Nokea
Nurse Pat promised to a post- surgical patient, that she would come back to assist in his ambulation after carrying out the physician's order. This follows the principle of
- A. beneficence
- B. justice
- C. autonomy
- D. fidelity
Correct Answer: D
Rationale: Fidelity is a principle of ethics that relates to being faithful or loyal to one's commitments and responsibilities. When Nurse Pat promises to assist the post-surgical patient with ambulation after carrying out the physician's order, she is demonstrating fidelity by honoring her commitment to the patient. This principle highlights the importance of keeping promises, being reliable, and maintaining trust in the nurse-patient relationship.
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Select nurses action in keeping with principle of confidentiality
- A. Hides identity of patient
- B. Shares information from patients chart in public
- C. Keeps all matters about the patient as a secret
- D. Discuss the case of the patient with others.
Correct Answer: C
Rationale: Maintaining patient confidentiality is a foundational principle in healthcare ethics. Nurses are obligated to keep all information about patients confidential, which means not disclosing any patient-related information to unauthorized individuals. This includes refraining from discussing patient cases with others who are not directly involved in the care of the patient. Sharing patient information without consent can be a breach of trust and privacy, which can have legal and ethical implications. Therefore, in order to uphold the principle of confidentiality, nurses must keep all matters about the patient as a secret.
Which of the following cell types is primarily responsible for the production of antibodies during the humoral immune response?
- A. Plasma cells
- B. T helper cells (Th cells)
- C. Memory B cells
- D. Macrophages
Correct Answer: A
Rationale: Plasma cells are the primary type of cells responsible for the production of antibodies during the humoral immune response. When activated by antigens, B cells differentiate into plasma cells, which are specialized in producing large quantities of antibodies. These antibodies are essential in fighting off infections by binding to antigens and marking them for destruction by other immune cells. T helper cells assist in activating B cells, but the actual production of antibodies is mainly carried out by plasma cells. Memory B cells are involved in mounting a rapid and specific secondary response upon re-exposure to the same antigen. Macrophages play a role in phagocytosis and antigen presentation, but they are not the primary cells responsible for producing antibodies during the humoral immune response.
A postpartum client who experienced a vaginal delivery expresses concerns about resuming sexual activity. What information should the nurse provide to address the client's concerns?
- A. Discuss the potential use of barrier contraceptives for contraception.
- B. Educate the client about the normal changes in sexual desire and response.
- C. Recommend delaying sexual activity until the postpartum check-up.
- D. Encourage the client to use lubricants to alleviate discomfort.
Correct Answer: B
Rationale: Option B is the most appropriate response when addressing a postpartum client's concerns about resuming sexual activity after a vaginal delivery. Educating the client about the normal changes in sexual desire and response following childbirth can help alleviate anxiety and provide reassurance. It is crucial for the nurse to explain that it is common for women to experience changes in libido, physical discomfort, and emotional adjustments after giving birth. By discussing these normal postpartum changes, the nurse can support the client in understanding that her feelings are valid and that it may take time for her to feel ready to engage in sexual activity again. Furthermore, the nurse can provide information on ways to enhance comfort and intimacy when resuming sexual activity, such as communication with partners, using lubricants, and gradually easing back into sexual activity as desired.
A patient with a history of type 2 diabetes mellitus is prescribed metformin therapy. Which adverse effect is associated with metformin use and requires immediate medical attention?
- A. Hypoglycemia
- B. Lactic acidosis
- C. Hyperkalemia
- D. Peripheral neuropathy
Correct Answer: B
Rationale: Metformin is a commonly prescribed medication for the treatment of type 2 diabetes mellitus. One of the rare but serious adverse effects associated with metformin use is lactic acidosis. Lactic acidosis results from the buildup of lactic acid in the bloodstream, leading to symptoms such as weakness, rapid breathing, abdominal pain, and muscle pain. Lactic acidosis can be life-threatening and requires immediate medical attention. It is important for patients taking metformin to be aware of the signs and symptoms of lactic acidosis and seek immediate medical help if they experience any of these symptoms. Regular monitoring of kidney function is crucial in patients taking metformin to reduce the risk of lactic acidosis.
A patient presents with abdominal pain, fever, and peripheral blood smear showing fragmented red blood cells (schistocytes). Laboratory tests reveal elevated lactate dehydrogenase (LDH), decreased haptoglobin, and increased indirect bilirubin. Which of the following conditions is most likely to cause these findings?
- A. Hemolytic uremic syndrome (HUS)
- B. Thrombotic thrombocytopenic purpura (TTP)
- C. Disseminated intravascular coagulation (DIC)
- D. Immune thrombocytopenic purpura (ITP)
Correct Answer: B
Rationale: Thrombotic thrombocytopenic purpura (TTP) is a rare blood disorder characterized by microangiopathic hemolytic anemia, thrombocytopenia, fever, neurological abnormalities, and renal dysfunction. The peripheral blood smear in TTP typically shows fragmented red blood cells (schistocytes) due to mechanical destruction within small blood vessels. Laboratory findings in TTP commonly include elevated lactate dehydrogenase (LDH), decreased haptoglobin (as it is consumed in the clearance of free hemoglobin), and increased indirect bilirubin due to increased red blood cell breakdown. This combination of clinical presentation and laboratory abnormalities is classic for TTP. Hemolytic uremic syndrome (HUS) may present similarly but is more commonly associated with renal dysfunction and is often triggered by infection with Shiga toxin-producing E. coli.