Nokea
As a strong believer of her faith and the need for spiritual guidance, patient Ximena requests that she wants that clergy will visit her. How did nurse Parker function when she initiated the visit?
- A. Dependently
- B. Interdependently
- C. Collegially
- D. Independently
Correct Answer: D
Rationale: Nurse Parker functioned independently when she initiated the visit by arranging for the clergy to see patient Ximena. In this scenario, the nurse took the initiative on her own without needing approval or direction from others. She recognized the patient's request for spiritual guidance and took independent action to meet that need. Independently functioning in this context demonstrates the nurse's autonomy and ability to make decisions based on the patient's preferences and well-being.
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Which of the following laboratory findings is characteristic of nephrotic syndrome?
- A. Hematuria
- B. Hypoalbuminemia
- C. Hyperkalemia
- D. Hypocalcemia
Correct Answer: B
Rationale: Nephrotic syndrome is a kidney disorder characterized by increased glomerular permeability, leading to protein loss in the urine. One of the hallmarks of nephrotic syndrome is hypoalbuminemia, which refers to low levels of albumin in the blood due to its excessive loss in the urine. This loss of albumin results in decreased oncotic pressure, leading to edema and ascites. Hematuria (choice A) is not typically found in nephrotic syndrome but may be present in other kidney conditions. Hyperkalemia (choice C) is not specific to nephrotic syndrome and may be more common in conditions affecting potassium regulation. Hypocalcemia (choice D) is also not a characteristic feature of nephrotic syndrome.
Which of the following conditions does the nurse explain to the patient the contributory factor that slows uterine involution?
- A. Full bladder during labor
- B. Difficult birth
- C. Prolonged labor
- D. Infection during pregnancy
Correct Answer: C
Rationale: Prolonged labor is a condition in which labor lasts for an extended period, typically more than 20 hours for first-time mothers and more than 14 hours for experienced mothers. Prolonged labor can contribute to slowing down uterine involution because the prolonged pressure and strain on the uterus can affect its ability to return to its pre-pregnancy size and position. The prolonged contractions and stretching of the uterine muscles can hinder the normal process of uterine involution, leading to a delay in the uterus shrinking back to its non-pregnant state. Additionally, prolonged labor can increase the risk of postpartum complications such as excessive bleeding and infection, which can further impact uterine involution. Therefore, it is crucial for healthcare providers to monitor labor progress closely to prevent prolonged labor and its potential effects on uterine involution.
Which of the following is a qualitative research design where lived experiences of individuals are examined in their "life-world"?
- A. Ethnography
- B. Phenomenology
- C. Ethology
- D. Grounded theory
Correct Answer: B
Rationale: Phenomenology is a qualitative research design that focuses on exploring and understanding the lived experiences of individuals within their "life-worlds." It seeks to uncover the essence of a phenomenon as it is experienced subjectively by individuals, aiming to understand the underlying meanings and perspectives through in-depth interviews, observations, and reflections. In phenomenology, researchers aim to set aside their own biases and preconceptions to capture the essence of the participants' experiences as they see them. This approach allows researchers to gain insight into how individuals make sense of and interpret their world, providing rich and detailed accounts of unique human experiences.
Which of the following actions is appropriate for managing a conscious patient with a suspected stroke?
- A. Administering aspirin immediately.
- B. Placing the patient in a supine position.
- C. Encouraging the patient to eat and drink.
- D. Activating emergency medical services (EMS) for rapid transport to a stroke center.
Correct Answer: D
Rationale: Activating emergency medical services (EMS) for rapid transport to a stroke center is the most appropriate action for managing a conscious patient with a suspected stroke. Time is critical in stroke care, and receiving specialized treatment at a stroke center as soon as possible can significantly improve outcomes for stroke patients. EMS providers are trained to recognize the signs of stroke and can begin essential pre-hospital care measures while en route to the hospital. Administering aspirin immediately is not recommended without medical evaluation, as certain types of strokes (such as hemorrhagic strokes) can be worsened by aspirin. Placing the patient in a supine position may not be ideal, as maintaining an elevated position can help prevent aspiration in stroke patients. Encouraging the patient to eat and drink is not appropriate, as swallowing difficulties are common in stroke patients and can lead to aspiration pneumonia.
A patient with chronic obstructive pulmonary disease (COPD) presents with acute exacerbation and severe dyspnea. Arterial blood gas (ABG) analysis reveals pH 7.28, PaO2 55 mmHg, PaCO2 65 mmHg, and HCO3- 30 mEq/L. Which of the following acid-base disturbances is most likely present in this patient?
- A. Respiratory acidosis with metabolic compensation
- B. Respiratory alkalosis with metabolic compensation
- C. Metabolic acidosis with respiratory compensation
- D. Metabolic alkalosis with respiratory compensation
Correct Answer: A
Rationale: In this case, the patient is experiencing respiratory acidosis as indicated by the low pH (7.28), elevated PaCO2 (65 mmHg), and elevated HCO3- (30 mEq/L). The primary acid-base disturbance is respiratory acidosis due to the retention of carbon dioxide (PaCO2 >45 mmHg) leading to an increase in HCO3- as a compensatory mechanism to maintain pH within normal limits. The elevated HCO3- levels (metabolic compensation) are trying to counterbalance the increased PaCO2 levels (respiratory acidosis) by increasing bicarbonate to attempt to normalize the pH. Overall, the ABG analysis shows respiratory acidosis with metabolic compensation in this COPD patient with an acute exacerbation and severe dyspnea.