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A woman in active labor experiences irregular and ineffective uterine contractions, resulting in prolonged cervical dilation. What nursing intervention should be implemented to address this abnormal labor pattern?
- A. Encourage the mother to ambulate and change positions frequently.
- B. Administer intravenous opioids to enhance pain relief and relaxation.
- C. Initiate continuous electronic fetal monitoring to assess fetal well-being.
- D. Prepare for immediate cesarean section due to labor dystocia.
Correct Answer: A
Rationale: A woman experiencing irregular and ineffective uterine contractions with prolonged cervical dilation may indicate labor dystocia, also known as abnormal labor progression. To address this issue, the nursing intervention that should be implemented is to encourage the mother to ambulate and change positions frequently. This can help optimize fetal positioning and encourage descent through the birth canal by using gravity to aid in the progression of labor. Changing positions can also potentially improve the quality and effectiveness of contractions, leading to more successful cervical dilation and labor progress. Encouraging ambulation and position changes are non-invasive, patient-centered interventions that can be helpful in managing labor dystocia before considering more invasive interventions like cesarean section.
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A patient is reluctant to undergo a recommended procedure due to fear of pain. What is the nurse's best approach to address this fear?
- A. Dismiss the patient's fear and assure them that the procedure will not be painful.
- B. Provide the patient with accurate information about pain management strategies and options.
- C. Ignore the patient's fear and proceed with scheduling the procedure.
- D. Tell the patient that fear of pain is irrational and unfounded.
Correct Answer: B
Rationale: The nurse's best approach to address the patient's fear of pain is to provide accurate information about pain management strategies and options. In doing so, the nurse can help alleviate the patient's concerns by empowering them with knowledge and potential solutions for managing pain during and after the procedure. By acknowledging the patient's fear and addressing it with practical information, the nurse can build trust, reduce anxiety, and create a more supportive and collaborative environment for the patient. Dismissing, ignoring, or invalidating the patient's fear would not be effective in addressing the underlying concerns and could potentially lead to increased distress and resistance to the recommended procedure.
Based on the Right to Privacy and Confidentiality under the Patient's Bill of Rights, the patient has the right to demand on the following, but NOT _______ pertaining to his care as confidential.
- A. Information
- B. Records
- C. Communication
- D. Financial status
Correct Answer: D
Rationale: The patient has the right to demand that information, records, and communications pertaining to their care be kept confidential under the Right to Privacy and Confidentiality as outlined in the Patient's Bill of Rights. However, financial status is generally not considered part of the confidential medical information and may not fall under the same level of protection as personal health information. Therefore, the patient cannot demand that their financial status be treated as confidential under this particular right.
A pregnant woman presents with vaginal bleeding and crampy abdominal pain at 22 weeks gestation. On examination, the cervix is dilated, and the amniotic sac is visible at the cervical os. Which of the following conditions is the most likely cause of these symptoms?
- A. Ectopic pregnancy
- B. Threatened abortion
- C. Placenta previa
- D. Incompetent cervix
Correct Answer: D
Rationale: Incompetent cervix, also known as cervical insufficiency, is the most likely cause of the symptoms described. Incompetent cervix is a condition where the cervix begins to dilate and efface prematurely, typically in the second trimester, without contractions or labor. This can lead to painless cervical dilation and bulging of the amniotic sac into the vagina, which can cause vaginal bleeding and crampy abdominal pain. It is a leading cause of second-trimester pregnancy loss. Treatment may involve a cervical cerclage, a surgical procedure where the cervix is stitched closed to provide additional support.
Which of the following historical data MOST probably led to a post-traumatic stress disorder?
- A. Unstable relationship with ex-fiancee.
- B. No gang-relationship with peers
- C. Suicide of her mother
- D. Dropping out of school.
Correct Answer: C
Rationale: The suicide of her mother is the most probable historical data that led to post-traumatic stress disorder. Experiencing the suicide of a close family member, especially a parent, can be an extremely traumatic event that can have long-lasting psychological effects. Witnessing or dealing with such a tragic loss can lead to feelings of helplessness, depression, guilt, and intense emotional distress, all of which are common in individuals with post-traumatic stress disorder (PTSD). This significant and distressing event could have a profound impact on the individual's mental health and well-being, contributing to the development of PTSD symptoms such as intrusive memories, avoidance behaviors, negative mood alterations, and changes in arousal or reactivity.
A nurse is participating in a healthcare team meeting to discuss a patient's care plan. What is the nurse's role in interdisciplinary collaboration?
- A. Dictating decisions and delegating tasks to other team members
- B. Listening actively, contributing expertise, and sharing information
- C. Assuming a passive role and deferring to other healthcare providers
- D. Working independently without considering input from other team members
Correct Answer: B
Rationale: The nurse's role in interdisciplinary collaboration is crucial for providing comprehensive and effective patient care. By actively participating in healthcare team meetings, the nurse should listen attentively to the input of other team members, contribute their expertise, and share relevant information about the patient's condition. Collaboration involves working together towards shared goals, pooling knowledge and resources, and fostering mutual respect among team members. The nurse's active involvement in the care planning process helps ensure coordinated and patient-centered care delivery. This approach enhances communication, improves outcomes, and promotes a holistic approach to patient care.