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A patient presents with petechiae, ecchymoses, and gingival bleeding. 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. Glanzmann thrombasthenia
- B. Bernard-Soulier syndrome
- C. Acquired von Willebrand syndrome
- D. Hemophilia A
Correct Answer: C
Rationale: The correct answer is C: Acquired von Willebrand syndrome. This condition is characterized by a defect in von Willebrand factor function, leading to prolonged bleeding time and mucocutaneous bleeding. Normal platelet count rules out Glanzmann thrombasthenia and Bernard-Soulier syndrome which are platelet disorders. Normal PT and aPTT rule out Hemophilia A, a coagulation factor deficiency. Acquired von Willebrand syndrome is the most likely cause based on the clinical presentation and laboratory findings.
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Which of the following directly VIOLATES the Patient's Bill of Rights?
- A. Informing patients about the billing policies of the hospital.
- B. Disclosing the HIV result to members of the patient's family.
- C. Honestly telling the patient about his current condition.
- D. Immediately referring results of laboratory to the physician.
Correct Answer: B
Rationale: The correct answer is B because disclosing a patient's HIV status to family members violates the patient's right to privacy and confidentiality. Patient confidentiality is a fundamental aspect of the Patient's Bill of Rights, ensuring that personal health information is protected. The other choices (A, C, D) do not directly violate the Patient's Bill of Rights. Choice A relates to transparency in billing, choice C is about honesty in communication, and choice D is about timely communication with the physician, all of which are in line with patient rights and quality care.
Which of the following would prove that the nursing action carried out met, the standards of care on falls ?
- A. Utilizing the nursing process in providing safe, quality nursing care
- B. Documenting the procedures done
- C. Carrying out the doctor's order
- D. Performing physical assessment
Correct Answer: A
Rationale: The correct answer is A: Utilizing the nursing process in providing safe, quality nursing care. This is because the nursing process involves assessment, diagnosis, planning, implementation, and evaluation, which ensures comprehensive and individualized care. Documenting procedures (B) is important but does not guarantee meeting standards of care. Simply carrying out doctor's orders (C) may not address all aspects of patient care. Performing physical assessment (D) is crucial but only one component of the nursing process. Ultimately, utilizing the nursing process ensures holistic and evidence-based care, meeting the standards of care on falls.
A woman in active labor demonstrates signs of uterine inertia, with weak and irregular contractions contributing to slow cervical dilation. What nursing intervention should be implemented to address this abnormal labor pattern?
- A. Administering intravenous oxytocin to augment contractions
- B. Preparing for immediate cesarean section
- C. Facilitating maternal rest and hydration
- D. Performing an emergency manual rotation of the fetus
Correct Answer: A
Rationale: In cases of uterine inertia, where weak and irregular contractions are causing slow cervical dilation during labor, administering intravenous oxytocin can help augment contractions and stimulate more effective progress. Oxytocin is a hormone that naturally stimulates uterine contractions and is commonly used in clinical settings to induce or enhance labor. By increasing the strength and frequency of contractions, oxytocin can help address uterine inertia and promote efficient cervical dilation to facilitate the progress of labor. It is important to monitor the response to oxytocin carefully to avoid complications such as hyperstimulation of the uterus, which can lead to fetal distress.
A patient presents with redness, pain, and photophobia in the left eye. Slit-lamp examination reveals ciliary injection, corneal edema, and a mid-dilated pupil with fixed reaction to light. Which of the following conditions is most likely responsible for this presentation?
- A. Anterior uveitis
- B. Acute angle-closure glaucoma
- C. Endophthalmitis
- D. Corneal abrasion
Correct Answer: A
Rationale: The correct answer is A: Anterior uveitis. This condition presents with redness, pain, and photophobia due to inflammation of the uveal tract. Ciliary injection, corneal edema, and mid-dilated pupil with fixed reaction to light are classic signs of anterior uveitis. The other choices can be ruled out based on specific findings: B: Acute angle-closure glaucoma would present with a high intraocular pressure, not fixed dilated pupil. C: Endophthalmitis typically presents with severe pain, hypopyon, and vitreous inflammation. D: Corneal abrasion would not cause ciliary injection or fixed dilated pupil.
A postpartum client who delivered via cesarean section expresses concerns about breastfeeding positions and comfort. What nursing intervention should be prioritized to address the client's concerns?
- A. Demonstrating breastfeeding positions that minimize pressure on the incision site
- B. Recommending the use of a breast pump instead of direct breastfeeding
- C. Encouraging the client to avoid breastfeeding until the incision is fully healed
- D. Referring the client to a lactation consultant for assistance
Correct Answer: A
Rationale: Demonstrating breastfeeding positions that minimize pressure on the incision site should be the nursing intervention prioritized to address the client's concerns. This is important because it ensures that the client can breastfeed comfortably while also protecting the healing incision. By showing the client appropriate positions, such as the football hold or side-lying position, the nurse can help minimize discomfort and promote successful breastfeeding without compromising the cesarean incision's healing process. It is crucial to support the client in establishing a good latch and positioning to encourage proper milk transfer and bonding while being mindful of the incision site.