D444 Adult Health I - Set 2 - Part 1

Correct Answer: Septic shock developing

Option b is correct because mental status changes with restlessness and confusion indicate septic shock, a life-threatening pneumonia complication requiring immediate intervention.
Option a is incorrect because antibiotics for pneumonia rarely cause confusion as a side effect, making septic shock more likely given the presentation.
Option c is incorrect because allergic reactions present with rash, itching, or respiratory distress rather than isolated mental status changes in pneumonia.
Option d is incorrect because while dehydration can cause confusion, the acute mental changes with pneumonia suggest more serious septic complications developing.

Correct Answer: Eye drop medications

Option b is correct because topical eye drops like timolol or travoprost effectively reduce intraocular pressure in open-angle glaucoma management long-term.
Option a is incorrect because oral steroids can actually increase intraocular pressure, worsening glaucoma rather than treating the condition effectively overall.
Option c is incorrect because systemic diuretics are reserved for acute angle-closure glaucoma emergencies, not chronic open-angle glaucoma management routinely.
Option d is incorrect because antibiotics do not reduce intraocular pressure or treat glaucoma unless secondary infection is present concurrently.

Correct Answer: Early morning collection

Option b is correct because early morning sputum contains concentrated overnight secretions with highest bacterial load for accurate tuberculosis diagnosis.
Option a is incorrect because bedtime collection misses the concentrated secretions that accumulate overnight, reducing diagnostic accuracy for tuberculosis detection.
Option c is incorrect because post-meal sputum may be diluted with saliva and food particles, interfering with accurate tuberculosis testing.
Option d is incorrect because random collection times produce inconsistent results compared to standardized early morning specimen collection for diagnosis.

Correct Answer: Chronic productive cough

Option b is correct because chronic bronchitis characteristically presents with persistent productive cough and sputum production unlike emphysema presentations typically seen.
Option a is incorrect because barrel chest occurs primarily in emphysema due to air trapping and hyperinflation, not chronic bronchitis specifically.
Option c is incorrect because pursed lip breathing occurs in both emphysema and chronic bronchitis as a compensatory breathing mechanism used.
Option d is incorrect because both conditions cause decreased oxygen saturation, making this finding non-specific for distinguishing between them clinically.

Correct Answer: Reduces contraceptive effectiveness

Option b is correct because rifampin induces liver enzymes that metabolize oral contraceptives faster, reducing their effectiveness and risking pregnancy.
Option a is incorrect because rifampin does not directly increase pregnancy risks but rather reduces the effectiveness of hormonal contraception methods.
Option c is incorrect because while some TB drugs are teratogenic, the contraceptive recommendation relates to effectiveness not birth defect risks.
Option d is incorrect because rifampin does not increase bleeding risk that would contraindicate hormonal contraceptive use in patients specifically.

Correct Answer: Mental confusion

Option b is correct because elevated ammonia crosses the blood-brain barrier causing mental confusion characteristic of hepatic encephalopathy in cirrhosis.
Option a is incorrect because hepatic encephalopathy typically causes decreased appetite and nausea rather than increased appetite in affected patients.
Option c is incorrect because bilirubin levels are independent of ammonia and do not indicate hepatic encephalopathy development or improvement.
Option d is incorrect because hepatic encephalopathy causes asterixis and poor coordination, not improvement in motor function or coordination abilities.

Correct Answer: Respiratory acidosis

Option b is correct because respiratory acidosis indicates carbon dioxide retention from severe airway obstruction, signaling potential respiratory failure approaching.
Option a is incorrect because return of wheezing actually indicates improved air movement compared to the silent chest of severe obstruction.
Option c is incorrect because increased coughing suggests improving airway clearance rather than a dangerous complication developing in asthma.
Option d is incorrect because chest tightness is expected in asthma attacks and less dangerous than respiratory acidosis indicating ventilatory failure.

Correct Answer: Eat small frequent meals

Option c is correct because small frequent meals reduce intestinal stress and inflammation, helping prevent Crohn's disease exacerbations and complications.
Option a is incorrect because high fiber can worsen inflammation and obstruction risk in Crohn's disease, especially during active flares.
Option b is incorrect because large meals increase intestinal workload and can trigger cramping, diarrhea, and inflammation in Crohn's patients.
Option d is incorrect because temperature of beverages is less important than meal size and frequency for managing Crohn's disease.

Correct Answer: Bile duct

Option c is correct because bile duct obstruction prevents bile from reaching intestines, causing clay-colored stools and gallbladder distention pain.
Option a is incorrect because hepatic artery obstruction would cause liver ischemia and necrosis rather than clay-colored stools specifically observed.
Option b is incorrect because portal vein obstruction causes portal hypertension and varices, not the biliary obstruction symptoms described here.
Option d is incorrect because pancreatic duct obstruction causes pancreatitis with epigastric pain, not RUQ pain with clay-colored stools.

Correct Answer: Tape eyelids shut

Option b is correct because taping eyes shut at night prevents corneal drying and abrasion when ptosis prevents complete lid closure.
Option a is incorrect because warm compresses do not prevent corneal exposure damage that occurs when eyelids cannot close completely overnight.
Option c is incorrect because antibiotic drops treat infection but do not prevent mechanical corneal damage from exposure during sleep periods.
Option d is incorrect because massaging eyelids does not address the fundamental problem of incomplete eye closure causing corneal exposure damage.

Correct Answer: HIV infection present

Option b is correct because CD4 count between two hundred and five hundred indicates HIV infection with moderate immunosuppression not yet AIDS.
Option a is incorrect because AIDS diagnosis requires CD4 count below two hundred or presence of opportunistic infections, not four hundred fifty.
Option c is incorrect because while improved, CD4 of four fifty still indicates immunosuppression as normal is above five hundred cells.
Option d is incorrect because any CD4 count below normal indicates increased infection risk requiring continued precautions and monitoring for complications.

Correct Answer: Ethambutol specifically

Option c is correct because ethambutol can cause optic neuritis leading to vision changes, requiring eye exams to detect toxicity early.
Option a is incorrect because rifampin causes orange body fluid discoloration but does not require routine eye examinations for toxicity monitoring.
Option b is incorrect because isoniazid causes peripheral neuropathy requiring vitamin B6 supplementation, not eye examinations for ocular toxicity specifically.
Option d is incorrect because pyrazinamide primarily causes hepatotoxicity and hyperuricemia, not ocular toxicity requiring eye examination monitoring routinely.

Correct Answer: Coffee regularly

Option b is correct because coffee contains caffeine that relaxes the lower esophageal sphincter, allowing acid reflux into the esophagus.
Option a is incorrect because most herbal teas are safe for GERD except peppermint or spearmint which can trigger reflux symptoms.
Option c is incorrect because plain water is the best beverage choice for GERD patients and does not trigger reflux episodes.
Option d is incorrect because while some patients avoid dairy, milk can actually buffer stomach acid temporarily in GERD management.

Correct Answer: Maintains hypoxic drive

Option b is correct because COPD patients rely on mild hypoxemia to stimulate breathing; higher oxygen suppresses this respiratory drive.
Option a is incorrect because oxygen at ninety percent does not prevent lung damage; the concern is suppressing respiratory drive mechanisms.
Option c is incorrect because ninety percent saturation may actually increase heart strain compared to normal oxygen levels in patients.
Option d is incorrect because oxygen saturation level does not directly affect work of breathing which relates to airway resistance primarily.

Correct Answer: Two to three

Option b is correct because two to three soft bowel movements daily optimally removes ammonia while preventing dehydration and electrolyte imbalances.
Option a is incorrect because one bowel movement daily is insufficient for adequate ammonia removal in hepatic encephalopathy management effectively.
Option c is incorrect because four to five movements may cause excessive fluid and electrolyte losses leading to dehydration and imbalances.
Option d is incorrect because six or more bowel movements indicates excessive lactulose effect requiring dose reduction to prevent complications.

Correct Answer: New vision loss

Option b is correct because new vision loss represents acute demyelination requiring immediate high-dose corticosteroids to reduce inflammation and prevent permanence.
Option a is incorrect because chronic fatigue is a persistent symptom in MS not indicating acute exacerbation requiring corticosteroid treatment immediately.
Option c is incorrect because mild depression is common in MS but treated with antidepressants not corticosteroids for exacerbation management.
Option d is incorrect because stable weakness represents baseline dysfunction not acute exacerbation requiring immediate corticosteroid intervention for treatment.

Correct Answer: Erythrodermic psoriasis

Option c is correct because erythrodermic psoriasis causes severe inflammation with skin shedding, risking dehydration, infection, and temperature regulation failure.
Option a is incorrect because plaque psoriasis presents with thick scaly patches but not the severe shedding described in this presentation.
Option b is incorrect because guttate psoriasis appears as small teardrop lesions, not the severe inflammation with sheet-like shedding described.
Option d is incorrect because nail psoriasis affects nails with pitting and splitting, not causing systemic skin shedding requiring emergency care.

Correct Answer: Gown and gloves

Option b is correct because contact precautions require both gown and gloves for all patient interactions to prevent MRSA transmission.
Option a is incorrect because N95 masks are for airborne precautions; MRSA spreads through contact not airborne transmission requiring different protection.
Option c is incorrect because surgical masks are for droplet precautions; MRSA requires contact precautions with gown and gloves instead.
Option d is incorrect because gloves alone are insufficient; gowns are also required to protect clothing from MRSA contamination during care.

Correct Answer: Avoid lifting heavy objects

Option b is correct because lifting over ten pounds increases intraocular pressure that could displace the new lens implant postoperatively.
Option a is incorrect because television watching at appropriate distance is acceptable and does not increase intraocular pressure significantly postoperatively.
Option c is incorrect because while eye strain should be avoided initially, reading restriction is less critical than avoiding pressure-increasing activities.
Option d is incorrect because gentle walking is encouraged postoperatively; distance restriction is unnecessary if patient avoids straining during ambulation.

Correct Answer: PTT ninety seconds

Option b is correct because PTT above seventy seconds on heparin indicates excessive anticoagulation requiring immediate dose adjustment or holding.
Option a is incorrect because PTT of forty seconds may indicate subtherapeutic heparin levels requiring dose increase rather than immediate intervention.
Option c is incorrect because INR monitors warfarin not heparin therapy; this value would not guide heparin management decisions appropriately.
Option d is incorrect because normal platelet count is expected and desired; thrombocytopenia would require intervention for HIT syndrome concerns.