial in patients taking metformin to reduce the risk of lactic acidosis.

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: B

Rationale: Mastitis is typically caused by bacterial infection, with predisposing factors including milk stasis (I) and nipple trauma (II). Milk stasis occurs when milk is not effectively removed from the breast, leading to a build-up that can block ducts and predispose to infection. Nipple trauma, such as cracks or damage, can provide entry points for bacteria to infect the breast tissue. Factors like using alcohol in cleaning nipples (III) and the baby's sitting position (IV) are not directly associated with the development of mastitis.

Correct Answer: D

Rationale: The Somogyi effect, also known as rebound hyperglycemia, is a phenomenon observed in patients with diabetes mellitus during sleep. It is characterized by a low blood sugar level (hypoglycemia) followed by high blood sugar (hyperglycemia) in the morning. This occurs due to limited insulin in the body during the night, leading to high blood sugar levels in the morning as a response to the hypoglycemia episode. Too much globulin or albumin are not directly associated with the Somogyi effect. Increasing insulin in the body would rather help prevent the hypoglycemia episode that triggers the rebound hyperglycemia in the Somogyi effect.

Correct Answer: A

Rationale: ** In a patient with ARDS, the priority intervention to manage respiratory failure is to initiate lung-protective mechanical ventilation with low tidal volume. ARDS is characterized by widespread inflammation and injury to the alveoli, leading to impaired gas exchange and severe hypoxemia. Lung-protective ventilation strategies aim to minimize ventilator-induced lung injury by using lower tidal volumes (around 6 mL/kg of predicted body weight) to reduce barotrauma and volutrauma.

Correct Answer: B

Rationale: Acetaminophen (Tylenol) is given pre-operatively to decrease intra-operative anesthetic requirements and post-operative pain. It is a common analgesic that can help reduce the amount of intra-operative anesthesia needed and provide some pain relief during the surgery. Unlike drugs like Celebrex, Ibuprofen, and Demerol, Acetaminophen does not have anti-inflammatory properties, but it is effective in managing pain and can contribute to overall pain control before, during, and after surgery. This makes it a preferred choice for pre-operative medication in order to decrease the need for higher doses of anesthetics and reduce post-operative pain levels.

Correct Answer: D

Rationale: Papillary thyroid carcinoma is the most common type of thyroid cancer and is known for presenting as a painless unilateral enlargement of the thyroid gland. Fine-needle aspiration cytology typically reveals classic features such as numerous microfollicles and psammoma bodies. Thyroglossal duct cyst, Hashimoto's thyroiditis, and thyroid adenoma would not typically present with these cytological features or with painless thyroid enlargement as seen in papillary thyroid carcinoma.