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Amy, a multiparous patient, 28 hours after Ceasarian delivery (CS), who is breastfeeding, complains of severe abdominal cramps. Nurse Kayla explains that these are caused by which of the following?
- A. Flatulence accumulation after CS
- B. Release of Oxytocin during the breastfeeding session
- C. Healing of the abdominal incision after CS
- D. Side effects of the medications administered after delivery
Correct Answer: B
Rationale: The severe abdominal cramps experienced by the multiparous patient Amy, 28 hours after a Cesarean delivery (CS) and while breastfeeding, are likely caused by the release of Oxytocin during the breastfeeding session. Oxytocin is a hormone that is naturally produced during breastfeeding to stimulate the contraction of the uterus and help reduce postpartum bleeding. These contractions may result in cramping sensations in the abdomen, specifically at the site of the uterus. It is a normal physiological response and an indication that the body is working as it should to support the postpartum recovery process.
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A patient receiving palliative care for end-stage chronic obstructive pulmonary disease (COPD) expresses a desire to discuss advance care planning. What action should the palliative nurse take?
- A. Dismiss the patient's request and focus on symptom management.
- B. Initiate a conversation about advance directives and future care preferences.
- C. Encourage the patient to postpone discussions about advance care planning.
- D. Refer the patient to a social worker for assistance with advance care planning.
Correct Answer: B
Rationale: When a patient receiving palliative care for end-stage COPD expresses a desire to discuss advance care planning, the palliative nurse should initiate a conversation about advance directives and future care preferences. Advance care planning involves discussing and documenting a patient's preferences regarding future medical care, particularly in situations where the patient may no longer be able to make decisions. This discussion helps ensure that the patient's wishes are respected and followed in the event they are unable to communicate their preferences. By engaging in advance care planning discussions, the nurse can help the patient feel empowered, supported, and in control of their medical care decisions. It also allows healthcare providers to align care with the patient's values and goals, ultimately improving quality of life and ensuring dignity at the end of life.
A patient with a severe viral infection exhibits reduced levels of circulating lymphocytes. Which of the following mechanisms is most likely responsible for this observation?
- A. Apoptosis of infected lymphocytes
- B. Clonal expansion of memory T cells
- C. T cell anergy
- D. Upregulation of adhesion molecules on lymphocytes
Correct Answer: A
Rationale: A patient with a severe viral infection exhibiting reduced levels of circulating lymphocytes is likely due to the apoptosis of infected lymphocytes. When a virus enters the body, it can infect and replicate within lymphocytes, subsequently triggering the immune system to induce apoptosis in infected cells to prevent further spread of the virus. This process is part of the body's defense mechanism to control the viral infection. As a result, the circulating lymphocyte levels may decrease as infected lymphocytes are targeted for apoptosis. This phenomenon helps to limit viral replication and spread within the body, thereby aiding in the immune response to eliminate the virus.
As an epidemiology nurse, Nurse Rona's PRIMARY function and responsibility is to _____.
- A. Assist the epidemiologist in making reports
- B. Implement public health surveillance
- C. Render nursing care to sick residents
- D. Follow up cases and contacts Situation.
Correct Answer: B
Rationale: As an epidemiology nurse, Nurse Rona's primary function and responsibility is to implement public health surveillance. Epidemiology nurses play a crucial role in monitoring and controlling the spread of diseases within communities. This involves conducting surveillance activities to identify patterns of disease occurrence, investigating outbreaks, collecting and analyzing data, and collaborating with various stakeholders to develop strategies for disease prevention and control. While providing nursing care to sick residents is important, the primary focus of an epidemiology nurse is on population-based health issues rather than individual patient care. Additionally, while Nurse Rona may assist epidemiologists in making reports and follow up cases and contacts, her main role is to implement public health surveillance to protect and promote the health of the community as a whole.
A nurse conducts a regular audit of the medical records the PRIMARY purpose of conducting audit in a health facility is to _____.
- A. identify errors made by health personnel.
- B. identify areas for improvement
- C. ensure that standards are met.
- D. promote risk management.
Correct Answer: C
Rationale: The primary purpose of conducting an audit in a health facility is to ensure that standards are met. Audits are conducted to review and evaluate the documentation and practices within a healthcare facility to ensure compliance with established standards, protocols, procedures, and regulations. By conducting audits, the facility can identify any discrepancies, non-compliance with standards, or areas for improvement to maintain high-quality care and patient safety. This process helps in maintaining a high standard of care, reducing errors, promoting quality improvement initiatives, and ensuring the overall efficiency and effectiveness of healthcare services provided in the facility.
Which of the following signs is indicative of shock in a trauma patient?
- A. Increased heart rate
- B. Hypertension
- C. Rapid capillary refill
- D. Hyperthermia
Correct Answer: C
Rationale: Rapid capillary refill is a sign indicative of shock in a trauma patient. Shock is a life-threatening condition where the body's organs and tissues do not receive adequate blood flow and oxygen, leading to cellular damage and eventual organ failure. In a trauma patient, rapid capillary refill suggests poor perfusion, which is a common feature of shock. The capillary refill time is an important clinical assessment that measures the time it takes for color to return to the nail bed after pressure is applied. In cases of shock, the refill time is faster than normal, indicating a systemic circulatory disturbance. Other signs of shock may include tachycardia (increased heart rate), hypotension (not hypertension), and hypothermia (not hyperthermia).