Nokea
A patient presents with recurrent episodes of deep vein thrombosis (DVT) and pulmonary embolism (PE). Laboratory tests reveal elevated levels of antiphospholipid antibodies (anticardiolipin and lupus anticoagulant). Which of the following conditions is most likely to cause these findings?
- A. Protein C deficiency
- B. Protein S deficiency
- C. Antithrombin III deficiency
- D. Antiphospholipid syndrome
Correct Answer: D
Rationale: Antiphospholipid syndrome is characterized by abnormal antiphospholipid antibodies, which can lead to an increased risk of blood clots such as deep vein thrombosis (DVT) and pulmonary embolism (PE). The two most common antiphospholipid antibodies are anticardiolipin and lupus anticoagulant. Patients with antiphospholipid syndrome can present with recurrent thrombotic events, such as DVT and PE, due to the pro-thrombotic effects of these antibodies. Protein C deficiency, Protein S deficiency, and Antithrombin III deficiency are other causes of hypercoagulability but would not typically present with elevated antiphospholipid antibodies.
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Which of the following is the BEST evidence of a family whose family coping index on therapeutic competence is rated as coping well?
- A. Shows positive interpersonal relationship
- B. Participates in the weekly clean and green program of the community
- C. Maintain clean and organized household ambiance
- D. Visits the clinic frequently well or sick.
Correct Answer: A
Rationale: Showing positive interpersonal relationships is the best evidence of a family coping well when their family coping index on therapeutic competence is rated as coping well. Positive interpersonal relationships indicate that family members are effectively communicating, supporting each other, and resolving conflicts in a healthy manner. This reflects strong family dynamics, emotional resilience, and adaptability which are important aspects of effective coping. While the other options (B, C, D) are beneficial activities or behaviors, positive interpersonal relationships directly demonstrate the family's ability to cope well together, making it the most relevant evidence for a high therapeutic competence rating.
Which of the following energy conserving strategies should NOT be done by COPD patients?
- A. Exhale when pushing or exerting effort when doing daily activities
- B. Assume tripod position with elbows supported on the table when shaving or combing
- C. Inhale when resting, sitting and lying down.
- D. Stand in front of the mirror while shaving or combing hair
Correct Answer: D
Rationale: COPD (Chronic Obstructive Pulmonary Disease) patients often struggle with breathing difficulties due to their conditions, hence it is important for them to conserve their energy as much as possible. Standing while performing activities like shaving or combing hair can be physically demanding for COPD patients as it requires more energy and can lead to increased shortness of breath. It is recommended for COPD patients to sit down or assume a supported position (like the tripod position with elbows supported on a table) to reduce the energy expended and minimize the strain on their respiratory system. Standing in front of the mirror while performing grooming activities is a task that can be easily modified to a seated position, thus conserving energy and reducing the risk of exacerbating breathing difficulties for COPD patients.
Nurse Nora notices patient's uterine contractions are 70 seconds long and occur every 90 seconds when assessing the frequency of her contractions after she receives oxytocin. what would be the nurse's FIRST action?
- A. Give an emergency bolus of oxytocin to relaxed the uterus
- B. Discontinue the administration of the oxytocin infusion
- C. Increase the rate of client's IV infusion
- D. Ask client to turn to her left side and breathe deeply
Correct Answer: B
Rationale: Patient's uterine contractions lasting 70 seconds and occurring every 90 seconds signify hyperstimulation, which can be a serious complication associated with oxytocin administration. This may result in decreased uterine perfusion, fetal distress, and other adverse effects. The first action should be to discontinue the oxytocin infusion to prevent further complications and allow the uterus to relax. Observations and assessment should continue to monitor the patient's condition and response after discontinuing the infusion. Giving an emergency bolus of oxytocin or increasing the IV infusion rate would exacerbate the hyperstimulation, and turning the client to her left side and breathing deeply would not address the underlying issue of oxytocin-induced hyperstimulation.
The patient made the following statement to the nurse, my doctor just told me that he cannot save my Leg and that I need to have an above-the-knee-amputation. Which response by the nurse is MOST APPROPRIATE?
- A. " Tell me more"
- B. "Dr. Benito is an excellent surgeon."
- C. "If I were you, I will get a second opinion."
- D. "Are you in pain?"
Correct Answer: C
Rationale: The most appropriate response by the nurse is, "If I were you, I will get a second opinion." This response acknowledges the seriousness of the situation and the life-changing decision the patient has been told to make. Suggesting the patient seek a second opinion is essential as it encourages the patient to explore all options and ensures they have considered all possibilities before proceeding with a major surgery like an above-the-knee amputation. It shows the nurse's support for the patient while also advocating for the patient's right to make an informed decision about their healthcare.
Joji, l7 years old, is admitted in a private room due to influenza. In one of Nurse Nilda's conversations with Joji, the patient expressed is unhappiness with the program he is taking up in college. This is not his choice but rather the choice of his parents. In which of Erikson 's stage of development does this case fall?
- A. Autonomy versus shame/ doubt
- B. Integrity versus despair
- C. Identity versus role Confusion
- D. Trust versus distrust
Correct Answer: C
Rationale: According to Erikson's theory of psychosocial development, the stage of Identity versus Role Confusion occurs during adolescence, which is typically around the ages of 12 to 18 years old. This stage is characterized by the individual exploring and developing their personal identity, values, and beliefs.