Nokea
A woman in active labor is diagnosed with an amniotic fluid embolism. What is the priority nursing intervention?
- A. Administering oxygen via face mask
- B. Preparing for immediate cesarean section
- C. Initiating cardiopulmonary resuscitation (CPR)
- D. Inserting an indwelling urinary catheter
Correct Answer: C
Rationale: An amniotic fluid embolism is a rare and life-threatening complication during labor and delivery. It occurs when amniotic fluid or fetal cells enter the maternal circulation, triggering a rapid immune response that can lead to cardiovascular collapse and respiratory failure. The priority nursing intervention for a woman in active labor diagnosed with an amniotic fluid embolism is to initiate cardiopulmonary resuscitation (CPR) to support her vital functions and circulation. Providing immediate CPR can help sustain her until further medical interventions can be implemented. Administering oxygen and preparing for a cesarean section may be necessary but should occur after CPR is initiated to stabilize the woman's condition. Inserting an indwelling urinary catheter is not the priority in this emergency situation, as maintaining adequate cardiac and respiratory function takes precedence.
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Which of the following is the most common risk factor for the development of ovarian cancer?
- A. Nulliparity
- B. Early menarche
- C. Late menopause
- D. Family history of breast cancer
Correct Answer: A
Rationale: Nulliparity, which refers to never having given birth to a child, is the most common risk factor for the development of ovarian cancer. Women who have never been pregnant have a higher risk of developing ovarian cancer compared to those who have had children. This association is believed to be related to the uninterrupted ovulation cycles that nulliparous women experience, leading to changes in the surface epithelium of the ovary that predispose them to cancer development. Conversely, factors like early menarche, late menopause, and a family history of breast cancer are also associated with an increased risk of ovarian cancer but are not as commonly observed as nulliparity in the general population.
A woman in active labor is experiencing persistent occiput posterior position despite position changes. What nursing intervention is most appropriate to facilitate fetal rotation?
- A. Encourage the mother to remain in a side-lying position.
- B. Assist the mother into a hands-and-knees position.
- C. Administer intravenous oxytocin to augment contractions.
- D. Perform manual rotation of the fetus during vaginal examination.
Correct Answer: B
Rationale: The most appropriate nursing intervention to facilitate fetal rotation in a woman experiencing persistent occiput posterior position is to assist the mother into a hands-and-knees position. This position can help encourage the baby to rotate into the optimal occiput anterior position for delivery. By being on her hands and knees, gravity can assist in aiding the rotation of the baby. This position can also help relieve pressure on the mother's back and potentially reduce discomfort during labor. Additionally, hands-and-knees position can help open up the pelvis and create more space for the baby to turn. It is a non-invasive and generally well-tolerated intervention to promote fetal rotation in labor.
A patient presents with chest pain that occurs during emotional stress and resolves spontaneously. An electrocardiogram (ECG) may show transient ST-segment elevation. Which cardiovascular disorder is most likely responsible for these symptoms?
- A. Stable angina
- B. Unstable angina
- C. Acute myocardial infarction
- D. Takotsubo cardiomyopathy
Correct Answer: D
Rationale: Takotsubo cardiomyopathy, also known as stress-induced cardiomyopathy or broken heart syndrome, presents with symptoms similar to acute coronary syndrome, such as chest pain and ECG changes. In Takotsubo cardiomyopathy, chest pain typically occurs during emotional stress and resolves spontaneously, similar to the scenario described in the question. The ECG may show transient ST-segment elevation. This condition is characterized by a reversible left ventricular dysfunction that can mimic a myocardial infarction. Unlike stable angina (Choice A) and unstable angina (Choice B), Takotsubo cardiomyopathy is not related to coronary artery disease. Acute myocardial infarction (Choice C) typically presents with persistent ST-segment elevation on ECG and is caused by atherosclerotic plaque rupture leading to myocardial infarction, which is not consistent with the transient ST-segment elevation seen in
A pregnant woman presents with lower abdominal pain, fever, and vaginal discharge. On examination, cervical motion tenderness and bilateral adnexal tenderness are noted. Which of the following conditions is the most likely cause of these symptoms?
- A. Ectopic pregnancy
- B. Pelvic inflammatory disease
- C. Placenta previa
- D. Ovarian torsion
Correct Answer: B
Rationale: Pelvic inflammatory disease (PID) is the most likely cause of the symptoms described in the pregnant woman. PID is an infection of the female reproductive organs, typically caused by sexually transmitted bacteria like Chlamydia or Gonorrhea. The classic presentation includes lower abdominal pain, fever, vaginal discharge, cervical motion tenderness, and bilateral adnexal tenderness on examination. This condition can lead to serious complications if not promptly treated, including infertility, ectopic pregnancy, and chronic pelvic pain. Therefore, it is crucial to diagnose and manage PID promptly, especially in pregnant women, to prevent adverse outcomes.
. The patient with nephrotic syndrome is ordered corticosteroids. Who of the following are NOT ALLOWED in the patient's
- A. Parents with diabetes.
- B. Relatives with upper respiratory tract infection.
- C. Visitors with mild asthma.
- D. Personnel with allergy.
Correct Answer: A
Rationale: Patients with nephrotic syndrome who are ordered corticosteroids need to avoid close contact with individuals who have infections or illnesses, as corticosteroids can suppress the immune system and increase the risk of infections. Therefore, it is important to prioritize the safety and well-being of the patient by minimizing potential sources of infection. While diabetes itself does not pose a direct risk to the patient with nephrotic syndrome, individuals with diabetes may have a compromised immune system or be at higher risk for infections, which could potentially be transmitted to the patient. This precaution helps to minimize the risk of infection and maximize the effectiveness of the treatment for nephrotic syndrome.