Nokea
Patient Ximena sought referral to an abort ion clinic from the nurse. She reasons out that her pregnancy a burden to her work and daily routines. What should be the BEST RESPONSE of the nurse?
- A. It will cause discrimination from friends and relatives.
- B. Inform her that abortion is morally and legally wrong by virtue of the law .
- C. It will cause infection.
- D. It is against any religion.
Correct Answer: A
Rationale: The correct response is A because it addresses the patient's concerns about potential discrimination. This shows empathy and understanding towards the patient's emotional well-being. Choices B, C, and D are incorrect because they do not directly address the patient's reasons for seeking an abortion. Choice B imposes moral and legal judgments, which can be insensitive. Choice C is not relevant to the patient's stated reason. Choice D imposes religious beliefs, which may not align with the patient's own beliefs.
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Nurse Pedrito is teaching a client with Parkinson's disease on ways to prevent curvatures of the spine associated with the disease. To prevent spinal flexion, the nurse should tell the client to _________.
- A. Rest in supine position with his head elevated.
- B. Sleep only in dorsal recumbent position.
- C. Periodically lie in prone position without a neck pillow.
- D. Sleep on either side, but keep his back straight.
Correct Answer: C
Rationale: The correct answer is C: Periodically lie in prone position without a neck pillow. This position helps to prevent spinal flexion by promoting extension of the spine and stretching of the hip flexors. Prone positioning also helps maintain alignment of the spine and prevents contractures. Resting in supine position (choice A) with the head elevated does not promote spinal extension. Sleeping only in dorsal recumbent position (choice B) may lead to spinal flexion. Sleeping on either side (choice D) does not specifically address spinal flexion prevention.
A patient presents with fever, chills, headache, and myalgia after returning from a trip to sub-Saharan Africa. Laboratory tests reveal intraerythrocytic ring forms and trophozoites on blood smear examination. Which of the following is the most likely causative agent?
- A. Plasmodium falciparum
- B. Trypanosoma cruzi
- C. Borrelia burgdorferi
- D. Leishmania donovani
Correct Answer: A
Rationale: The correct answer is A: Plasmodium falciparum. Plasmodium falciparum is the most likely causative agent because the patient's symptoms of fever, chills, headache, and myalgia, along with the presence of intraerythrocytic ring forms and trophozoites on blood smear, are characteristic of malaria, particularly caused by P. falciparum in sub-Saharan Africa.
Summary of other choices:
B: Trypanosoma cruzi causes Chagas disease, which presents with symptoms like fever, rash, and swelling at the site of entry, not consistent with the patient's presentation.
C: Borrelia burgdorferi causes Lyme disease, which typically presents with a characteristic rash (erythema migrans) and arthritis, not matching the patient's symptoms.
D: Leishmania donovani causes visceral leishmaniasis, which presents with symptoms like weight loss, hepatosplen
A woman in active labor demonstrates signs of prolonged second stage, characterized by ineffective pushing efforts and slow fetal descent. What maternal condition should the nurse assess for that may contribute to this abnormal labor pattern?
- A. Maternal fatigue
- B. Pelvic floor dysfunction
- C. Fetal macrosomia
- D. Maternal hypotension
Correct Answer: B
Rationale: When a woman in active labor exhibits signs of prolonged second stage, such as ineffective pushing efforts and slow fetal descent, one of the maternal conditions that should be considered is pelvic floor dysfunction. The pelvic floor muscles play a crucial role in supporting the uterus, bladder, and rectum. If these muscles are weak or dysfunctional, it can lead to difficulty in pushing effectively and impede the descent of the fetus through the birth canal. This can result in prolonged labor and increase the risk of complications for both the mother and the baby. Therefore, assessing for pelvic floor dysfunction is important in addressing the abnormal labor pattern and providing appropriate interventions to support the progress of labor.
During the active phase of labor, a woman's cervical dilation is progressing slowly despite regular contractions. What maternal condition should the nurse assess for that may contribute to abnormal labor progression?
- A. Maternal exhaustion
- B. Pelvic outlet obstruction
- C. Fetal macrosomia
- D. Uterine hyperstimulation
Correct Answer: B
Rationale: One potential maternal condition that may contribute to abnormal labor progression with slow cervical dilation despite regular contractions is pelvic outlet obstruction. This can occur if the maternal pelvis is too small, misshapen, or has an obstruction such as a fibroid tumor. The inadequate space in the pelvis can prevent the fetus from descending properly and can result in a prolonged or difficult labor. If suspected, interventions such as a cesarean delivery may be necessary to prevent complications for both the mother and baby. It is essential for the nurse to assess for signs of pelvic outlet obstruction and work with the healthcare team to address any issues promptly to ensure a safe delivery.
Lillian complains of unbearable pain. Which of the following characteristics axe EMPHASIZED in a culturally sensitive nursing Care? (Select all that apply) I The expression of pain is affected by learned behavior II. Physiologically, all individuals experience pain in a similar manner, III.. Some Asian people has high response to pain medications IV. Patients should be assessed for pain regardless of overt symptomatology.
- A. III and IV
- B. I and II I
- C. I and II
- D. II and III
Correct Answer: C
Rationale: Step-by-step rationale for the correct answer (C: I and II):
1. Choice I (The expression of pain is affected by learned behavior) is correct because cultural beliefs and upbringing influence how individuals express and perceive pain.
2. Choice II (Physiologically, all individuals experience pain in a similar manner) is correct because pain perception is largely influenced by biological factors that are universal.
3. Choice III (Some Asian people have a high response to pain medications) is incorrect as it focuses on a specific cultural group, which is not a general characteristic emphasized in culturally sensitive care.
4. Choice IV (Patients should be assessed for pain regardless of overt symptomatology) is incorrect as it is not specifically related to cultural sensitivity in pain management.