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A patient presents with chest pain, dyspnea, and a history of recent surgery or trauma. An echocardiogram reveals a large pericardial effusion with right ventricular collapse during diastole. Which cardiovascular disorder is most likely responsible for these symptoms?
- A. Stable angina
- B. Pericardial effusion
- C. Myocardial infarction
- D. Aortic dissection
Correct Answer: B
Rationale: The cardiovascular disorder most likely responsible for the symptoms described is a pericardial effusion. A pericardial effusion is an accumulation of fluid within the pericardial space surrounding the heart. When a large pericardial effusion is present, it can lead to compression of the heart chambers, resulting in symptoms such as chest pain and dyspnea.
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Twelve hours after vaginal delivery, Nurse Kayla palpates the fundus of a primiparous patient and finds it to be firm, above the umbilicus and deviated to the right. What is the BEST thing for Nurse Kayla to do for the patient?
- A. Contact the physician for an order of methylergonovine
- B. Gently massage the fundus to expel the clots
- C. Encourage patient to ambulate and to void
- D. Document this is a normal finding in the patient's records
Correct Answer: C
Rationale: The best thing for Nurse Kayla to do for the patient is to encourage her to ambulate and to void. In this scenario, the fundus being firm, above the umbilicus, and deviated to the right indicates uterine atony with a full bladder. This finding is suggestive of a distended bladder pushing the uterus upwards and to the right. Encouraging the patient to ambulate helps promote uterine contractions, which can aid in the firming up of the uterus. Additionally, emptying the bladder will help the uterus to contract and return to its midline position. This intervention is non-invasive and promotes normal postpartum recovery without the need for medication or excessive manipulation.
A patient with a history of heart failure is prescribed carvedilol. Which parameter should the nurse monitor closely during carvedilol therapy?
- A. Blood glucose levels
- B. Serum potassium levels
- C. Blood pressure
- D. Liver function tests Medical Surgical Nursing
Correct Answer: C
Rationale: Carvedilol is a beta-blocker primarily used to manage heart failure and hypertension. Monitoring blood pressure closely during carvedilol therapy is crucial because it helps assess the drug's effectiveness in managing heart failure and controlling hypertension. Carvedilol works by blocking certain receptors in the heart and blood vessels, which can lower blood pressure. Monitoring blood pressure fluctuations allows healthcare providers to adjust the dosage accordingly to achieve optimal results and prevent potential complications in patients with heart failure. While monitoring blood glucose levels, serum potassium levels, and liver function tests are essential in managing other conditions or medications, the priority in a patient being prescribed carvedilol for heart failure is to monitor blood pressure levels.
Primary care nursing is organized so that the patient is at the center of the structure. How many nurses have 24-hour responsibility for care planning and coordination?
- A. One
- B. Three
- C. Two
- D. Four
Correct Answer: A
Rationale: In primary care nursing, typically, one nurse is designated to have 24-hour responsibility for care planning and coordination for each patient. This helps ensure continuity of care and accountability. By having one nurse overseeing all aspects of the patient's care, it allows for a more personalized and coordinated approach that puts the patient at the center of the care structure. Having one primary care nurse also promotes better communication, efficiency, and consistency in managing the patient's health and well-being.
Nurse Noli should include in his teachings the following EXCEPT:
- A. Less saturated fat
- B. Weight within normal limits
- C. Exercise regularly
- D. More fats in the diet
Correct Answer: D
Rationale: Nurse Noli should include in his teachings less saturated fat, maintaining weight within normal limits, and exercising regularly as these are all components of a healthy lifestyle. However, including "more fats in the diet" goes against the principles of healthy eating and weight management. Consuming excessive amounts of fats, especially unhealthy saturated fats, can contribute to various health issues such as obesity, cardiovascular diseases, and other medical conditions. Therefore, it is crucial for Nurse Noli to emphasize reducing saturated fat intake rather than promoting more fats in the diet for overall health and wellness.
Which of the following dental conditions is characterized by the irreversible demineralization of the enamel and dentin, leading to cavitation and destruction of tooth structure?
- A. Gingivitis
- B. Dental caries
- C. Periodontitis
- D. Dental abscess
Correct Answer: B
Rationale: Dental caries, commonly known as tooth decay, is characterized by the irreversible demineralization of the enamel and dentin due to acids produced by bacterial activity. This process leads to cavitation and destruction of the tooth structure, ultimately resulting in the formation of a cavity. Gingivitis is inflammation of the gums, periodontitis is inflammation and infection of the supporting structures of the teeth (gums, bone, and ligaments), and a dental abscess is a collection of pus in the tissues surrounding the tooth, none of which are specifically related to the irreversible demineralization of enamel and dentin seen in dental caries.