Nokea
A nurse is assessing a patient's pain using a pain rating scale. What action by the nurse demonstrates cultural competence in pain assessment?
- A. Assuming that the patient experiences pain similarly to other patients
- B. Using nonverbal cues to assess the patient's pain intensity
- C. Asking the patient about their cultural beliefs and preferences related to pain
- D. Administering pain medication without assessing the patient's pain level
Correct Answer: C
Rationale: Choosing option C, asking the patient about their cultural beliefs and preferences related to pain, demonstrates cultural competence in pain assessment. Pain experiences can vary greatly across different cultures, and a patient's cultural background can influence how they perceive and express pain. By inquiring about the patient's cultural beliefs and preferences, the nurse can gain a better understanding of the patient's perspective on pain. This information is crucial for providing individualized and culturally sensitive pain management interventions. It also shows respect for the patient's unique cultural background and helps build a trusting and collaborative relationship between the nurse and the patient.
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Which of the following structures is responsible for the production of saliva, which aids in lubricating the oral cavity and initiating the digestion of carbohydrates?
- A. Liver
- B. Gallbladder
- C. Salivary glands
- D. Pancreas
Correct Answer: C
Rationale: The salivary glands are responsible for the production of saliva, which aids in lubricating the oral cavity and initiating the digestion of carbohydrates. Saliva contains enzymes that begin the digestive process by breaking down carbohydrates into simpler sugars. The liver is involved in the production of bile, which aids in the digestion and absorption of fats. The gallbladder stores bile produced by the liver, which is released into the small intestine. The pancreas produces digestive enzymes that are released into the small intestine to aid in the digestion of proteins, fats, and carbohydrates.
Betamethasone (Celestone) is prescribed to be administered and the patient asks nurse Hope about the purpose of this medication?
- A. Promote fetal lung maturity.
- B. Prevent the premature closure of the ductus arteriosus.
- C. Delay delivery for at 1east 48 hours.
- D. Stop the premature uterine contractions.
Correct Answer: A
Rationale: Betamethasone (Celestone) is a corticosteroid medication that is commonly used to promote fetal lung maturity in pregnant women at risk of preterm delivery. Administering betamethasone to the mother helps accelerate the production of surfactant in the fetal lungs, which is essential for proper lung function and development. This medication is typically given to pregnant women between 24 and 34 weeks of gestation to reduce the risk of respiratory distress syndrome in preterm infants. It does not prevent premature closure of the ductus arteriosus, delay delivery, or stop premature uterine contractions.
Which of the following structures is responsible for secreting bile, which aids in the emulsification and digestion of fats?
- A. Liver
- B. Gallbladder
- C. Pancreas
- D. Spleen
Correct Answer: A
Rationale: The liver is responsible for secreting bile, which aids in the emulsification and digestion of fats. Bile is produced by the liver and is stored and concentrated in the gallbladder before being released into the small intestine to help with the breakdown of fats during the digestion process. The gallbladder functions as a storage organ for bile produced by the liver. The pancreas secretes digestive enzymes and bicarbonate to aid in the digestion process, while the spleen is mainly involved in immune function and blood storage.
A patient with a history of chronic liver disease presents with easy bruising and prolonged bleeding from minor cuts. Laboratory tests reveal prolonged PT and aPTT, and mixing studies show correction of coagulation times with normal plasma. Which of the following conditions is most likely to cause these findings?
- A. Disseminated intravascular coagulation (DIC)
- B. Vitamin K deficiency
- C. Liver cirrhosis
- D. Hemophilia A
Correct Answer: B
Rationale: Vitamin K is essential for the production of several clotting factors in the liver, including factors II, VII, IX, and X. In a patient with chronic liver disease, impaired liver function can lead to decreased synthesis of these clotting factors. As a result, there is an underlying deficiency of these clotting factors, leading to prolonged PT (prothrombin time) and aPTT (activated partial thromboplastin time). The mixing studies showing correction with normal plasma further support the diagnosis of a factor deficiency rather than an inhibitor, which helps in ruling out conditions like DIC or hemophilia.
A woman in active labor is experiencing a shoulder dystocia during delivery. What nursing intervention should be prioritized?
- A. Apply suprapubic pressure to dislodge the shoulder.
- B. Perform an episiotomy to facilitate delivery.
- C. Insert an oropharyngeal airway to maintain airway patency.
- D. Administer intravenous magnesium sulfate for uterine relaxation.
Correct Answer: A
Rationale: Shoulder dystocia is an obstetric emergency where one of the baby's shoulders becomes impacted behind the mother's pubic bone after the head delivers. This can lead to compression of the umbilical cord and compromise fetal oxygenation. The most critical nursing intervention in managing shoulder dystocia is applying suprapubic pressure to dislodge the impacted shoulder and allow for delivery of the baby. By gently pushing downwards on the mother's abdomen just above the pubic bone, the shoulder can be released, and the baby can be delivered successfully. This intervention should be prioritized to prevent potential complications for both the mother and the baby. Episiotomy may be considered if necessary, but it is secondary to addressing the shoulder dystocia. Oropharyngeal airway insertion and administering magnesium sulfate are not indicated in the immediate management of shoulder dystocia.