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A 45-year-old woman presents with heavy menstrual bleeding and iron deficiency anemia. On pelvic examination, the uterus is enlarged, and multiple irregularly shaped masses are palpated. Which condition is most likely to be responsible for these findings?
- A. Leiomyomas (uterine fibroids)
- B. Endometrial hyperplasia
- C. Endometrial polyps
- D. Adenomyosis
Correct Answer: A
Rationale: The clinical presentation of heavy menstrual bleeding, iron deficiency anemia, an enlarged uterus, and irregularly shaped masses palpated on pelvic examination is most indicative of leiomyomas, also known as uterine fibroids. Leiomyomas are benign smooth muscle tumors that commonly occur in women of reproductive age. They can lead to heavy menstrual bleeding and iron deficiency anemia due to their size and location within the uterus. On pelvic examination, leiomyomas can be felt as irregularly shaped masses within the uterine wall. This presentation is classic for leiomyomas and distinguishes them from conditions such as endometrial polyps, endometrial hyperplasia, and adenomyosis.
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A nurse is teaching a group of nursing students about the importance of professional boundaries in nursing practice. What statement by a student indicates understanding of this concept?
- A. "It's okay to share personal information with patients to build rapport."
- B. "Maintaining professional boundaries helps protect both patients and nurses."
- C. "Establishing friendships with patients enhances trust and communication."
- D. "Being emotionally involved with patients improves patient outcomes."
Correct Answer: B
Rationale: Option B, "Maintaining professional boundaries helps protect both patients and nurses," indicates an understanding of the importance of professional boundaries in nursing practice. Professional boundaries define the limits of the nurse-patient relationship and help ensure that interactions are safe, therapeutic, and based on the patient's best interest. By maintaining these boundaries, nurses can uphold ethical standards, prevent harm, and maintain trust with patients. It also helps prevent issues such as transference, countertransference, and breaches of confidentiality. Overall, understanding and respecting professional boundaries are essential for promoting the well-being of both patients and healthcare providers.
A patient presents with pallor, fatigue, and dyspnea on exertion. Laboratory tests reveal a low hemoglobin level, low MCV, and elevated red blood cell distribution width (RDW). Which of the following conditions is most likely to cause these findings?
- A. Iron deficiency anemia
- B. Thalassemia
- C. Anemia of chronic disease
- D. Megaloblastic anemia
Correct Answer: A
Rationale: #NAME?
Nurse May is alarm by the incidence of number of young adults in the community with mental problems. Which of the following should be her PRIORITY nursing initiative?
- A. Refer all tertiary hospital
- B. Request for psychiatrict drugs.
- C. Set up debriefing center
- D. Set up mental health program
Correct Answer: D
Rationale: The priority nursing initiative for Nurse May should be to set up a mental health program in the community. This proactive approach focuses on prevention, early intervention, and support for individuals experiencing mental health issues. By setting up a mental health program, Nurse May can address the root causes of mental problems in young adults in the community, provide education and awareness, offer counseling services, and promote mental well-being. This initiative can have a long-term impact on the mental health of individuals and help reduce the incidence of mental problems in the community. Setting up a mental health program is a holistic and sustainable approach to addressing mental health issues in the community.
A patient with a history of chronic obstructive pulmonary disease (COPD) is experiencing respiratory distress. Which nursing intervention is the priority for managing the patient's respiratory status?
- A. Administering bronchodilators
- B. Positioning the patient in high Fowler's position
- C. Performing chest physiotherapy
- D. Administering oxygen therapy
Correct Answer: D
Rationale: Administering oxygen therapy is the priority nursing intervention for managing a patient with COPD experiencing respiratory distress. In COPD, the patient's lungs are less efficient at oxygen exchange, leading to hypoxemia. Oxygen therapy helps improve oxygenation in the body and alleviates respiratory distress in these patients. Positioning the patient in high Fowler's position can also help improve lung expansion, but providing supplemental oxygen takes precedence in addressing the underlying hypoxemia. Administering bronchodilators and performing chest physiotherapy aim to manage airway obstruction and promote airway clearance, but ensuring the patient has adequate oxygenation is crucial in the immediate management of respiratory distress in COPD.
Ms. C is at risk for refeeding syndrome that is caused by rapid feeding. What should be the priority action of the health care team to prevent complications associated with this syndrome?
- A. Assess for signs of pallor of the extremities and sluggish capillary refill
- B. Monitor for decreased bowel sounds, nausea, bloating, and abdominal distention
- C. Observe for signs of secret purging and ingestion of water to increase weight
- D. Monitor for peripheral edema, crackles in the lungs, and jugular vein distention
Correct Answer: B
Rationale: Refeeding syndrome is a potentially dangerous condition that can occur in malnourished individuals when nutrition is reintroduced too quickly. It is characterized by shifts in electrolytes, fluid imbalance, and metabolic abnormalities. Monitoring for decreased bowel sounds, nausea, bloating, and abdominal distention is the priority action to prevent complications associated with refeeding syndrome. These symptoms can indicate gastrointestinal issues such as ileus or overfeeding, which can lead to further complications. Early recognition and intervention can help prevent serious consequences of refeeding syndrome.