A patient presents with recurrent episodes of venous thrombosis, including deep vein thrombosis (DVT) and pulmonary embolism (PE), despite no apparent provoking factors. Which of the following conditions is most likely to cause these findings?
- A. Antithrombin III deficiency
- B. Protein C deficiency
- C. Protein S deficiency
- D. Factor V Leiden mutation
Correct Answer: D
Rationale: Factor V Leiden mutation is the most common inherited predisposition to venous thrombosis. In this condition, there is a specific mutation in the factor V gene (also known as factor V Leiden) that makes factor V resistant to inactivation by activated protein C. This resistance leads to excessive clot formation, increasing the risk of recurrent venous thrombosis like DVT and PE. Patients with Factor V Leiden mutation may have a history of recurrent unprovoked venous thrombosis at a young age. In comparison, antithrombin III deficiency, protein C deficiency, and protein S deficiency are other inherited thrombophilias that may increase the risk of venous thrombosis, but Factor V Leiden mutation is the most likely cause in this case based on the presentation of recurrent episodes without apparent provoking factors.
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A patient with a history of chronic obstructive pulmonary disease (COPD) is experiencing respiratory distress. Which nursing intervention is the priority for managing the patient's respiratory status?
- A. Administering bronchodilators
- B. Positioning the patient in high Fowler's position
- C. Performing chest physiotherapy
- D. Administering oxygen therapy
Correct Answer: D
Rationale: Administering oxygen therapy is the priority nursing intervention for managing a patient with COPD experiencing respiratory distress. In COPD, the patient's lungs are less efficient at oxygen exchange, leading to hypoxemia. Oxygen therapy helps improve oxygenation in the body and alleviates respiratory distress in these patients. Positioning the patient in high Fowler's position can also help improve lung expansion, but providing supplemental oxygen takes precedence in addressing the underlying hypoxemia. Administering bronchodilators and performing chest physiotherapy aim to manage airway obstruction and promote airway clearance, but ensuring the patient has adequate oxygenation is crucial in the immediate management of respiratory distress in COPD.
When an accurate documentation whether done manually or by electronic by the health care professionals in their Work setting is a component of what quality standards in a health care delivery system?
- A. Patient care standards
- B. Leadership and management
- C. Information management
- D. Human resource management
Correct Answer: C
Rationale: Accurate documentation, whether done manually or electronically by health care professionals, is a critical component of information management in a health care delivery system. Information management involves the collection, storage, processing, and sharing of data to support decision-making and ensure quality care for patients. Properly documented records enable health care providers to have access to relevant information about a patient's medical history, treatment plans, and progress. This helps in delivering effective and coordinated care, reducing medical errors, and improving overall patient outcomes. Moreover, well-kept records are essential for legal and regulatory compliance, billing, quality assessment, and research purposes. Therefore, accurate documentation plays a key role in information management within the healthcare setting.
The nurse is conducting an assessment to her patient who has edema of the lower extremities due to congestive heart failure. If edema is graded on a scale of +1 (no visible edema in the leg) to 4+ (leg very swollen), what will the Nurse document in her chart if her assessment findings of the edema is SLIGHTLY swollen?
- A. 4
- B. 2
- C. 1
- D. 3
Correct Answer: B
Rationale: In the grading system used for edema, +1 indicates no visible edema in the leg, +2 indicates slight edema with indentations that quickly resolve, +3 indicates moderate edema with deeper indentations that may take longer to resolve, and +4 indicates severe edema with very swollen legs. In this case, since the edema is described as slightly swollen, the appropriate grade to document would be +2.
A patient expresses fear of needles before a scheduled blood draw. What is the nurse's best approach to address this fear?
- A. Dismiss the patient's fear and proceed with the blood draw.
- B. Provide the patient with information about relaxation techniques and distraction methods.
- C. Ignore the patient's fear and proceed with the blood draw quickly.
- D. Tell the patient that fear of needles is irrational and unfounded.
Correct Answer: B
Rationale: The nurse's best approach to address the patient's fear of needles before a blood draw is to provide the patient with information about relaxation techniques and distraction methods (Option B). Dismissing the patient's fear (Option A), ignoring the fear and proceeding quickly (Option C), or telling the patient that the fear is irrational and unfounded (Option D) would not be helpful and could potentially escalate the patient's anxiety. Providing information on relaxation techniques such as deep breathing or visualization, as well as distraction methods like listening to music or engaging in conversation, can help the patient feel more comfortable and reduce their fear and anxiety during the blood draw procedure. It is important for the nurse to acknowledge and address the patient's concerns in a supportive and empathetic manner to build trust and ensure a successful blood draw experience.
The staff assigned to check the fire extinguisher failed to monitor the assigned equipment. The following statements are "whereabouts" of true, EXCEPT
- A. all employees are lazy
- B. monitoring staff is important
- C. not all staff are diligent in their tasks
- D. two errors added together can be potentially devastating
Correct Answer: A
Rationale: The statement "all employees are lazy " is not a correct assertion. It is a generalization that is unfair to make about all employees. It is incorrect to assume that all employees are lazy based on the failure of a certain staff member to monitor the fire extinguisher. Making blanket statements like this can lead to further misunderstandings and negativity in the workplace. The focus should be on individual accountability, proper training, and clear communication to ensure that tasks are being diligently carried out.
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