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A patient undergoing mechanical ventilation in the ICU develops acute exacerbation of chronic obstructive pulmonary disease (COPD). What intervention should the healthcare team prioritize to manage the patient's exacerbation?
- A. Initiate non-invasive positive pressure ventilation (NIPPV).
- B. Administer bronchodilator medications for bronchodilation.
- C. Perform endotracheal intubation for invasive mechanical ventilation.
- D. Recommend chest physiotherapy to promote airway clearance.
Correct Answer: A
Rationale: The correct answer is A: Initiate non-invasive positive pressure ventilation (NIPPV). This intervention is prioritized as it helps improve oxygenation and ventilation in COPD exacerbation without the need for invasive mechanical ventilation, reducing the risk of ventilator-associated complications. NIPPV also decreases the work of breathing and can prevent the need for intubation. Administering bronchodilator medications (B) is important in COPD exacerbation but may not address the immediate need for ventilatory support. Endotracheal intubation (C) should be reserved for cases of respiratory failure not responding to NIPPV. Chest physiotherapy (D) may be beneficial in some cases but is not the first-line intervention for managing acute COPD exacerbation.
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Annie states,'I 'm afraid to 1et my children out of my sight now that I can't hear them." What is the nurse ' s BEST response?
- A. Tell me about your fears of losing contact with your children now that you can't hear them.
- B. Children need some freedom, and the mother has to learn trust them. "
- C. Do the children usually misbehave when they cannot be seen or heard by you?"
- D. "What can the children do to make you feel more comfortable?
Correct Answer: A
Rationale: Rationale:
A is the correct answer as it demonstrates therapeutic communication by encouraging Annie to express her feelings and fears. It shows empathy and understanding, allowing Annie to elaborate on her concerns. B is incorrect as it dismisses Annie's fears and implies blame on her parenting. C is incorrect as it focuses on the behavior of the children rather than addressing Annie's emotions. D is incorrect as it places the responsibility on the children to make Annie feel comfortable, rather than addressing her concerns directly.
A nurse is conducting an admission assessment for a newly admitted patient. What aspect of cultural competence should the nurse prioritize during the assessment?
- A. Assuming that the patient shares the nurse's cultural beliefs
- B. Asking the patient about their cultural background and preferences
- C. Avoiding discussions about cultural differences to prevent discomfort
- D. Disregarding the patient's cultural practices and beliefs
Correct Answer: B
Rationale: Correct Answer: B
Rationale:
1. Asking the patient about their cultural background and preferences shows respect for their individuality and acknowledges the importance of cultural competence in providing person-centered care.
2. It allows the nurse to gain valuable insights into the patient's beliefs, values, and practices, enabling them to deliver culturally appropriate care.
3. By prioritizing this aspect, the nurse can establish rapport, build trust, and enhance communication with the patient, leading to better outcomes.
4. Choices A, C, and D are incorrect as they either involve assumptions, avoidance, or disregard for the patient's cultural background, which can lead to misunderstandings, discomfort, and ineffective care.
Which is the simple meaning of standards of nursing care?
- A. What protects the nurse
- B. How the nurse will behave
- C. How much work is done
- D. Ask the local offficials
Correct Answer: B
Rationale: The correct answer is B: How the nurse will behave. Standards of nursing care refer to the expected behaviors and practices that nurses should adhere to in providing quality care to patients. This encompasses ethical principles, professional conduct, and best practices in nursing. It is essential for nurses to follow these standards to ensure patient safety and quality outcomes.
Explanation:
- A: What protects the nurse. This choice is incorrect because standards of nursing care primarily focus on patient care and outcomes, rather than protecting the nurse.
- C: How much work is done. This choice is incorrect as it does not directly relate to the behaviors and practices expected of nurses in providing quality care.
- D: Ask the local officials. This choice is unrelated to the concept of standards of nursing care and is not relevant to the question.
A patient presents with acute onset of shoulder pain and limited range of motion after a fall onto an outstretched hand. Physical examination reveals tenderness over the greater tuberosity of the humerus and pain with passive abduction and external rotation of the shoulder. Which of the following conditions is most likely?
- A. Rotator cuff tear
- B. Glenohumeral dislocation
- C. Acromioclavicular joint separation
- D. Proximal humerus fracture
Correct Answer: A
Rationale: The correct answer is A: Rotator cuff tear. The presentation of acute shoulder pain and limited range of motion after a fall onto an outstretched hand, along with tenderness over the greater tuberosity and pain with passive abduction and external rotation, is classic for a rotator cuff tear. The mechanism of injury and physical exam findings are consistent with this condition.
B: Glenohumeral dislocation typically presents with a visibly deformed shoulder and loss of normal shoulder contour.
C: Acromioclavicular joint separation would present with tenderness over the AC joint rather than the greater tuberosity, and typically involves a history of direct trauma to the shoulder.
D: Proximal humerus fracture would present with more diffuse shoulder pain and swelling, and not specific tenderness over the greater tuberosity.
A pregnant woman presents with severe abdominal pain and passage of tissue at 12 weeks gestation. On examination, the cervix is partially dilated, and products of conception are protruding through the cervical os. Which of the following conditions is the most likely cause of these symptoms?
- A. Ectopic pregnancy
- B. Incomplete abortion
- C. Placenta previa
- D. Gestational trophoblastic disease
Correct Answer: B
Rationale: In this scenario, the pregnant woman is presenting with severe abdominal pain, passage of tissue, and cervical dilation with products of conception protruding through the cervical os at 12 weeks gestation. These are classic signs and symptoms of an incomplete abortion. Incomplete abortion occurs when not all of the products of conception are expelled from the uterus. It can present with vaginal bleeding, abdominal pain, cervical dilation, and passage of tissue. The management of incomplete abortion may involve expectant, medical, or surgical options depending on the clinical context and the patient's condition.