A woman in active labor experiences a prolonged latent phase, characterized by irregular contractions and minimal cervical dilation. What maternal condition should the nurse assess for that may contribute to this abnormal labor pattern?
- A. Maternal dehydration
- B. Fetal malposition
- C. Maternal anxiety
- D. Fetal macrosomia
Correct Answer: A
Rationale: Maternal dehydration can lead to a prolonged latent phase in labor due to inadequate hydration affecting the progress of labor. Dehydration can cause decreased blood volume, leading to poor uterine perfusion and inefficient uterine contractions. It also contributes to reduced amniotic fluid volume and can lead to maternal exhaustion. Therefore, assessment and correction of maternal hydration status are crucial in improving labor patterns and preventing complications during labor and delivery.
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A patient presents with a displaced fracture of the distal radius and ulna after a fall. What is the preferred initial treatment for this injury?
- A. Closed reduction and splinting
- B. Open reduction and internal fixation (ORIF)
- C. Closed reduction and external fixation (CREF)
- D. Cast immobilization without reduction
Correct Answer: A
Rationale: In the case of a displaced fracture of the distal radius and ulna, the preferred initial treatment is typically closed reduction and splinting. Closed reduction involves manually realigning the fractured bones without the need for surgery. Splinting is then utilized to immobilize the wrist and forearm to allow for proper healing of the fracture. This approach is often effective in realigning the bones and stabilizing the injury, allowing for adequate healing without the need for more invasive interventions like surgery. Following the initial management with closed reduction and splinting, the patient's progress will be monitored, and further interventions may be considered based on the specific characteristics of the fracture and the patient's response to treatment.
Which of the following clinical findings is most consistent with a diagnosis of pneumonia?
- A. Inspiratory crackles and dullness to percussion
- B. Hemoptysis and pleuritic chest pain
- C. Clubbing of the fingers and cyanosis
- D. Decreased breath sounds and tracheal deviation
Correct Answer: A
Rationale: The clinical findings of inspiratory crackles (also known as rales) and dullness to percussion are most consistent with a diagnosis of pneumonia. Inspiratory crackles are abnormal lung sounds heard on auscultation and are typically due to the presence of fluid or mucus in the alveoli. Dullness to percussion can indicate consolidation of lung tissue, which is a common finding in pneumonia where the alveolar spaces are filled with inflammatory exudate. These findings suggest localized lung pathology and are commonly observed in patients with pneumonia. Hemoptysis and pleuritic chest pain (Choice B) are more suggestive of pulmonary embolism or pleurisy. Clubbing of the fingers and cyanosis (Choice C) are signs of chronic hypoxemia and are not specific to pneumonia. Decreased breath sounds and tracheal deviation (Choice D) are more indicative of conditions such as a pneumoth
During a shift handover, the nurse receives information about a patient's condition from the outgoing nurse. What action by the nurse demonstrates effective communication during the handover process?
- A. Interrupting the outgoing nurse to ask questions
- B. Writing down the information without asking for clarification
- C. Summarizing key points and asking clarifying questions as needed
- D. Disregarding the information and relying on personal assessment later
Correct Answer: C
Rationale: Option C, summarizing key points and asking clarifying questions as needed, demonstrates effective communication during the handover process. This action ensures that the nurse fully understands the information being provided and helps to prevent misunderstandings or missing critical details. By summarizing key points, the nurse confirms their understanding and can ask for clarification on any areas that are unclear. Effective communication during handovers is essential for maintaining patient safety and continuity of care.
A patient with a history of heart failure is prescribed spironolactone. Which electrolyte imbalance is the patient at risk for developing with spironolactone therapy?
- A. Hypernatremia
- B. Hyperkalemia
- C. Hypokalemia
- D. Hyponatremia
Correct Answer: B
Rationale: Spironolactone is a potassium-sparing diuretic commonly used in the management of heart failure. One of the significant side effects of spironolactone is hyperkalemia, which is an elevated level of potassium in the bloodstream. Spironolactone works by blocking the action of aldosterone, a hormone that regulates potassium and sodium balance in the body. By inhibiting aldosterone, spironolactone reduces potassium excretion in the urine, leading to potential accumulation of potassium in the body.
Who among the passengers will take PRIORITY for the rescue team to transport to the hospital?
- A. Student with Colle's fracture.
- B. Jay with lacerations
- C. Pregnant women
- D. Conductor with broken leg
Correct Answer: C
Rationale: In emergency situations, pregnant women are typically given priority when it comes to transportation to the hospital. This is because they have unique medical needs and potential complications that require immediate attention. It is important to ensure the well-being of both the mother and the unborn child. Additionally, the health and safety of the unborn child are critical considerations in determining priority for medical treatment and transport. Therefore, the pregnant woman should be the priority for the rescue team to transport to the hospital.