Nokea
Amy, a multiparous patient, 28 hours after Ceasarian delivery (CS), who is breastfeeding, complains of severe abdominal cramps. Nurse Kayla explains that these are caused by which of the following?
- A. Flatulence accumulation after CS
- B. Release of Oxytocin during the breastfeeding session
- C. Healing of the abdominal incision after CS
- D. Side effects of the medications administered after delivery
Correct Answer: B
Rationale: The severe abdominal cramps experienced by the multiparous patient Amy, 28 hours after a Cesarean delivery (CS) and while breastfeeding, are likely caused by the release of Oxytocin during the breastfeeding session. Oxytocin is a hormone that is naturally produced during breastfeeding to stimulate the contraction of the uterus and help reduce postpartum bleeding. These contractions may result in cramping sensations in the abdomen, specifically at the site of the uterus. It is a normal physiological response and an indication that the body is working as it should to support the postpartum recovery process.
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A patient presents with recurrent episodes of epistaxis, gum bleeding, and easy bruising. Laboratory tests reveal prolonged bleeding time, normal platelet count, and normal PT and aPTT. Which of the following conditions is most likely to cause these findings?
- A. Von Willebrand disease
- B. Glanzmann thrombasthenia
- C. Hemophilia A
- D. Bernard-Soulier syndrome
Correct Answer: A
Rationale: The clinical presentation of recurrent episodes of epistaxis, gum bleeding, and easy bruising, along with laboratory findings of prolonged bleeding time, normal platelet count, and normal coagulation studies (PT and aPTT) are highly suggestive of Von Willebrand disease. Von Willebrand disease is the most common inherited bleeding disorder and is characterized by a deficiency or dysfunction of von Willebrand factor (vWF), which plays a key role in platelet adhesion and aggregation. The prolonged bleeding time is due to impaired platelet adhesion to the damaged vessel wall in the absence of functional vWF. Normal platelet count and normal PT/aPTT help differentiate Von Willebrand disease from other bleeding disorders such as hemophilia and platelet function disorders like Glanzmann thrombasthenia and Bernard-Soulier syndrome.
Sandy asks the nurse if her new joint will function normally. The nurse can BEST answer this by saying that the________.
- A. doctor will be able to assess your limitations in 6 weeks and then explain them to you
- B. new joint will function almost as well as a normal joint, if you perform your exercises faithfully
- C. new joint will be stronger than the old one if you exercise well
- D. new joint won't function as well as the new joint, but will be better than the arthritic joint
Correct Answer: B
Rationale: The nurse can assure Sandy that her new joint will function almost as well as a normal joint if she performs her exercises faithfully because post-joint replacement surgery recovery often involves physical therapy and exercises aimed at restoring strength and mobility to the affected joint. By following the recommended exercise regimen and post-operative care instructions, Sandy can improve the function of her new joint and achieve a good level of mobility and functionality, similar to that of a normal joint. It is important for Sandy to be diligent and committed to her rehabilitation process to maximize the benefits of the joint replacement surgery.
The nurse would determine that her teaching goal one the use of a decongestant nasal spray has been met when the client says ______..
- A. "The spray should be used round-the-clock at equally spaced intervals"
- B. "Nasal sprays must be combined with an oral antihistamine to achieve relief"
- C. "Overuse can result in nosebleeds and mucosal ulceration"
- D. "Rebound rhinitis (rhinitis medicamentosa) is common with continued use"
Correct Answer: A
Rationale: The correct statement that indicates the teaching goal has been met is when the client says, "The spray should be used round-the-clock at equally spaced intervals." This statement shows an understanding of how to properly use the decongestant nasal spray as instructed by the nurse. Using the spray round-the-clock at equally spaced intervals helps maintain consistent relief from congestion without the risk of overuse or rebound effects. This response indicates that the client has grasped the correct usage instructions for the decongestant nasal spray, which is the goal of the teaching.
Demography is concerned with the study of population. Which of the following are included in demographic profile?
- A. Size, composition, health status, and environment.
- B. Change in population, distribution, and health status
- C. Size, distribution, composition, and change in population.
- D. Size, distribution, and composition.
Correct Answer: C
Rationale: The demographic profile of a population encompasses various aspects, including size, distribution, composition, and change over time.
A postpartum client who experienced a third-degree perineal laceration expresses concerns about the healing process and potential complications. What nursing intervention should be prioritized to promote optimal wound healing?
- A. Providing perineal care using peri-bottles with warm water
- B. Instructing the client on proper peri-pad application to the incision
- C. Encouraging the use of sitz baths for pain relief and wound cleansing
- D. Monitoring the incision site for signs of infection or dehiscence
Correct Answer: D
Rationale: Third-degree perineal lacerations are significant injuries that require careful monitoring for signs of infection or wound dehiscence, which are potential complications that could hinder optimal wound healing. Signs of infection may include increased redness, warmth, swelling, pain, and purulent drainage from the wound site. Dehiscence refers to the separation of the wound edges, which can be a serious complication requiring immediate attention. By closely monitoring the incision site for these signs, the nurse can promptly intervene if any complications arise, ensuring proper healing and preventing further complications. While providing perineal care, proper application of peri-pads, and encouraging sitz baths are important for comfort and cleanliness, monitoring for complications takes priority in promoting optimal wound healing in this scenario.