Nokea
A woman in active labor is diagnosed with uterine rupture. What is the priority nursing action?
- A. Preparing for immediate cesarean section
- B. Administering intravenous oxytocin to augment contractions
- C. Assisting the mother into a hands-and-knees position
- D. Initiating cardiopulmonary resuscitation (CPR)
Correct Answer: A
Rationale: The priority nursing action for a woman diagnosed with uterine rupture during labor is to prepare for immediate cesarean section. Uterine rupture is a serious obstetric emergency that can lead to severe maternal and fetal complications, including hemorrhage, fetal distress, and injury to both mother and baby. A cesarean section is necessary to deliver the baby promptly and address any potential complications, such as controlling bleeding and ensuring the safety of both the mother and the baby. Time is critical in these situations, and prompt surgical intervention is essential to optimize outcomes. Administering intravenous oxytocin or assisting the mother into a hands-and-knees position would not address the immediate risks associated with uterine rupture. Initiating cardiopulmonary resuscitation (CPR) is only necessary if the mother's condition deteriorates to the point of cardiac or respiratory arrest, which may occur as a result of significant hemorrhage or other complications associated with uterine
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A patient presents with chest pain that worsens with exertion and improves with rest. An electrocardiogram (ECG) shows ST-segment depression. Which cardiovascular disorder is most likely responsible for these symptoms?
- A. Stable angina
- B. Unstable angina
- C. Acute myocardial infarction
- D. Prinzmetal's angina
Correct Answer: A
Rationale: The patient is presenting with chest pain that worsens with exertion and improves with rest, which is characteristic of stable angina. Additionally, ST-segment depression on ECG is a common finding in patients with stable angina. Stable angina is typically caused by coronary artery disease, which leads to partial obstruction of the coronary arteries resulting in inadequate blood flow to the heart muscle during periods of increased demand (such as exertion). The chest pain is usually predictable and reproducible, occurring with similar intensity and duration during episodes of exertion. Rest or nitroglycerin can help relieve the symptoms by increasing coronary blood flow. It is important to differentiate stable angina from unstable angina and acute myocardial infarction, which have different management and prognostic implications.
A 24-year-old woman presents with cyclic pelvic pain, dysmenorrhea, and dyspareunia. On pelvic examination, tender nodules are palpated along the uterosacral ligaments. Which of the following conditions is most likely to be responsible for these findings?
- A. Pelvic inflammatory disease (PID)
- B. Endometriosis
- C. Ovarian cyst rupture
- D. Uterine fibroids
Correct Answer: B
Rationale: The symptoms of cyclic pelvic pain, dysmenorrhea (painful menstruation), dyspareunia (painful intercourse), and tender nodules along the uterosacral ligaments are classic findings associated with endometriosis. In endometriosis, tissue similar to the lining of the uterus (endometrium) grows outside the uterus, commonly on the ovaries, fallopian tubes, and pelvic peritoneum. The presence of tender nodules along the uterosacral ligaments is known as "nodularity" and is a characteristic feature of advanced endometriosis. It occurs due to the formation of endometrial implants that respond to hormonal changes during the menstrual cycle, resulting in inflammation, scarring, and pain in affected areas.
Nurse Carmi plans to gather 6 participants who are victims of domestic violence where she will base her questionnaires. What technique in qualitative research is applicable to this plan?
- A. Data triangulation
- B. Interview
- C. Focus group discussion
- D. Case study
Correct Answer: C
Rationale: In qualitative research, a focus group discussion is a technique where a group of participants are brought together to discuss specific topics in depth. In this case, Nurse Carmi's plan to gather 6 participants who are victims of domestic violence aligns well with the focus group discussion technique. By involving multiple participants who have experienced domestic violence, she can facilitate a dynamic conversation to gather rich data and insights. This approach allows for the exploration of diverse perspectives, experiences, and opinions within the group setting, providing a deeper understanding of the issue at hand. Additionally, focus group discussions can be more cost-effective and efficient than conducting individual interviews when working with a small group of participants. Therefore, conducting a focus group discussion would be an appropriate qualitative research technique for Nurse Carmi's plan to gather data from victims of domestic violence for her questionnaires.
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.
A patient with a history of sickle cell disease presents with severe abdominal pain, fever, and jaundice. Laboratory tests reveal anemia, reticulocytosis, elevated indirect bilirubin, and presence of Howell-Jolly bodies on peripheral blood smear. Which of the following conditions is most likely to cause these findings?
- A. Acute splenic sequestration crisis
- B. Aplastic crisis
- C. Hemolytic crisis
- D. Vaso-occlusive crisis
Correct Answer: A
Rationale: Acute splenic sequestration crisis is a complication seen in patients with sickle cell disease characterized by the sudden pooling of sickled red blood cells in the spleen, leading to splenic enlargement, severe anemia, and hypovolemic shock. This pooling results in a rapid drop in hemoglobin levels, causing anemia. The spleen's sequestration of large numbers of red blood cells can cause a sudden rise in the number of immature red blood cells (reticulocytes) in the blood (reticulocytosis). The destruction of these trapped red blood cells in the spleen leads to hemolysis, evidenced by elevated indirect bilirubin levels and the presence of Howell-Jolly bodies (nuclear remnants of erythrocytes) on peripheral blood smear. Patients may present with severe abdominal pain, fever, jaundice, and signs of hemodynamic instability, which