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A patient with a history of deep vein thrombosis (DVT) is prescribed warfarin therapy. Which laboratory test is used to monitor the therapeutic effect of warfarin?
- A. Activated partial thromboplastin time (aPTT)
- B. International normalized ratio (INR)
- C. Platelet count
- D. D-dimer
Correct Answer: B
Rationale: The laboratory test used to monitor the therapeutic effect of warfarin therapy is the International Normalized Ratio (INR). Warfarin is a commonly prescribed anticoagulant medication that works by inhibiting the action of vitamin K-dependent clotting factors. Maintaining the INR within the target range specific to the indication for anticoagulation (e.g., DVT prevention or treatment) is essential to balance the risk of bleeding and clotting.
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A nurse is caring for a patient who is experiencing end-of-life symptoms. What action by the nurse demonstrates palliative care principles?
- A. Focusing solely on physical comfort and pain management
- B. Encouraging the patient to make decisions about life-sustaining treatments
- C. Providing emotional support and addressing psychosocial needs
- D. Withholding information about the patient's prognosis to avoid distress
Correct Answer: C
Rationale: Providing emotional support and addressing psychosocial needs demonstrates palliative care principles when caring for a patient experiencing end-of-life symptoms. Palliative care focuses on holistic care that encompasses physical, emotional, and spiritual support for patients and their families during times of serious illness. By addressing emotional needs and providing support, the nurse helps improve the patient's quality of life and comfort during this difficult time. This approach goes beyond just managing physical symptoms and pain, recognizing the importance of supporting the patient's overall well-being. Encouraging the patient to make decisions about life-sustaining treatments is also an important aspect of palliative care, but providing emotional support and addressing psychosocial needs is crucial in palliative care practice.
A patient presents with sudden-onset unilateral headache, along with ipsilateral ptosis, miosis, and anhidrosis. Which of the following neurological conditions is most likely responsible for these symptoms?
- A. Cluster headache
- B. Migraine headache
- C. Tension-type headache
- D. Trigeminal neuralgia
Correct Answer: D
Rationale: The presentation described in the question – sudden-onset unilateral headache along with ipsilateral ptosis, miosis, and anhidrosis – is characteristic of Horner syndrome. Horner syndrome is caused by disruption of the sympathetic nerve pathway and can occur in trigeminal neuralgia. Trigeminal neuralgia is a painful condition affecting the trigeminal nerve commonly characterized by sudden and severe facial pain that can be triggered by various stimuli. The involvement of the sympathetic pathway in trigeminal neuralgia can lead to Horner syndrome symptoms such as ptosis (drooping eyelid), miosis (constricted pupil), and anhidrosis (lack of sweating) on the affected side of the face. Cluster headaches usually involve severe unilateral pain around the eye, but they do not typically present with Horner syndrome symptoms. Migraine and tension-type headaches also do not typically present with Horner syndrome symptoms.
The QA team was alerted by the Administration, that they have to anticipate for a possible earthquake in the forthcoming days. As part of Safe Practice Environment (SPE) standards, which of the following are to be given PRIORITY attention by the team? I Electrical wires II Combustible materials III Entry, Exit of the building IV Infected waste materials
- A. I, II, III & IV
- B. I & II
- C. II and II
- D. I, II & III
Correct Answer: B
Rationale: In preparing for a possible earthquake as part of Safe Practice Environment (SPE) standards, the QA team should prioritize attention on Electrical wires (I) and Combustible materials (II).
During surgery, the nurse notices a discrepancy between the surgical count and the number of instruments on the sterile field. What should the nurse do?
- A. Re-count the instruments on the sterile field
- B. Document the discrepancy in the surgical count log
- C. Continue with the procedure as planned
- D. Inform the surgical team and initiate a thorough search
Correct Answer: D
Rationale: If a nurse notices a discrepancy between the surgical count and the number of instruments on the sterile field during surgery, it is crucial to inform the surgical team immediately and initiate a thorough search. Patient safety is of utmost importance, and any missing instruments could potentially pose a risk to the patient. By informing the team and conducting a thorough search, the missing instrument can be located promptly to ensure it is not inadvertently left inside the patient's body. Continuing with the procedure or ignoring the discrepancy without further investigation could lead to serious consequences for the patient's well-being. It is always better to address any discrepancies or concerns during surgery proactively to maintain a high standard of patient care and safety.
Patient Hydee asks how she could Distinguish between true and false labor? Which is NOT included among the factors in which the nurse should base her answer from?
- A. Contractions
- B. Cervical by vaginal examination
- C. Vital signs
- D. Engagement of fetus
Correct Answer: D
Rationale: The engagement of the fetus refers to the baby's head moving down into the mother's pelvis in preparation for birth. This factor is not typically used to distinguish between true and false labor because it is a sign of progress in labor rather than a defining characteristic of true labor. In contrast, the factors that are commonly used to differentiate between true and false labor include contractions (e.g., regularity, intensity, duration), cervical changes observed through vaginal examination (e.g., effacement and dilation), and monitoring vital signs.