Nokea
A woman in active labor is receiving intravenous fentanyl for pain relief. What fetal assessment finding indicates potential neonatal opioid withdrawal syndrome (NOWS)?
- A. Hypertonicity
- B. Bradycardia
- C. Hypoglycemia
- D. Respiratory depression
Correct Answer: A
Rationale: Neonatal Opioid Withdrawal Syndrome (NOWS), previously known as Neonatal Abstinence Syndrome (NAS), can occur when a newborn is exposed to opioids in utero. Opioid exposure in utero can lead to physical dependence in the fetus, and when the drug is no longer available after birth, withdrawal symptoms can occur.
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The client has been "pesky," seeking the attention of nurses in the nurses' station much of the day. Now the nurse escorts the client to the room and tells the client to stay there or be put into seclusion. The nurse is threatening to give the client an injection in order to restrain the client for inappropriate behavior. This is an example of
- A. Abuse
- B. Assault
- C. False imprisonment
- D. Battery
Correct Answer: C
Rationale: False imprisonment is the act of improperly restraining another individual against their will. In this scenario, the nurse's threat of putting the client into seclusion and administering an injection to restrain them for inappropriate behavior constitutes false imprisonment. The client is being restricted in their movement without valid reason or proper procedure. This type of action is not acceptable in healthcare settings and violates the client's rights. It is important for healthcare professionals to use appropriate de-escalation techniques and interventions to manage challenging behaviors without resorting to threats of physical restraint.
A patient with chronic obstructive pulmonary disease (COPD) presents with acute exacerbation and severe dyspnea. Arterial blood gas (ABG) analysis reveals pH 7.28, PaO2 55 mmHg, PaCO2 65 mmHg, and HCO3- 30 mEq/L. Which of the following acid-base disturbances is most likely present in this patient?
- A. Respiratory acidosis with metabolic compensation
- B. Respiratory alkalosis with metabolic compensation
- C. Metabolic acidosis with respiratory compensation
- D. Metabolic alkalosis with respiratory compensation
Correct Answer: A
Rationale: In this case, the patient is experiencing respiratory acidosis as indicated by the low pH (7.28), elevated PaCO2 (65 mmHg), and elevated HCO3- (30 mEq/L). The primary acid-base disturbance is respiratory acidosis due to the retention of carbon dioxide (PaCO2 >45 mmHg) leading to an increase in HCO3- as a compensatory mechanism to maintain pH within normal limits. The elevated HCO3- levels (metabolic compensation) are trying to counterbalance the increased PaCO2 levels (respiratory acidosis) by increasing bicarbonate to attempt to normalize the pH. Overall, the ABG analysis shows respiratory acidosis with metabolic compensation in this COPD patient with an acute exacerbation and severe dyspnea.
Upon history-taking, the nurse notes that the cough of a patient with lung cancer usually STARTS off to be ___________.
- A. blood-tinged
- B. dark yellow sputum
- C. productive
- D. dry and persistent
Correct Answer: D
Rationale: The cough of a patient with lung cancer typically starts off as dry and persistent. This is because lung cancer can irritate the airways, leading to a persistent dry cough as an early symptom. As the cancer progresses, the cough may become more productive with blood-tinged or dark yellow sputum. However, in the early stages, the cough is often dry and persistent, which can be a warning sign for healthcare providers to further investigate potential underlying issues such as lung cancer.
A safe patient environment includes following factors EXCEPT
- A. Socio-economic needs
- B. sanitation is maintained
- C. basic needs are met
- D. physical hazards are reduced
Correct Answer: A
Rationale: A safe patient environment should address the physical, emotional, and psychological well-being of the patient. While socio-economic needs are important for overall patient care, they are not directly related to creating a safe environment within a healthcare setting. Factors such as maintaining sanitation, meeting basic needs, and reducing physical hazards are crucial to ensuring the safety and well-being of patients. However, addressing socio-economic needs falls more within the realm of holistic patient care beyond just the physical safety aspect.
Cell-mediated immunity is NOT usually associated with what condition:
- A. Rejection of tissue graft
- B. Production of antibodies
- C. Skin hypersensitivity reaction
- D. Surveying for malignant cells
Correct Answer: B
Rationale: Cell-mediated immunity is a type of immune response that involves the activation of cytotoxic T cells and other immune cells to directly target and destroy infected or abnormal cells. It does not involve the production of antibodies, which are the primary component of humoral immunity. Antibodies are produced by B cells and are responsible for targeting extracellular pathogens such as bacteria and viruses. In contrast, cell-mediated immunity is more focused on targeting intracellular pathogens, cancerous cells, and other cells that have been compromised. So, production of antibodies is not usually associated with cell-mediated immunity.