Nokea
A pregnant woman presents with vaginal bleeding and crampy abdominal pain at 22 weeks gestation. On examination, the cervix is dilated, and the amniotic sac is visible at the cervical os. Which of the following conditions is the most likely cause of these symptoms?
- A. Ectopic pregnancy
- B. Threatened abortion
- C. Placenta previa
- D. Incompetent cervix
Correct Answer: D
Rationale: Incompetent cervix, also known as cervical insufficiency, is the most likely cause of the symptoms described. Incompetent cervix is a condition where the cervix begins to dilate and efface prematurely, typically in the second trimester, without contractions or labor. This can lead to painless cervical dilation and bulging of the amniotic sac into the vagina, which can cause vaginal bleeding and crampy abdominal pain. It is a leading cause of second-trimester pregnancy loss. Treatment may involve a cervical cerclage, a surgical procedure where the cervix is stitched closed to provide additional support.
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There are pre operative medications given to the patient. Which of the following drugs are given in order to decrease intra-operative anesthetic requirements and pain?
- A. Celebrex (celecoxib)
- B. Acetaminophen (tylenol)
- C. Ibuprofen (motrin)
- D. Demerol (Meperidine HC
Correct Answer: D
Rationale: Demerol (meperidine hydrochloride) is an opioid analgesic commonly used as a preoperative medication to decrease intra-operative anesthetic requirements and provide analgesia. Opioids like Demerol act on the central nervous system to reduce pain sensations, making it an effective choice for preoperative pain management. This can help decrease the amount of anesthesia needed during surgery, leading to better pain control and overall patient comfort during and after the procedure. Celebrex, acetaminophen, and ibuprofen are also used for pain management, but they do not have the same potency and mechanism of action as opioids like Demerol for reducing intra-operative anesthetic requirements.
Nurse Vera informs the patient she should be screened for pre-eclmapsia during this term of pregnancy_______.
- A. first
- B. Third
- C. second
- D. Before delivery
Correct Answer: A
Rationale: Pre-eclampsia is a serious condition that can occur during pregnancy, usually after 20 weeks gestation. It is important to screen for pre-eclampsia early in the pregnancy to monitor and manage the condition effectively. Screening for pre-eclampsia typically begins in the first trimester of pregnancy to identify any risk factors and provide appropriate care for the patient. Therefore, Nurse Vera informing the patient to get screened for pre-eclampsia in the first term of pregnancy is the most appropriate time to start monitoring for this condition.
Should the investigation of the fall go further, which of the following is the best source of factual information ?
- A. incident report.
- B. nurse's notes in the chart
- C. anecdotal record
- D. process recording
Correct Answer: A
Rationale: The incident report is the best source of factual information to investigate the fall further. Incident reports are official documents that provide a detailed account of what happened leading up to and during an incident. They include factual information such as the date, time, location, individuals involved, and details of the event. By reviewing the incident report, investigators can gather accurate information to determine the cause of the fall and any contributing factors. This document serves as an essential tool in conducting a thorough investigation into the fall and helps in identifying preventive measures to avoid similar incidents in the future.
Autonomy is the prerogative of the patient to give consent or refusal of treatment with the EXCEPTION of which of the following situations?
- A. Erroneous belief of a head of a church
- B. Negative effect of superstition
- C. Near death
- D. Peer pressure
Correct Answer: A
Rationale: Autonomy refers to the patient's right to make decisions about their own health care, including the ability to give consent or refusal of treatment. This right is based on the patient's own beliefs, values, and preferences. However, in the case of an erroneous belief of a head of a church, it may conflict with the patient's own autonomy and ability to make decisions based on their own beliefs. In such a situation, it is important for healthcare providers to respect the patient's autonomy while also addressing any potential conflicts that may arise from external influences such as the erroneous belief of a head of a church.
A nurse is preparing to perform a wound debridement procedure for a patient with a necrotic wound. What action should the nurse prioritize to minimize patient discomfort during the procedure?
- A. Administering systemic analgesia before the procedure
- B. Using sharp debridement techniques to minimize manipulation
- C. Applying a topical anesthetic cream to the wound site
- D. Performing the debridement procedure quickly to reduce duration
Correct Answer: A
Rationale: Administering systemic analgesia, such as pain medications or anesthesia, before the wound debridement procedure is the most effective way to minimize patient discomfort. These medications will help manage and reduce the pain experienced by the patient during the procedure, making it more tolerable for them. Topical anesthetic cream may provide some localized relief but may not be sufficient for significant pain management during a wound debridement procedure. Using sharp debridement techniques or performing the procedure quickly may help reduce manipulation or duration, respectively, but these actions alone may not adequately address the patient's pain and discomfort. Administering systemic analgesia ensures that the patient's overall pain is managed, promoting a more comfortable and successful wound debridement procedure.