Nokea
A woman in active labor is experiencing precipitous labor with rapid cervical dilation and descent of the fetal presenting part. What maternal complication should the nurse anticipate?
- A. Postpartum hemorrhage
- B. Uterine atony
- C. Shoulder dystocia
- D. Placental abruption
Correct Answer: A
Rationale: Precipitous labor is characterized by rapid cervical dilation and descent of the fetal presenting part, leading to a shortened labor duration of less than 3 hours. This rapid progression can increase the risk of maternal complications, such as postpartum hemorrhage. Postpartum hemorrhage is defined as excessive bleeding of more than 500 ml after vaginal delivery or more than 1000 ml after cesarean delivery. The rapid delivery in precipitous labor can result in inadequate uterine contractions after delivery, leading to poor uterine tone and potential postpartum hemorrhage due to uterine atony. Therefore, the nurse should anticipate postpartum hemorrhage as a potential maternal complication in a woman experiencing precipitous labor.
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A patient expresses distrust in the healthcare system due to previous negative experiences. What is the nurse's best approach to rebuild trust?
- A. Dismiss the patient's concerns and assure them that the healthcare team is trustworthy.
- B. Listen actively to the patient's concerns, acknowledge their past experiences, and work to rebuild trust through transparency and reliability.
- C. Ignore the patient's distrust and proceed with providing care.
- D. Tell the patient that their distrust is unfounded and they should trust the healthcare system.
Correct Answer: B
Rationale: The correct answer is B because actively listening, acknowledging the patient's concerns, and working towards rebuilding trust through transparency and reliability are essential steps in addressing distrust. By validating the patient's experiences and actively involving them in the process, the nurse can foster a supportive and trusting relationship.
Choice A is incorrect because dismissing the patient's concerns can further damage trust and undermine the patient's feelings. Choice C is incorrect as ignoring the distrust can lead to a breakdown in communication and trust. Choice D is incorrect because telling the patient to trust the healthcare system without addressing their concerns is dismissive and unhelpful.
When the lecture presentation was finished, the CI proceeded with the _______.
- A. evaluation of the activity
- B. Q and A portion on anything the students are interested tackle
- C. open forum to solicit questions related to the topic under discussion .
- D. cracking of humorous anecdotes to keep the class alive
Correct Answer: C
Rationale: The correct answer is C because an open forum to solicit questions related to the topic under discussion is a common practice after a lecture presentation. This allows for clarification and deeper understanding. Choice A is incorrect as evaluation usually comes after the lecture. Choice B is incorrect because the Q&A portion typically focuses on the lecture content only. Choice D is incorrect as cracking humorous anecdotes is not a standard practice after a lecture.
Nurse has a complaint from a parent for administering gwrong dose of vaccine to the child. This act is a form of _______.
- A. Battery
- B. Negligence
- C. Assault
- D. Malpractice
Correct Answer: B
Rationale: The correct answer is B: Negligence. Negligence refers to the failure to exercise the care that a reasonably prudent person would under similar circumstances. In this case, administering the wrong dose of a vaccine indicates a lack of proper care or attention to detail, which constitutes negligence.
A: Battery involves intentional harmful or offensive contact without consent, which is not applicable in this situation.
C: Assault involves the threat of harm or unwanted physical contact, which is also not relevant here.
D: Malpractice typically refers to professional misconduct or negligence by a healthcare provider, which could be a broader term but not specific to the situation described.
The nurse assesses the uterine fundus of the mother. Which part of the abdomen will the nurse begin?
- A. Symphysis pubis
- B. Midline
- C. Umbilicus
- D. Sides of the abdomen
Correct Answer: C
Rationale: The correct answer is C: Umbilicus. The nurse begins assessing the uterine fundus at the level of the umbilicus as it is a standard reference point for postpartum fundal height measurement. This location allows for consistency and accuracy in tracking the descent of the uterus back into the pelvic cavity. Starting at the umbilicus also helps in monitoring the involution process and prevents potential errors in fundal height assessment.
Symphysis pubis (A) is too low and not typically used as a reference point for uterine fundal assessment. Midline (B) is vague and does not provide a specific anatomical landmark. Sides of the abdomen (D) do not give a standardized starting point for measuring the uterine fundus, leading to potential variability in assessment.
A patient with a history of chronic liver disease presents with ecchymoses, mucosal bleeding, and altered mental status. Laboratory tests reveal prolonged PT and aPTT, low fibrinogen levels, and elevated D-dimer. Which of the following conditions is most likely to cause these findings?
- A. Liver cirrhosis
- B. Disseminated intravascular coagulation (DIC)
- C. Hemophilia A
- D. Vitamin K deficiency
Correct Answer: B
Rationale: The correct answer is B: Disseminated intravascular coagulation (DIC). In DIC, there is widespread activation of coagulation leading to consumption of clotting factors, resulting in prolonged PT and aPTT, low fibrinogen levels, and elevated D-dimer. This pattern matches the laboratory findings in the patient. In liver cirrhosis (choice A), there is a decrease in clotting factors synthesis, leading to prolonged PT but not aPTT. Hemophilia A (choice C) is a genetic disorder that affects specific clotting factors, typically leading to prolonged aPTT but not PT. Vitamin K deficiency (choice D) impairs the synthesis of clotting factors, leading to prolonged PT but not aPTT and low levels of factors II, VII, IX, and X.