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A woman in active labor is diagnosed with a prolapsed umbilical cord. What is the priority nursing action?
- A. Elevate the mother's hips to relieve pressure on the cord.
- B. Prepare for immediate cesarean section.
- C. Administer intravenous fluids rapidly.
- D. Perform a vaginal examination to assess cervical dilation.
Correct Answer: B
Rationale: A prolapsed umbilical cord is a medical emergency during labor because it can cause compression of the umbilical cord, leading to decreased oxygen supply to the fetus. The priority nursing action in this situation is to prepare for an immediate cesarean section. This is necessary to quickly deliver the baby and relieve pressure on the cord, preventing potential fetal distress or death. Elevating the mother's hips may help reduce pressure on the cord temporarily, but it is not the definitive treatment for a prolapsed cord. Administering intravenous fluids rapidly may be necessary, but it is not the priority intervention when the fetus is at risk due to a prolapsed cord. Performing a vaginal examination to assess cervical dilation is contraindicated in the presence of a prolapsed umbilical cord as it can further compress the cord and worsen the situation.
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A patient presents with recurrent episodes of sudden, severe vertigo lasting hours, accompanied by nausea, vomiting, and nystagmus. Vestibular function tests demonstrate unilateral weakness. Which of the following conditions is most likely responsible for this presentation?
- A. Vestibular neuritis
- B. Benign paroxysmal positional vertigo (BPPV)
- C. Ménière's disease
- D. Acoustic neuroma
Correct Answer: A
Rationale: The patient's presentation of recurrent episodes of sudden, severe vertigo lasting hours, along with nausea, vomiting, nystagmus, and unilateral weakness on vestibular function tests, is most consistent with vestibular neuritis. Vestibular neuritis is an inflammatory disorder of the vestibular nerve, typically viral in origin, leading to acute onset of vertigo. Patients often experience severe vertigo, imbalance, nausea, and vomiting, along with characteristic nystagmus. Unilateral weakness on vestibular function testing supports the diagnosis of vestibular neuritis, as it indicates dysfunction of one vestibular organ. Benign paroxysmal positional vertigo (BPPV) typically presents with brief episodes of vertigo triggered by changes in head position without associated unilateral vestibular weakness. Ménière's disease is characterized by recurrent episodes of vertigo associated with fluctuating hearing loss, tinnitus, and aural fullness, and
What should be the color of trash bin for the proper disposal of waste product such as papers from the admin office?
- A. Yellow
- B. green
- C. Black
- D. orange
Correct Answer: C
Rationale: The color black is commonly used for general waste or non-recyclable materials, which includes papers and other waste products typically found in an office setting. By designating a black trash bin for the proper disposal of these items, it helps in efficient waste management and ensures that they are disposed of correctly. This color coding system helps individuals easily identify which type of waste goes in which bin, promoting recycling and proper waste segregation practices in the office environment.
A pregnant woman presents with sudden onset of severe abdominal pain and vaginal bleeding. On examination, her abdomen is rigid, and fetal parts are palpable abdominally. Which of the following conditions is the most likely cause of these symptoms?
- A. Ectopic pregnancy
- B. Pelvic inflammatory disease
- C. Uterine rupture
- D. Ovarian torsion
Correct Answer: C
Rationale: Uterine rupture is the most likely cause of these symptoms in a pregnant woman presenting with sudden onset of severe abdominal pain, vaginal bleeding, rigidity of the abdomen, and palpable fetal parts abdominally. Uterine rupture is a rare but serious complication of pregnancy, typically occurring during labor in women with a previous cesarean delivery or other uterine scars. The sudden onset of severe abdominal pain can be associated with vaginal bleeding due to the tearing of the uterine wall, causing fetal parts to be palpable abdominally. This is a life-threatening emergency that requires immediate medical intervention. Ectopic pregnancy, pelvic inflammatory disease, and ovarian torsion may present with abdominal pain and vaginal bleeding but would not typically present with palpable fetal parts abdominally in a pregnant woman.
A patient with chronic kidney disease is prescribed erythropoietin-stimulating agents (ESAs) to manage anemia. Which laboratory parameter should be monitored closely during ESA therapy?
- A. Serum potassium
- B. Serum creatinine
- C. Hemoglobin
- D. Platelet count
Correct Answer: C
Rationale: Erythropoietin-stimulating agents (ESAs) are prescribed to manage anemia in patients with chronic kidney disease. Monitoring the hemoglobin level closely during ESA therapy is crucial to ensure that the treatment is effective in increasing red blood cell production without causing excessive elevation. Hemoglobin levels should be checked regularly to adjust the ESA dosage accordingly and prevent risks associated with high hematocrit levels, such as increasing blood viscosity and cardiovascular events. Monitoring serum potassium, creatinine, and platelet count are important in the management of chronic kidney disease for different reasons, but for ESA therapy, monitoring hemoglobin is the most essential parameter.
A patient is prescribed a benzodiazepine for the management of insomnia. Which adverse effect should the nurse monitor closely in the patient?
- A. Hypotension
- B. Hyperglycemia
- C. Daytime drowsiness
- D. Bradycardia
Correct Answer: C
Rationale: Benzodiazepines are commonly prescribed for the management of insomnia due to their sedative effects. One of the most common adverse effects of benzodiazepines is daytime drowsiness, which can impair the patient's ability to function normally during the day. Monitoring the patient closely for daytime drowsiness is important to ensure their safety and well-being, as it can affect their daily activities and increase the risk of accidents or falls. It is essential for the nurse to educate the patient on the potential for daytime drowsiness and advise them to avoid activities that require full alertness, such as driving or operating heavy machinery, until they know how the medication affects them. If the patient experiences severe or persistent daytime drowsiness, the healthcare provider may need to adjust the dosage or consider alternative treatment options.