Nokea
A nurse is preparing to perform an intramuscular (IM) injection for a patient. What action should the nurse take to ensure proper injection technique?
- A. Selecting a small-gauge needle to minimize patient discomfort
- B. Administering the injection rapidly to reduce patient anxiety
- C. Aspirating the syringe to confirm needle placement before injection
- D. Inserting the needle at a 90-degree angle into the muscle
Correct Answer: D
Rationale: When performing an intramuscular (IM) injection, the nurse should insert the needle at a 90-degree angle into the muscle. This angle helps ensure proper and deep penetration into the muscle tissue for effective administration of the medication. It also helps prevent leakage or tissue damage at the injection site. Additionally, inserting the needle at a 90-degree angle facilitates accurate delivery of the medication into the muscle where it can be absorbed properly. Therefore, selecting the correct angle for inserting the needle is critical in ensuring the success and effectiveness of the IM injection.
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The PRC-Board of Nursing (PR-BON) ha5 the power to regulate Nursing Practice in the Philippines. The regulatory functions include the following except
- A. enforce and monitor quality standards of nursing practice in the county
- B. issue, suspend revoke or reissue certification of registered nurses
- C. ensure proper conduct.
- D. issue permit for the opening of nursing programs in the country
Correct Answer: D
Rationale: The correct answer is D, issuing a permit for the opening of nursing programs in the country. The PRC-Board of Nursing (PR-BON) in the Philippines primarily focuses on regulating nursing practice and ensuring the quality and standards of nursing care provided in the country. While they have the authority to oversee aspects such as certification of registered nurses, enforcing quality standards, and monitoring proper conduct of nurses, the responsibility of issuing permits for the opening of nursing programs typically falls under the jurisdiction of other relevant educational or accrediting bodies.
A postpartum client presents with persistent, severe abdominal pain, tenderness, and rigidity. Which nursing action is most appropriate?
- A. Administering analgesics for pain relief
- B. Assisting the client to a comfortable position
- C. Notifying the healthcare provider immediately
- D. Providing emotional support and reassurance
Correct Answer: C
Rationale: Persistent, severe abdominal pain, tenderness, and rigidity in a postpartum client can be indicative of serious conditions such as uterine rupture, hemorrhage, or infection, which require urgent medical attention. As a nurse, the priority action in this situation is to notify the healthcare provider immediately so that appropriate interventions can be initiated promptly to ensure the safety and well-being of the client. Administering analgesics or providing emotional support may not address the underlying cause of the symptoms and could potentially delay necessary medical treatment. Assisting the client to a comfortable position can be considered once the healthcare provider has been informed and appropriate assessments and interventions have been initiated.
In handling all information about the famiilies in the community, which of the following principles should the nurse consider ethical?
- A. Confidentialty
- B. Justice
- C. Fair treatment
- D. Beneficence
Correct Answer: A
Rationale: When handling information about families in the community, the nurse should consider the principle of confidentiality as ethical. Confidentiality refers to the obligation of healthcare providers to safeguard the privacy of patient information. By maintaining confidentiality, the nurse upholds trust and respect in the nurse-family relationship. This principle ensures that sensitive information shared by families is kept secure and not disclosed without permission, thus respecting their autonomy and promoting open communication in healthcare settings.
A woman in active labor demonstrates persistent occiput posterior fetal position, contributing to prolonged labor and severe back pain. What nursing intervention should be prioritized to facilitate fetal rotation and optimize labor progress?
- A. Assisting the mother into a hands-and-knees position
- B. Administering intravenous opioids for pain relief
- C. Preparing for immediate instrumental delivery
- D. Initiating continuous electronic fetal monitoring
Correct Answer: A
Rationale: Placing the mother in a hands-and-knees position can help facilitate fetal rotation from occiput posterior to the desired occiput anterior position. This position utilizes gravity to assist in the repositioning of the baby, ultimately helping to alleviate back pain and promoting more efficient labor progress. It allows the baby's head to descend properly into the pelvis, potentially reducing the risk of a prolonged labor or the need for instrumental delivery. Additionally, being in this position can help the mother feel more comfortable and empowered during labor. Overall, assisting the mother into a hands-and-knees position is a non-invasive, low-risk intervention that can have a positive impact on both the mother and baby's well-being during labor.
A patient presents with sudden-onset, severe eye pain, headache, nausea, and vomiting. On examination, the affected eye appears red, with a steamy cornea and mid-dilated, non-reactive pupil. Which of the following conditions is most likely responsible for this presentation?
- A. Acute angle-closure glaucoma
- B. Central retinal artery occlusion
- C. Optic neuritis
- D. Corneal ulcer
Correct Answer: A
Rationale: The described presentation is classic for acute angle-closure glaucoma. This condition is characterized by sudden-onset severe eye pain, headache, nausea, and vomiting. The red eye, steamy cornea (corneal edema), and mid-dilated non-reactive pupil are consistent with acute angle-closure glaucoma. The sudden increase in intraocular pressure leads to impaired aqueous humor outflow, causing these symptoms. Immediate intervention is required to prevent permanent vision loss in such cases. Central retinal artery occlusion would present with sudden painless vision loss. Optic neuritis typically presents with vision loss and pain with eye movements. Corneal ulcer presents with eye discomfort, foreign body sensation, and may have a history of corneal trauma or contact lens wear.