Nokea
In caring for this patient suffering from anorexia nervous, which task can be delegated to the nursing assistant?
- A. Obtaining special food for the patient when she request it
- B. Sitting with the patient during meals and for about an hour after/meals
- C. Weighing the patient daily and reinforcing that she is underweight
- D. Observing for reporting ritualistic behaviors related to food
Correct Answer: A
Rationale: Task A, obtaining special food for the patient when she requests it, can be delegated to the nursing assistant. This task involves simple assistance with gathering food items and does not require specific medical knowledge or interventions. Tasks B, C, and D involve more direct patient care and assessment, which should be performed by the nursing staff who have the necessary training and expertise to address the complexities of anorexia nervosa.
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A woman in active labor is experiencing persistent occiput posterior position despite position changes. What nursing intervention is most appropriate to facilitate fetal rotation?
- A. Encourage the mother to remain in a side-lying position.
- B. Assist the mother into a hands-and-knees position.
- C. Administer intravenous oxytocin to augment contractions.
- D. Perform manual rotation of the fetus during vaginal examination.
Correct Answer: B
Rationale: The most appropriate nursing intervention to facilitate fetal rotation in a woman experiencing persistent occiput posterior position is to assist the mother into a hands-and-knees position. This position can help encourage the baby to rotate into the optimal occiput anterior position for delivery. By being on her hands and knees, gravity can assist in aiding the rotation of the baby. This position can also help relieve pressure on the mother's back and potentially reduce discomfort during labor. Additionally, hands-and-knees position can help open up the pelvis and create more space for the baby to turn. It is a non-invasive and generally well-tolerated intervention to promote fetal rotation in labor.
A patient presents with a yellowish-white spot on the cornea, surrounded by a ring of inflammation. Slit-lamp examination reveals branching, filamentous opacities extending from the corneal lesion. Which of the following conditions is most likely responsible for this presentation?
- A. Herpes simplex keratitis
- B. Bacterial keratitis
- C. Fungal keratitis
- D. Acanthamoeba keratitis Dental, Alimentary, and Biliary
Correct Answer: C
Rationale: The presentation described is consistent with fungal keratitis. Fungal keratitis typically presents with a yellowish-white spot on the cornea, surrounded by a ring of inflammation. The filamentous opacities seen on slit-lamp examination are characteristic of fungal hyphae extending from the corneal lesion. This condition is often associated with risk factors such as trauma with vegetable matter, contact lens wear, or topical corticosteroid use. Prompt diagnosis and treatment with antifungal medications are essential to prevent complications and preserve vision.
A patient presents with redness, pain, and photophobia in the left eye. Slit-lamp examination reveals ciliary injection, corneal edema, and a mid-dilated pupil with fixed reaction to light. Which of the following conditions is most likely responsible for this presentation?
- A. Anterior uveitis
- B. Acute angle-closure glaucoma
- C. Endophthalmitis
- D. Corneal abrasion
Correct Answer: A
Rationale: The presentation described in the question is characteristic of anterior uveitis. Anterior uveitis is inflammation of the iris and ciliary body in the eye. Patients typically present with symptoms such as redness, pain, and photophobia. Slit-lamp examination findings include ciliary injection (redness and engorgement of blood vessels in the ciliary body), corneal edema (swelling of the cornea), and a mid-dilated pupil with a fixed reaction to light due to involvement of the iris muscles. These features differentiate anterior uveitis from other conditions. Treatment of anterior uveitis may involve topical steroids and cycloplegics to reduce inflammation and alleviate symptoms.
A patient with a history of chronic kidney disease presents with pruritus, pale skin, and easy bruising. Laboratory findings reveal anemia, thrombocytopenia, and elevated blood urea nitrogen (BUN) and creatinine levels. Which of the following conditions is most likely?
- A. Uremic encephalopathy
- B. Uremic pericarditis
- C. Uremic bleeding diathesis
- D. Uremic neuropathy
Correct Answer: C
Rationale: The given patient with chronic kidney disease (CKD) is likely experiencing uremic bleeding diathesis. Uremic bleeding diathesis is a complication of CKD characterized by abnormal platelet function, leading to a tendency for bleeding. The presence of anemia, thrombocytopenia (low platelet count), pale skin, easy bruising, and elevated blood urea nitrogen (BUN) and creatinine levels are all consistent with uremic bleeding diathesis.
A client with end-stage renal disease decides against further treatment and requests a "Do Not Resuscitate" (DNR) order. The DNR status is part of the change-of-shift report. The client stops breathing and a nurse begins cardiopulmonary resuscitation. The family is upset and makes a complaint to the charge nurse. The charge nurse appropriately identifies that nurse has committed:
- A. Defamation
- B. assault
- C. battery .
- D. fraud.
Correct Answer: C
Rationale: Battery occurs when there is an intentional touching of another person without their consent. In this case, the nurse began cardiopulintary resuscitation on a client who had requested a "Do Not Resuscitate" (DNR) order, which means the client did not consent to the resuscitation. This action can be considered as battery because the client's wishes were not respected, and the nurse proceeded with a medical intervention against those wishes, leading to harm and potential legal consequences. This is different from assault, which involves a threat of force, and from defamation and fraud, which are not applicable to this situation.