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A woman in active labor presents with a prolonged latent phase, characterized by irregular and ineffective contractions. What maternal condition should the nurse assess for that may contribute to this abnormal labor pattern?
- A. Maternal hypotension
- B. Maternal anxiety
- C. Fetal macrosomia
- D. Maternal fever
Correct Answer: B
Rationale: Maternal anxiety can contribute to a prolonged latent phase during labor. Stress and anxiety can trigger the release of stress hormones such as adrenaline, which can interfere with the production of oxytocin, the hormone responsible for initiating contractions. This can result in irregular and ineffective contractions, leading to a prolonged latent phase. It is important for the nurse to assess the woman's anxiety levels and provide reassurance and support to help facilitate the progression of labor.
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A patient presents with muscle weakness, fatigue, constipation, and hyperpigmentation of the skin. Laboratory tests reveal low serum cortisol levels and elevated adrenocorticotropic hormone (ACTH) levels. Which endocrine disorder is most likely responsible for these symptoms?
- A. Hyperthyroidism
- B. Hypothyroidism
- C. Diabetes mellitus
- D. Addison's disease
Correct Answer: D
Rationale: The symptoms described - muscle weakness, fatigue, constipation, hyperpigmentation of the skin, low serum cortisol levels, and elevated ACTH levels - are classic findings in Addison's disease. Addison's disease is a primary adrenal insufficiency characterized by the insufficient production of cortisol and, to some extent, aldosterone. The low cortisol levels result in symptoms such as muscle weakness, fatigue, and skin hyperpigmentation due to increased levels of ACTH stimulating melanin production. In contrast, in conditions like hyperthyroidism, hypothyroidism, and diabetes mellitus, the symptoms and laboratory findings would not fully align with those described in the patient in this scenario.
As a newly 1icensed nurse employed in a tertiary hospital, you are required to attend Continuing Professional Development (CPD) program. When the training program is for the enrichment of nurses in the hospital, it is called __________.
- A. informal training program
- B. formal education program
- C. self-directed
- D. In-service training program
Correct Answer: D
Rationale: In-service training programs are specifically designed to provide continuing education and professional development for employees within a particular organization, in this case, a hospital. These programs are tailored to meet the needs of the staff and enhance their skills and knowledge within their work environment. Since the CPD program in the tertiary hospital is aimed at enriching and supporting the growth of the nurses' knowledge and expertise within the hospital setting, it falls under the category of an in-service training program.
If Baby Sharon develops dehydration, what is the FIRST sign to look for by Nurse Juvy?
- A. Oliguria
- B. Sunken fontanels
- C. Soft and depressed eyeballs
- D. Non-elastic skin/poor skin turgor on thighs and abdomen Situation 3 -
Correct Answer: B
Rationale: Sunken fontanels are one of the earliest signs of dehydration in infants. Fontanels are soft spots on an infant's head where the skull bones have not yet fused together. If a baby's fontanel appears sunken, it indicates that the baby is likely dehydrated. This occurs because when there is a lack of fluid in the body, the soft spots on the head will appear depressed or sunken. It is crucial for Nurse Juvy to closely monitor the fontanels of Baby Sharon, as identifying dehydration early is essential for prompt intervention and preventing complications.
When documenting the procedures done, which of the following should NOT be recorded?
- A. Date
- B. Manufacturer
- C. Lot number
- D. Needle gauge
Correct Answer: B
Rationale: In documenting procedures, it is essential to record information that is relevant to the specific procedure done. Recording the date (A), lot number (C), and needle gauge (D) are critical details that provide important context and traceability for the procedure performed. The date helps to keep track of when the procedure was conducted. The lot number is essential for tracking the specific batch of materials used in the procedure. The needle gauge is important for ensuring the appropriate equipment is used for the procedure. However, recording the manufacturer (B) is not necessary for documenting the procedures as it does not directly impact the quality or traceability of the procedure itself.
A patient with chronic kidney disease presents with periorbital edema, hypertension, and proteinuria. Laboratory findings reveal elevated serum creatinine and urea levels, hyperkalemia, and metabolic acidosis. What is the most likely diagnosis?
- A. Nephrotic syndrome
- B. Diabetic nephropathy
- C. Acute glomerulonephritis
- D. Chronic kidney disease (CKD)
Correct Answer: D
Rationale: The constellation of symptoms presented (periorbital edema, hypertension, proteinuria) along with the laboratory findings (elevated creatinine and urea levels, hyperkalemia, metabolic acidosis) are classical signs of chronic kidney disease (CKD). In CKD, the kidneys gradually lose their function over time, leading to impaired filtration of waste products and electrolyte imbalance. The presence of hypertension and proteinuria are common in CKD due to the compromised renal function. Additionally, elevated serum creatinine and urea levels, hyperkalemia, and metabolic acidosis are indicative of kidney dysfunction.