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A woman in active labor is diagnosed with uterine rupture, resulting in fetal distress and maternal hemorrhage. What nursing intervention is essential in managing this obstetric emergency?
- A. Initiating immediate oxytocin infusion
- B. Preparing for immediate instrumental delivery
- C. Performing an emergency cesarean section
- D. Administering intravenous magnesium sulfate
Correct Answer: C
Rationale: Uterine rupture is a severe obstetric complication that requires prompt and decisive management to prevent adverse outcomes for both the mother and the baby. In cases of uterine rupture leading to fetal distress and maternal hemorrhage, performing an emergency cesarean section is crucial. This intervention allows for rapid delivery of the baby, relieving the distress on the fetus and enabling immediate access to manage the maternal hemorrhage. By performing a timely cesarean section, healthcare providers can expedite the delivery process and effectively address both the fetal and maternal complications associated with uterine rupture. This intervention is essential in saving lives and reducing the risk of further complications in such a critical obstetric emergency.
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Which of the following statements accurately describes the role of natural killer (NK) cells in the immune response?
- A. NK cells directly kill virus-infected cells and tumor cells.
- B. NK cells produce antibodies against pathogens.
- C. NK cells present antigens to T cells to initiate adaptive immunity.
- D. NK cells release cytokines to recruit other immune cells to the site of infection.
Correct Answer: A
Rationale: Natural killer (NK) cells play a vital role in the innate immune response by identifying and eliminating virus-infected cells, as well as tumor cells, without the need for prior exposure or activation. NK cells are able to detect abnormal cells by recognizing changes in the cell surface molecules, such as downregulation of MHC class I molecules. Once activated, NK cells release cytotoxic granules containing perforin and granzyme, leading to the destruction of the target cell. This direct killing mechanism is crucial for controlling viral infections and preventing the development of tumors. NK cells do not produce antibodies (option B), present antigens to T cells (option C), or release cytokines to recruit other immune cells (option D) as their primary function in the immune response.
A 32-year-old pregnant woman presents with painless vaginal bleeding at 10 weeks of gestation. On ultrasound, a gestational sac with no embryo is visualized within the uterus. Which of the following conditions is most likely to be responsible for these findings?
- A. Threatened abortion
- B. Inevitable abortion
- C. Missed abortion
- D. Ectopic pregnancy
Correct Answer: C
Rationale: In a missed abortion, the embryo has died, but the products of conception remain in the uterus, leading to the visualization of a gestational sac without an embryo on ultrasound. This is a type of missed miscarriage where the woman may not have any symptoms initially and the diagnosis is made during a routine ultrasound. The most common presenting symptom is painless vaginal bleeding. The absence of an embryo within the gestational sac can be confirmed through serial ultrasound examinations showing no fetal growth or cardiac activity. It is important for healthcare providers to provide appropriate counseling and management options to support the patient through this emotional experience.
Bleeding is the most serious complication of Dengue infection. When is the patient be watched for symptoms of bleeding?
- A. 4 th to 7 days
- B. 2nd to 3rd day
- C. At the onset of symptoms
- D. 1St day
Correct Answer: A
Rationale: Bleeding is the most serious complication of Dengue infection, typically occurring between the 4th to 7th day after the onset of symptoms. This is known as the critical phase of Dengue fever, where the patient is at a higher risk of developing severe symptoms such as bleeding manifestations. Monitoring for symptoms of bleeding during this period is crucial for timely intervention and proper management to prevent further complications or fatalities. While bleeding can occur outside this timeframe in some cases, the 4th to 7th day window is when the risk is highest and vigilance is most needed.
A woman in active labor experiences frequent and intense uterine contractions with minimal rest intervals, leading to maternal fatigue and decreased fetal oxygenation. What maternal condition should the nurse assess for that may contribute to this abnormal labor pattern?
- A. Maternal dehydration
- B. Uterine hyperstimulation
- C. Pelvic outlet obstruction
- D. Maternal exhaustion
Correct Answer: B
Rationale: Uterine hyperstimulation, also known as tachysystole, is a condition characterized by frequent and intense uterine contractions with minimal rest intervals. This can lead to maternal fatigue and decreased fetal oxygenation due to the insufficient time for the uterus to relax and refill with oxygenated blood between contractions. Uterine hyperstimulation can be caused by various factors such as excessive use of uterotonics (oxytocin or prostaglandins), improper labor induction techniques, or maternal conditions like previous uterine surgery. It is essential for the nurse to assess for signs of uterine hyperstimulation and take appropriate interventions to prevent potential complications for both the mother and the baby.
Which of the following statements is TRUE of Quality Improvement?
- A. Focuses on the organizational structure than patient care
- B. Continually improve every process in the organization.
- C. Centered on people rather than processes.
- D. An approach that is externally driven by the stakeholders.
Correct Answer: B
Rationale: Quality Improvement is a systematic approach that aims to continually enhance the quality of services or products within an organization. The statement that is true of Quality Improvement is that it focuses on continually improving every process in the organization (Option B). This includes processes related to patient care, organizational structure, and all aspects of operations. Quality Improvement involves identifying areas for improvement, implementing changes, monitoring the effectiveness of those changes, and then making further refinements. By focusing on every process within the organization, Quality Improvement helps drive positive outcomes and ensures sustainable improvements in quality and performance.