What are likely causes of this constellation of symptoms?
Jim is an HIV-positive patient who complains about back pain in addition to several other problems. On percussion, there is slight tenderness over the T7 vertebrae, and when you flex his thigh to 90 degrees and extend his lower legs, you meet strong resistance at about 45 degrees of extension.
A) Fractured vertebrae
B) Malingering
C) Infection
D) Medication side effect
C) Infection
This represents Kernig's sign. When present bilaterally it often indicates meningeal irritation. (Kernig was a physician in eastern Europe and treated many children with tuberculous meningitis.) It is useful in cases when there has been chronic inflammation of the meninges, as seen in TB and cryptococcal disease. There was no trauma reported, and these signs are too important to ascribe them to malingering. Such localized physical findings are unlikely to be caused by medication side effects.
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The nurse explains to a newly diagnosed type 1 diabetic that the beta cells can no longer produce adequate insulin because:
a. they are inhibited by pituitary disorder. b. an allergic response has altered their re-sponse to hyperglycemia. c. alpha cells have proliferated in the islets of Langerhans. d. the body's immune system has destroyed them.
Which of the following is a key strategy to improving maternal health?
A) Decreasing access to skilled birth attendants B) Preventing pregnancies in women older than 40 years C) Preventing multiple birth pregnancies D) Increasing access to prenatal care
When assessing a client for hypovolemic hypernatremia, the nurse would expect to find:
A. Thirst B. Serum sodium level of 135 mEq/L C. Moist mucous membranes D. Hypoactive reflexes
The vaginal examination is an essential component of labor assessment. It reveals whether the patient is in true labor and enables the examiner to determine whether membranes have ruptured
This examination is often stressful and uncomfortable for the patient and should be performed only when indicated. Please match the correct step number, from 1 to 7, with each component of a vaginal examination of the laboring woman. a. After obtaining permission, gently insert the index and middle fingers into the vagina. b. Explain findings to the patient. c. Position the woman to prevent supine hypotension. d. Use sterile gloves and soluble gel for lubrication. e. Document findings and report to the provider. f. Cleanse the perineum and vulva if necessary. g. Determine dilation, presenting part, status of membranes, and characteristics of amniotic fluid. 46. Step 1 47. Step 2 48. Step 3 49. Step 4 50. Step 5 51. Step 6 52. Step 7