Nokea
The nurse instructs the patient that the BEST time for an incontinent patient to take his diuretics is
- A. Any time of the day
- B. In the morning
- C. After 4:00 PM
- D. At bedtime
Correct Answer: D
Rationale: The best time for an incontinent patient to take diuretics is at bedtime. This timing allows for increased urine production during the night, consequently reducing the need for frequent toileting during the day. By taking the diuretic at bedtime, the patient can manage their incontinence more effectively and have better rest without disruptions from frequent urination during the day.
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A 45-year-old woman presents with heavy menstrual bleeding and iron deficiency anemia. On pelvic examination, the uterus is enlarged, and multiple irregularly shaped masses are palpated. Which condition is most likely to be responsible for these findings?
- A. Leiomyomas (uterine fibroids)
- B. Endometrial hyperplasia
- C. Endometrial polyps
- D. Adenomyosis
Correct Answer: A
Rationale: The clinical presentation of heavy menstrual bleeding, iron deficiency anemia, an enlarged uterus, and irregularly shaped masses palpated on pelvic examination is most indicative of leiomyomas, also known as uterine fibroids. Leiomyomas are benign smooth muscle tumors that commonly occur in women of reproductive age. They can lead to heavy menstrual bleeding and iron deficiency anemia due to their size and location within the uterus. On pelvic examination, leiomyomas can be felt as irregularly shaped masses within the uterine wall. This presentation is classic for leiomyomas and distinguishes them from conditions such as endometrial polyps, endometrial hyperplasia, and adenomyosis.
A 70- year-old has been rushed to the hospital due to bradycardia and palpitation. The physician suggested that a pacemaker be inserted to correct the symptoms. The patient voluntarily decides not to have the pacemaker Inserted. This is respected by the family. This is an example of what ethical principles
- A. Beneficence
- B. Autonomy
- C. Fidelity
- D. Justice
Correct Answer: B
Rationale: Autonomy is the ethical principle that respects an individual's right to make their own decisions about their medical treatment, even if it goes against medical advice or the preferences of others. In this case, the 70-year-old patient has voluntarily decided not to have the pacemaker inserted despite the physician's recommendation. The fact that the patient's decision is respected by the family reflects the importance of honoring the patient's autonomy and right to make decisions about their own healthcare.
A pregnant woman presents with sudden onset of severe abdominal pain and dark red vaginal bleeding at 28 weeks gestation. On examination, the uterus is tender, and the fundus feels firm. Which of the following conditions is the most likely cause of these symptoms?
- A. Ectopic pregnancy
- B. Threatened abortion
- C. Placenta previa
- D. Abruptio placentae
Correct Answer: D
Rationale: The most likely cause of the sudden onset of severe abdominal pain and dark red vaginal bleeding with a tender, firm uterus at 28 weeks gestation is abruptio placentae. Abruptio placentae, also known as placental abruption, is the premature separation of the placenta from the uterine wall before delivery. This condition can be life-threatening to both the mother and the fetus, as it can lead to severe bleeding and compromise the oxygen and nutrients supply to the fetus. The presentation typically includes severe abdominal pain, dark red or maroon vaginal bleeding, uterine tenderness, and a firm uterus due to the blood accumulation behind the placenta. Prompt recognition and intervention are crucial to prevent adverse maternal and fetal outcomes.
A patient admitted to the ICU develops acute exacerbation of chronic heart failure (CHF) with pulmonary edema and respiratory distress. What intervention should the healthcare team prioritize to manage the patient's exacerbation?
- A. Administer intravenous loop diuretics for fluid removal.
- B. Initiate positive pressure ventilation for respiratory support.
- C. Perform emergent pericardiocentesis for tamponade relief.
- D. Recommend inotropic medications to improve myocardial contractility.
Correct Answer: B
Rationale: In this scenario, the patient is presenting with acute exacerbation of chronic heart failure (CHF) complicated by pulmonary edema and respiratory distress. The priority intervention for managing this exacerbation is to initiate positive pressure ventilation for respiratory support. Positive pressure ventilation, such as non-invasive positive pressure ventilation (NIPPV) or invasive mechanical ventilation, can help improve oxygenation and decrease the work of breathing for the patient. By providing adequate respiratory support, ventilation can reduce the negative effects of pulmonary edema and respiratory distress due to CHF exacerbation. Administering intravenous loop diuretics (Choice A) might be necessary to address fluid overload, but it is not the initial priority as ensuring adequate ventilation is crucial. Emergent pericardiocentesis (Choice C) is not indicated in this scenario as there is no mention of cardiac tamponade. Inotropic medications (Choice D) may be considered in managing acute exacerbation of CHF but
Patient Josephine was referred to the physician, routine blood examinations were taken. After reviewing the serum electrolyte. levels an order of isotonic intravenous (IV) infusion was prescribed. Which IV solution should the nurse prepare?
- A. 5 percent dextrose in water
- B. 0.45 percent sodium chloride solution
- C. 10 percent dextrose in water
- D. 3 percent sodium chloride solution
Correct Answer: B
Rationale: The order for isotonic intravenous (IV) infusion indicates that the IV solution should have an osmolarity similar to that of blood serum, which is approximately 0.9 percent sodium chloride solution (normal saline). In the given choices, the closest option to isotonic solution is the 0.45 percent sodium chloride solution. This solution is hypotonic compared to blood serum, making it a suitable choice for isotonic IV infusion to prevent fluid shifts and maintain electrolyte balance in the patient. The other options, such as 5 percent dextrose in water (hypotonic), 10 percent dextrose in water (hypertonic), and 3 percent sodium chloride solution (hypertonic), do not match the requirement for an isotonic IV solution in this case.