Nokea
A patient presents with swelling of the ankles, dyspnea on exertion, and orthopnea. An echocardiogram reveals decreased left ventricular ejection fraction and dilated left ventricle. Which cardiovascular disorder is most likely responsible for these symptoms?
- A. Stable angina
- B. Heart failure with preserved ejection fraction
- C. Heart failure with reduced ejection fraction
- D. Valvular heart disease
Correct Answer: C
Rationale: The patient's presentation of swelling of the ankles, dyspnea on exertion, and orthopnea is highly suggestive of heart failure. The echocardiogram findings of decreased left ventricular ejection fraction and dilated left ventricle are characteristic of heart failure with reduced ejection fraction (HFrEF), also known as systolic heart failure. In this condition, the heart's ability to pump blood effectively is compromised, leading to symptoms of congestion and decreased cardiac output. The decreased ejection fraction indicates that the heart is not able to efficiently pump out blood with each contraction. Dilatation of the left ventricle is a compensatory mechanism in response to increased volume overload.
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In planning for Jose's oxygen therapy, the nurse shall consider which of the following, EXCEPT
- A. need for a humidifier.
- B. length of tubing.
- C. determine the age of Jose.
- D. manner of administering oxygen, continuous or intermittent.
Correct Answer: C
Rationale: When planning for Jose's oxygen therapy, the nurse should consider the need for a humidifier to prevent drying of the mucous membranes, the appropriate length of tubing for mobility and safety reasons, and the manner of administering oxygen (continuous or intermittent) based on Jose's condition and oxygen requirements. However, determining Jose's age is not a relevant factor in planning for his oxygen therapy. The decision-making process should be based on his specific medical needs and condition rather than his age.
A woman in active labor demonstrates signs of cephalopelvic disproportion (CPD), with the fetal head failing to descend despite strong contractions. What nursing action should be prioritized to address this abnormal labor presentation?
- A. Perform a pelvic exam to assess for CPD.
- B. Assist the mother into a hands-and-knees position.
- C. Administer intravenous oxytocin to augment contractions.
- D. Prepare for immediate instrumental delivery.
Correct Answer: D
Rationale: When a woman in active labor demonstrates signs of cephalopelvic disproportion (CPD) with the fetal head failing to descend despite strong contractions, the nursing action that should be prioritized is to prepare for immediate instrumental delivery. CPD can lead to a prolonged and difficult labor, increasing the risks for both the mother and the fetus. In cases where the fetal head is not descending adequately and the mother's contractions are strong, instrumental delivery, like forceps or vacuum extraction, may be necessary to facilitate the safe delivery of the baby. It is important to act promptly to avoid potential complications associated with prolonged labor. Other actions, such as performing a pelvic exam, changing maternal positions, or administering oxytocin, may be considered but addressing the issue of CPD efficiently through instrumental delivery should take precedence in this scenario.
A nurse conducts a regular audit of the medical records the PRIMARY purpose of conducting audit in a health facility is to _____.
- A. identify errors made by health personnel.
- B. identify areas for improvement
- C. ensure that standards are met.
- D. promote risk management.
Correct Answer: C
Rationale: The primary purpose of conducting an audit in a health facility is to ensure that standards are met. Audits are conducted to review and evaluate the documentation and practices within a healthcare facility to ensure compliance with established standards, protocols, procedures, and regulations. By conducting audits, the facility can identify any discrepancies, non-compliance with standards, or areas for improvement to maintain high-quality care and patient safety. This process helps in maintaining a high standard of care, reducing errors, promoting quality improvement initiatives, and ensuring the overall efficiency and effectiveness of healthcare services provided in the facility.
A patient is prescribed a benzodiazepine for the management of insomnia. Which adverse effect should the nurse monitor closely in the patient?
- A. Hypotension
- B. Hyperglycemia
- C. Daytime drowsiness
- D. Bradycardia
Correct Answer: C
Rationale: Benzodiazepines are commonly prescribed for the management of insomnia due to their sedative effects. One of the most common adverse effects of benzodiazepines is daytime drowsiness, which can impair the patient's ability to function normally during the day. Monitoring the patient closely for daytime drowsiness is important to ensure their safety and well-being, as it can affect their daily activities and increase the risk of accidents or falls. It is essential for the nurse to educate the patient on the potential for daytime drowsiness and advise them to avoid activities that require full alertness, such as driving or operating heavy machinery, until they know how the medication affects them. If the patient experiences severe or persistent daytime drowsiness, the healthcare provider may need to adjust the dosage or consider alternative treatment options.
The immunity conferred by tetanus toxoid is best described as:
- A. Lifelong passive
- B. Temporary passive
- C. Long-lasting active
- D. Lifelong active
Correct Answer: C
Rationale: Tetanus toxoid provides long-lasting active immunity. When a person is vaccinated with tetanus toxoid, their immune system is stimulated to produce antibodies against the tetanus toxin. These antibodies provide protection against tetanus infection by recognizing and neutralizing the toxin if the person is exposed to the bacteria that causes tetanus in the future. This active immune response can last for many years, providing ongoing protection against tetanus. However, booster doses are recommended every 10 years to maintain adequate levels of protection.