Nokea
A woman in active labor demonstrates persistent occiput posterior fetal position, leading to prolonged labor and severe back pain. What nursing intervention should be prioritized to facilitate fetal rotation and optimize labor progress?
- A. Assisting the mother into a hands-and-knees position
- B. Administering intravenous opioids for pain relief
- C. Preparing for immediate instrumental delivery
- D. Initiating continuous electronic fetal monitoring
Correct Answer: A
Rationale: Assisting the mother into a hands-and-knees position should be prioritized to facilitate fetal rotation and optimize labor progress in the case of persistent occiput posterior fetal position. This position helps in promoting fetal rotation to a more favorable position for delivery by allowing the baby's head to move into the anterior position. It can help alleviate back pain and may help reduce the duration of labor. This simple maneuver can sometimes correct the malposition without the need for interventions like instrumental delivery. It is a non-invasive and effective technique that can be easily implemented by healthcare providers to support the progression of labor.
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Simple hysterectomy involves the removal of which structure(s)?
- A. uterus only
- B. uterus and fallopian tubes
- C. uterus and cervix
- D. uterus, ovaries, and fallopian tubes
Correct Answer: C
Rationale: A simple hysterectomy involves the removal of the uterus and cervix. It does not involve the removal of the fallopian tubes or ovaries. In some cases, the fallopian tubes may be removed along with the uterus, but this would be specified as a different type of hysterectomy (such as a total hysterectomy or a radical hysterectomy). The removal of the ovaries, if necessary, would be indicated as an oophorectomy.
A patient presents with fever, headache, and a maculopapular rash that started on the face and spread to the trunk and extremities. Laboratory tests reveal leukopenia and thrombocytopenia. Which of the following is the most likely causative agent?
- A. Borrelia burgdorferi
- B. Plasmodium falciparum
- C. Rickettsia rickettsii
- D. Leishmania donovani
Correct Answer: C
Rationale: The clinical presentation described with fever, headache, maculopapular rash starting on the face and spreading to the trunk and extremities, along with leukopenia and thrombocytopenia suggests a likely diagnosis of Rocky Mountain spotted fever (RMSF), which is caused by the bacterium Rickettsia rickettsii.
Mr. Steve is brought to the medical ward. the next day, he wants to know about his illness. The nurse on duty replied,'You don't need to know your diagnosis'. Which of the following rights of the patient is violated? Right to_____.
- A. Obtain from his physician complete current information concerning his diagnosis , treatment and prognosis
- B. Receive from his physician information necessary to give informed consent.
- C. Expect reasonable continuity of care.
- D. Considerate and respectful care, irrespective of one's socio-economic status
Correct Answer: A
Rationale: The right being violated in this scenario is the right to obtain from his physician complete current information concerning his diagnosis, treatment, and prognosis. Patients have the right to be fully informed about their health status and to understand the details of their condition, treatment options, and likely outcomes. Withholding this information can prevent the patient from participating in their own care decisions and can violate their autonomy and right to make informed choices about their health.
A patient presents with fatigue, weakness, and jaundice. Laboratory tests reveal hemolytic anemia, elevated LDH, decreased haptoglobin, and presence of schistocytes on peripheral blood smear. Which of the following conditions is most likely to cause these findings?
- A. Hereditary spherocytosis
- B. Glucose-6-phosphate dehydrogenase (G6PD) deficiency
- C. Autoimmune hemolytic anemia (AIHA)
- D. Thalassemia
Correct Answer: B
Rationale: Glucose-6-phosphate dehydrogenase (G6PD) deficiency is an X-linked recessive disorder that leads to hemolytic anemia in response to oxidative stress. The patient's presentation of fatigue, weakness, and jaundice along with laboratory findings of hemolytic anemia (evidenced by schistocytes), elevated LDH, and decreased haptoglobin are all characteristic of G6PD deficiency. The oxidative stress causes red blood cell destruction, resulting in the release of LDH and bilirubin, leading to jaundice. Decreased haptoglobin is seen due to its consumption in binding free hemoglobin released from the lysed red blood cells. Additionally, the presence of schistocytes on a peripheral blood smear is indicative of red blood cell fragmentation, a common finding in hemolytic anemias including G6PD deficiency
Which of the following salivary glands is located inferior and posterior to the mandible and produces serous saliva rich in enzymes?
- A. Parotid gland
- B. Sublingual gland
- C. Submandibular gland
- D. Submaxillary gland
Correct Answer: C
Rationale: The submandibular gland is located inferior and posterior to the mandible. It produces a mixed type of saliva, which is primarily serous (enzyme-rich) but also contains some mucous components. This gland plays a significant role in digestion, as its serous saliva contains enzymes such as amylase that help break down carbohydrates in the mouth before they reach the stomach.