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1. A 35-year-old man presents with fatigue, weight loss, and hyperpigmentation of the skin. Laboratory tests reveal hyponatremia, hyperkalemia, and low cortisol levels. What is the most likely diagnosis?
- A. Cushing's syndrome
- B. Addison's disease
- C. Hypothyroidism
- D. Pheochromocytoma
Correct answer: B
Rationale: The clinical presentation of a 35-year-old man with fatigue, weight loss, hyperpigmentation of the skin, hyponatremia, hyperkalemia, and low cortisol levels is classic for Addison's disease. These findings are consistent with primary adrenal insufficiency, where the adrenal glands fail to produce adequate cortisol. In Addison's disease, the adrenal cortex is damaged, leading to decreased cortisol production and elevated levels of ACTH. This results in symptoms such as fatigue, weight loss, and hyperpigmentation due to increased ACTH production stimulating melanocytes. Hyponatremia and hyperkalemia are common electrolyte abnormalities seen in Addison's disease due to aldosterone deficiency. Therefore, the correct diagnosis in this case is Addison's disease.
2. As the public health nurse in a municipality with a total population of about 20,000 and 3 health midwives among the RHU personnel, how many more midwife positions will the RHU need?
- A. 1
- B. 2
- C. 3
- D. 4
Correct answer: A
Rationale: Since each rural health midwife is typically assigned a population of about 5,000, with the municipality's total population being 20,000, the existing 3 midwives can cover the current population adequately. Therefore, the RHU would not need any more midwife positions, making option A, '1', the correct answer.
3. A healthcare professional is reviewing the medical record of a client who is receiving furosemide. Which of the following laboratory values should the healthcare professional monitor while the client is taking this medication?
- A. Sodium
- B. Glucose
- C. Potassium
- D. Calcium
Correct answer: C
Rationale: The correct answer is C: Potassium. Furosemide is a diuretic that can cause potassium depletion due to increased urinary excretion. Monitoring potassium levels is crucial to prevent hypokalemia, which can lead to serious complications such as cardiac arrhythmias. Sodium (choice A) levels are not typically affected by furosemide. Glucose (choice B) monitoring is important with other medications like corticosteroids but is not directly related to furosemide use. Calcium (choice D) levels are not significantly impacted by furosemide.
4. Which of the following is an example of a vector-borne disease?
- A. Measles
- B. Tuberculosis
- C. Malaria
- D. Hepatitis B
Correct answer: C
Rationale: Malaria is caused by the Plasmodium parasite that is transmitted to humans through the bite of infected Anopheles mosquitoes. These mosquitoes act as vectors in transmitting the disease from one host to another. The other choices, Measles, Tuberculosis, and Hepatitis B, are not vector-borne diseases. Measles is a highly contagious airborne viral infection, Tuberculosis is an airborne bacterial infection, and Hepatitis B is a bloodborne virus.
5. A nurse is caring for a client who has been experiencing chronic pain. Which of the following interventions should the nurse implement?
- A. Provide the client with distractions such as television
- B. Administer pain medication around the clock
- C. Teach the client relaxation techniques
- D. Perform massage therapy on the client
Correct answer: C
Rationale: The correct intervention for a client experiencing chronic pain is to teach relaxation techniques. This helps the client manage pain more effectively by reducing stress and anxiety, which can contribute to the perception of pain. Providing distractions like television (Choice A) may offer temporary relief but does not address the underlying issue of chronic pain. Administering pain medication around the clock (Choice B) may lead to dependency and not promote holistic pain management. Massage therapy (Choice D) can be beneficial but may not be as effective as teaching relaxation techniques in the long term for managing chronic pain.
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