D444 Adult Health I - Set 1 - Part 2

Correct Answer: Corticosteroids immediately

Option b is correct because corticosteroids rapidly reduce inflammation in the central nervous system during multiple sclerosis exacerbations effectively.
Option a is incorrect because muscle relaxants treat spasticity symptoms but do not address the underlying inflammatory process during exacerbations.
Option c is incorrect because antibiotics are not indicated for multiple sclerosis exacerbations unless a concurrent infection triggers the relapse.
Option d is incorrect because anticonvulsants may help with neuropathic pain but do not reduce the acute inflammation during exacerbations.

Correct Answer: Rigid boardlike abdomen

Option c is correct because a rigid boardlike abdomen indicates peritonitis from spontaneous bacterial infection requiring immediate antibiotics and intervention.
Option a is incorrect because spider angiomas are expected skin changes in cirrhosis due to estrogen excess, not requiring emergency intervention.
Option b is incorrect because palmar erythema is a chronic manifestation of liver disease from altered hormone metabolism, not acute complication.
Option d is incorrect because ankle edema from fluid retention is common in cirrhosis but not immediately life-threatening like peritonitis.

Correct Answer: Stop infusion immediately

Option b is correct because Red Man Syndrome requires immediate cessation of vancomycin infusion to prevent progression to severe hypotension and shock.
Option a is incorrect because slowing the rate is insufficient once Red Man Syndrome develops; the infusion must be stopped completely first.
Option c is incorrect because antihistamine administration should occur after stopping the infusion, not as the initial priority action taken.
Option d is incorrect because continuing the infusion at any rate worsens Red Man Syndrome and risks cardiovascular collapse development.

Correct Answer: Before starting antibiotics

Option b is correct because obtaining sputum culture before antibiotics ensures accurate identification of organisms without medication interference affecting results.
Option a is incorrect because antibiotics alter bacterial growth making culture results unreliable for identifying the true causative organism accurately.
Option c is incorrect because ongoing antibiotic therapy suppresses bacterial growth leading to false negative culture results and missed organisms.
Option d is incorrect because waiting until after antibiotic completion delays appropriate targeted therapy and may miss resistant organisms entirely.

Correct Answer: Improved mental status

Option b is correct because lactulose reduces ammonia levels causing hepatic encephalopathy, with mental status improvement indicating successful treatment response.
Option a is incorrect because lactulose does not directly affect bilirubin levels which are related to bile metabolism not ammonia excretion.
Option c is incorrect because lactulose does not reduce ascites or abdominal girth which requires diuretics or paracentesis for management.
Option d is incorrect because lactulose specifically targets ammonia reduction, not liver enzyme normalization which reflects hepatocellular damage levels.

Correct Answer: Recent nasal surgery

Option c is correct because recent nasal surgery contrainddicates nasopharyngeal suctioning due to risk of disrupting surgical site and causing hemorrhage.
Option a is incorrect because decreased oxygen saturation actually indicates need for suctioning to clear airways and improve gas exchange.
Option b is incorrect because increased respiratory rate may indicate respiratory distress from secretions requiring suctioning for airway clearance immediately.
Option d is incorrect because abnormal breath sounds from secretions indicate suctioning is needed rather than contraindicated for airway management.

Correct Answer: Keeping feet dry

Option c is correct because tinea pedis thrives in warm moist environments, making thorough drying especially between toes essential for prevention.
Option a is incorrect because thick socks may increase moisture retention and warmth, creating ideal conditions for fungal growth and infection.
Option b is incorrect because antibacterial soap does not prevent fungal infections; antifungal preparations are needed for tinea pedis prevention.
Option d is incorrect because moisturizers can create damp environment between toes where tinea pedis commonly develops and spreads easily.

Correct Answer: Stress and trauma

Option b is correct because psychological stress and skin trauma are well-documented triggers that precipitate psoriasis exacerbations requiring avoidance strategies.
Option a is incorrect because moderate exercise actually helps reduce stress and may improve psoriasis symptoms rather than trigger exacerbations.
Option c is incorrect because vegetables are part of healthy diet and do not trigger psoriasis flares unlike certain medications or infections.
Option d is incorrect because adequate hydration supports skin health and does not trigger psoriasis exacerbations when maintained appropriately.

Correct Answer: Creatinine one point five

Option b is correct because creatinine elevation above normal range is the most specific indicator of decreased kidney filtration function.
Option a is incorrect because BUN can be elevated from dehydration or high protein intake without necessarily indicating kidney dysfunction specifically.
Option c is incorrect because hyperkalemia can result from kidney dysfunction but also from other causes like medication effects or hemolysis.
Option d is incorrect because hyponatremia has multiple causes including fluid overload and does not specifically indicate kidney function decline.

Correct Answer: Increased respiratory rate

Option a is correct because respiratory compensation occurs within minutes through hyperventilation to blow off carbon dioxide and raise pH.
Option b is incorrect because decreasing respiratory rate would retain carbon dioxide, worsening acidosis rather than providing compensatory pH correction.
Option c is incorrect because kidney compensation through bicarbonate retention takes hours to days, not providing immediate pH correction needed.
Option d is incorrect because renal hydrogen excretion is slower compensation taking hours to days versus immediate respiratory compensation response.

Correct Answer: Tetrabenazine specifically

Option b is correct because tetrabenazine specifically reduces chorea by depleting dopamine, targeting the excessive involuntary movements in Huntington's disease.
Option a is incorrect because pyridostigmine treats myasthenia gravis by increasing acetylcholine, not the dopamine excess causing Huntington's chorea movements.
Option c is incorrect because interferon beta treats multiple sclerosis relapses, not the choreiform movements characteristic of Huntington's disease progression.
Option d is incorrect because methylprednisolone treats acute inflammation but does not specifically address the choreiform movements of Huntington's disease.

Correct Answer: Elevated blood glucose

Option a is correct because hyperglycemia in diabetes creates ideal conditions for candida overgrowth by providing excess glucose for fungal metabolism.
Option b is incorrect because low protein intake does not directly promote candida growth though it may affect immune function generally.
Option c is incorrect because water consumption does not contribute to candida overgrowth and actually supports overall health and immunity.
Option d is incorrect because sodium levels do not directly influence candida growth or create conditions favoring fungal infections development.

Correct Answer: Gastric strangulation risk

Option c is correct because gastric strangulation represents a surgical emergency requiring immediate fundoplication to prevent tissue necrosis and perforation.
Option a is incorrect because occasional heartburn can be managed medically with antacids and lifestyle modifications without requiring surgery immediately.
Option b is incorrect because mild dysphagia often improves with dietary modifications and positioning rather than requiring surgical intervention initially.
Option d is incorrect because intermittent reflux typically responds to medical management with proton pump inhibitors and lifestyle changes effectively.

Correct Answer: Surgical mask on patient

Option b is correct because patients on airborne precautions wear surgical masks during transport to prevent spreading infectious particles to others.
Option a is incorrect because while staff need N95 masks in the patient's room, the patient wearing a mask during transport protects others.
Option c is incorrect because gowns are not specifically required for airborne precautions during transport when the patient wears a mask.
Option d is incorrect because gloves on transport staff are not the primary protective measure for airborne transmission during patient transport.

Correct Answer: Dull percussion sounds

Option c is correct because dull percussion sounds indicate fluid accumulation in the pleural space characteristic of pleural effusion development.
Option a is incorrect because productive sputum occurs with pneumonia itself and does not specifically indicate pleural effusion has developed.
Option b is incorrect because fever occurs with pneumonia infection and does not specifically indicate the development of pleural effusion.
Option d is incorrect because fine crackles indicate alveolar fluid from pneumonia rather than pleural space fluid accumulation in effusion.

Correct Answer: Breathe in through device

Option b is correct because incentive spirometry requires slow deep inhalation through the device to expand lungs and prevent atelectasis.
Option a is incorrect because incentive spirometry uses inhalation not exhalation, as the goal is lung expansion through deep breathing exercises.
Option c is incorrect because breath holding occurs after inhalation not exhalation when using incentive spirometry for maximum lung expansion.
Option d is incorrect because incentive spirometry should be performed ten times hourly while awake, not just once daily for effectiveness.

Correct Answer: Oral care every two hours

Option b is correct because frequent oral care with suctioning every two hours reduces bacterial colonization preventing ventilator-associated pneumonia effectively.
Option a is incorrect because while chest physiotherapy helps mobilize secretions, it is less effective than oral care for VAP prevention.
Option c is incorrect because prophylactic antibiotics are not recommended routinely as they promote resistance without preventing VAP effectively overall.
Option d is incorrect because continuous sedation actually increases VAP risk by suppressing cough reflex and prolonging mechanical ventilation duration.

Correct Answer: Acute cholecystitis

Option b is correct because gallstones causing RUQ pain radiating to right shoulder after fatty foods indicates acute gallbladder inflammation.
Option a is incorrect because pancreatitis causes epigastric pain radiating to the back, not specifically right shoulder pain after fatty foods.
Option c is incorrect because chronic hepatitis does not typically cause acute pain episodes related to fatty food intake or shoulder radiation.
Option d is incorrect because peptic ulcers cause epigastric pain that may improve with eating rather than worsen with fatty foods.

Correct Answer: Foam dressing

Option b is correct because foam dressings effectively absorb moderate exudate while maintaining moist wound healing environment for optimal recovery.
Option a is incorrect because transparent films are for minimal drainage wounds and cannot adequately absorb moderate exudate levels effectively.
Option c is incorrect because hydrogels add moisture to dry wounds rather than absorbing excess exudate from moderately draining wounds appropriately.
Option d is incorrect because dry gauze causes tissue trauma during removal and does not maintain optimal moisture balance for healing.

Correct Answer: Vitamin K administration

Option b is correct because vitamin K reverses warfarin anticoagulation effects when INR exceeds therapeutic range of two to three.
Option a is incorrect because fresh frozen plasma is reserved for life-threatening bleeding, not for elevated INR without active hemorrhage present.
Option c is incorrect because protamine sulfate reverses heparin not warfarin, making it ineffective for elevated INR from warfarin therapy.
Option d is incorrect because platelet transfusion does not reverse warfarin effects since warfarin affects clotting factors not platelet function.