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A pregnant woman presents with painless, bright red vaginal bleeding at 34 weeks gestation. On examination, the cervix is found to be closed. Which of the following conditions is the most likely cause of these symptoms?
- A. Ectopic pregnancy
- B. Abruptio placentae
- C. Placenta previa
- D. Gestational trophoblastic disease
Correct Answer: C
Rationale: Placenta previa is a condition where the placenta partially or completely covers the cervix, leading to painless vaginal bleeding during pregnancy. In the scenario described, the painless, bright red vaginal bleeding at 34 weeks gestation with a closed cervix is classic for placenta previa. This condition is more common in the third trimester and can be diagnosed through ultrasound. It is important to manage placenta previa carefully to prevent complications such as severe bleeding, preterm birth, and maternal/fetal distress.
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Endocrine changes often result in a bulimic patient. Which of the following would be an expected change in Sherry?
- A. Delayed Thyroid Stimulating Hormone response to Hormone Replacement Therapy
- B. Increased production of Follicle Stimulating Hormone
- C. Hypopituitarism
- D. Decreased Adrenocorticotropic Hormone in response to cortisone
Correct Answer: C
Rationale: Endocrine changes in a bulimic patient, such as Sherry, can lead to disruptions in the pituitary gland's function. Hypopituitarism refers to a disorder in which the pituitary gland does not produce one or more of its hormones adequately. This can result in hormonal imbalances and have various effects on the body's functions. In Sherry's case, developing hypopituitarism would be an expected change due to the endocrine disruptions associated with bulimia. It is important for healthcare providers to monitor and address these endocrine changes in bulimic patients to prevent further complications.
An infant's current weight indicates that the maximum safe dose of Tylenol is 30 mg by mouth. The physician orders 65 mg to be given, the pharmacist is responsible for filling the medication order, and the nurse administers Tylenol 65 mg. Who is legally responsible in the event that the infant has a toxic reaction to the medication?
- A. nurse
- B. physician
- C. pharmacist
- D. pharmacist and physician
Correct Answer: C
Rationale: The pharmacist is legally responsible in this situation because they are the healthcare professional authorized to dispense medications according to the physician's order. In this case, the physician ordered a dose higher than the maximum safe dose recommended based on the infant's current weight. While the nurse administers the medication, the pharmacist has the responsibility to ensure that the correct dose is dispensed and to alert the physician if there is a discrepancy in the order. If the pharmacist dispensed the incorrect dose without verifying with the physician, they would bear legal responsibility for any adverse effects resulting from the medication error.
Verbal communication is the use of words when talking to your patient. The use of literal words when you speak is the :
- A. Understandable phrases
- B. The circumstances
- C. Content
- D. Understandable sentences
Correct Answer: C
Rationale: Verbal communication involves the use of words and language to convey information. The content refers to the actual words and messages being communicated. In verbal communication with your patient, the content of what you say is key to ensuring effective communication that is clear, accurate, and easily understood. Therefore, the use of literal words when speaking to your patient embodies the content of your communication.
Applying multidisciplinary approach of patient care, which among the members of the multidisciplinary team that the nurse would MOST likely collaborate with when the patient is at risk of fall due to an impaired gait?
- A. Podiatrist
- B. Speech therapist
- C. Physica l therapist
- D. Nutritionist
Correct Answer: C
Rationale: When a patient is at risk of falls due to an impaired gait, a physical therapist would be the most appropriate member of the multidisciplinary team for the nurse to collaborate with. Physical therapists specialize in improving mobility, balance, and coordination through exercises, gait training, and other interventions. They can assess the patient's gait pattern, strength, and balance, and develop a personalized plan to address the impairments contributing to the fall risk. By working closely with a physical therapist, the nurse can help the patient improve their gait and reduce the risk of falls, ultimately promoting safety and independence.
When communicating with a patient from a different cultural background, what should the nurse prioritize?
- A. Ignoring cultural differences to avoid making the patient uncomfortable.
- B. Using medical jargon to ensure clarity and precision.
- C. Recognizing and respecting the patient's cultural beliefs and practices.
- D. Minimizing the time spent communicating with the patient.
Correct Answer: C
Rationale: When communicating with a patient from a different cultural background, the nurse should prioritize recognizing and respecting the patient's cultural beliefs and practices. This is essential in providing culturally competent care, fostering trust and rapport with the patient, and ultimately improving health outcomes. By acknowledging and understanding the cultural context of the patient, the nurse can adapt communication strategies, address the patient's needs effectively, and avoid misunderstandings or misinterpretations. Building a culturally sensitive approach can enhance the quality of care and strengthen the therapeutic relationship between the nurse and patient.