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A postpartum client presents with sudden chest pain, dyspnea, and tachycardia. Which nursing action should be prioritized?
- A. Elevating the head of the bed
- B. Providing supplemental oxygen therapy
- C. Administering analgesics for pain relief
- D. Notifying the healthcare provider immediately
Correct Answer: D
Rationale: Sudden chest pain, dyspnea, and tachycardia in a postpartum client can be indicative of serious conditions such as pulmonary embolism or myocardial infarction. These conditions are emergencies that require immediate medical attention. Notifying the healthcare provider immediately is the priority to ensure prompt evaluation and intervention to address the potential life-threatening situation. While other nursing interventions such as elevating the head of the bed, providing supplemental oxygen therapy, and administering analgesics may be necessary, they should be done after notifying the healthcare provider to ensure appropriate management of the underlying cause.
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Which of the following statements accurately describes the role of dendritic cells in the immune response?
- A. Dendritic cells directly kill infected cells and tumor cells.
- B. Dendritic cells produce antibodies against pathogens.
- C. Dendritic cells activate na(cid:239)ve T cells and initiate adaptive immune responses.
- D. Dendritic cells release histamine and other inflammatory mediators.
Correct Answer: C
Rationale: Dendritic cells play a critical role in initiating adaptive immune responses by capturing antigens from pathogens, migrating to lymphoid organs, and presenting these antigens to naïve T cells. This activation of naïve T cells by dendritic cells is essential for the adaptive immune system to generate specific immune responses against pathogens. Dendritic cells act as professional antigen-presenting cells, which are specialized to capture, process, and present antigens to T cells, thereby facilitating the activation of T cells and the coordination of adaptive immune responses, such as the production of specific antibodies and the generation of memory T cells.
Should the investigation of the fall go further, which of the following is the best source of factual information ?
- A. incident report.
- B. nurse's notes in the chart
- C. anecdotal record
- D. process recording
Correct Answer: A
Rationale: The incident report is the best source of factual information to investigate the fall further. Incident reports are official documents that provide a detailed account of what happened leading up to and during an incident. They include factual information such as the date, time, location, individuals involved, and details of the event. By reviewing the incident report, investigators can gather accurate information to determine the cause of the fall and any contributing factors. This document serves as an essential tool in conducting a thorough investigation into the fall and helps in identifying preventive measures to avoid similar incidents in the future.
Nurse Rica is in charge of the animal bite program of the health center, which of the following is the causative agent of rabies?
- A. Parasite
- B. Bacteria
- C. Virus
- D. Fungi
Correct Answer: C
Rationale: Rabies is a viral disease that affects the central nervous system. It is primarily transmitted through the bite of an infected animal, such as dogs, bats, raccoons, and foxes. The causative agent of rabies is the rabies virus, specifically from the genus Lyssavirus. Once the virus enters the body, it spreads through the nervous system to the brain, leading to severe neurological symptoms and, if left untreated, is almost always fatal. This is why prompt medical attention and vaccination following an animal bite are crucial in preventing the development of rabies in humans.
Nurse Maris is correct in identifying whinch of the following is a health resource problem?
- A. Increase in number of deaths fromm Pneumonia
- B. Feud between Midwife andHead of t he Sanitation Committee
- C. Absence of midwife in the communtiy to render health services
- D. High Maternal Mortality Rate
Correct Answer: C
Rationale: The correct answer, C, reflects a health resource problem. The absence of a midwife in the community means that there is a lack of a critical health resource necessary for providing essential health services, especially for pregnant women and infants. This directly impacts the access to healthcare services and can contribute to negative health outcomes, such as high maternal mortality rates. The other options do not directly address a health resource problem but rather focus on specific issues or conflicts within the community.
Nurse Adalynn explains to the mothers that early indication for hypovolemia caused by postpartum hemorrhage is _____.
- A. increasing pulse and decreasing blood pressure
- B. altered mental status and level of consciousness
- C. dizziness and increasing respiratory rate
- D. Cool, clammy skin, and pale mucous membranes
Correct Answer: A
Rationale: Nurse Adalynn explains to the mothers that early indication for hypovolemia caused by postpartum hemorrhage is an increasing pulse and decreasing blood pressure. Hypovolemia is a condition where there is a decreased volume of circulating blood in the body, often characterized by fluid loss such as through bleeding. As blood volume decreases, the heart rate increases in an attempt to maintain adequate perfusion to organs and tissues. This results in an elevated pulse rate. Additionally, as the blood volume decreases, the blood pressure may drop due to the reduced amount of blood being pumped around the body. Therefore, monitoring for an increasing pulse and decreasing blood pressure is crucial in detecting hypovolemia early, allowing for prompt intervention to prevent further complications.