and tumor necrosis factor-alpha (TNF-α) during the acute phase response?
- A. Macrophages
- B. T lymphocytes
- C. B lymphocytes
- D. Natural killer (NK) cells
Correct Answer: A
Rationale: Macrophages are the primary cells responsible for producing tumor necrosis factor-alpha (TNF-α) during the acute phase response. TNF-α is a pro-inflammatory cytokine that plays a critical role in initiating and propagating the inflammatory response. Macrophages secrete TNF-α in response to infection, injury, or other inflammatory stimuli, contributing to the recruitment of immune cells and the activation of additional inflammatory pathways. In the context of the acute phase response, macrophages are key mediators of the immune response and play a crucial role in host defense mechanisms.
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A woman in active labor is experiencing a shoulder dystocia during delivery. What nursing intervention should be prioritized?
- A. Apply suprapubic pressure to dislodge the shoulder.
- B. Perform an episiotomy to facilitate delivery.
- C. Insert an oropharyngeal airway to maintain airway patency.
- D. Administer intravenous magnesium sulfate for uterine relaxation.
Correct Answer: A
Rationale: Shoulder dystocia is an obstetric emergency where one of the baby's shoulders becomes impacted behind the mother's pubic bone after the head delivers. This can lead to compression of the umbilical cord and compromise fetal oxygenation. The most critical nursing intervention in managing shoulder dystocia is applying suprapubic pressure to dislodge the impacted shoulder and allow for delivery of the baby. By gently pushing downwards on the mother's abdomen just above the pubic bone, the shoulder can be released, and the baby can be delivered successfully. This intervention should be prioritized to prevent potential complications for both the mother and the baby. Episiotomy may be considered if necessary, but it is secondary to addressing the shoulder dystocia. Oropharyngeal airway insertion and administering magnesium sulfate are not indicated in the immediate management of shoulder dystocia.
Nurse Nanie is aware that history taking and physical exam are critical to the diagnostic process and often provide more information than can be gained broad testing strategies. History taking includes the by following, EXCEPT _______
- A. History of present illness
- B. Religious Affiliation
- C. Social & Family history
- D. Past medical history
Correct Answer: B
Rationale: Religious Affiliation is not typically included in the history taking process for diagnosing medical conditions. While a patient's religious beliefs may sometimes be relevant in certain situations, it is not a standard component of medical history. History taking usually includes aspects such as the history of present illness, social and family history, and past medical history as these can provide important information related to the patient's health condition.
A rape victim tells the emergency nurse, I feel so dirty. Help me take a shower before I get examined. The nurse should:
- A. arrange for the victim to shower.
- B. give the victim a basin of water and towels.
- C. offer the victim a shower after evidence is collected .
- D. explain that bathing facilities are not available in the emergency department.
Correct Answer: C
Rationale: The correct response for the nurse in this situation would be to offer the victim a shower after evidence is collected. It is essential to preserve any physical evidence that may be present from the assault during the forensic examination. Allowing the victim to shower before evidence is collected could potentially compromise the evidence and hinder the investigation. The nurse should provide support to the victim during this difficult time and assure them that they will have the opportunity to shower once the necessary evidence is obtained. It is also crucial for the nurse to offer empathy and understanding while explaining the importance of preserving any evidence related to the assault.
A postpartum client presents with persistent, severe perineal pain despite analgesic medication. On assessment, the nurse observes ecchymosis and swelling of the perineum. Which nursing action is most appropriate?
- A. Applying ice packs to the perineum for pain relief
- B. Encouraging the client to sit on a donut cushion
- C. Notifying the healthcare provider immediately
- D. Administering additional analgesic medication
Correct Answer: C
Rationale: The presence of persistent, severe perineal pain along with ecchymosis and swelling of the perineum can indicate a complication such as a hematoma. A hematoma is a collection of blood that can occur in the perineal area postpartum, usually as a result of trauma during delivery. It is essential to notify the healthcare provider immediately to assess the situation, provide appropriate treatment, and prevent further complications. Applying ice packs or administering additional analgesic medication may not address the underlying issue of a possible hematoma, so prompt medical evaluation is crucial in this situation.
A patient with hypertension is prescribed an angiotensin-converting enzyme (ACE) inhibitor. Which adverse effect is most commonly associated with ACE inhibitors?
- A. Hyperkalemia
- B. Hypokalemia
- C. Dry cough
- D. Bradycardia
Correct Answer: C
Rationale: The most commonly associated adverse effect with ACE inhibitors is a dry cough. This cough is non-productive and can be quite bothersome for patients, often leading to non-compliance with the medication. The cough is thought to be due to the accumulation of bradykinin and substance P, which are vasodilatory and bronchoconstrictive peptides that are normally degraded by ACE. When ACE is inhibited, these peptides accumulate and can lead to irritation of the respiratory tract, resulting in the dry cough. It's important for healthcare providers to be aware of this common side effect and consider alternative medications if the cough becomes problematic for the patient.