Nokea
Twelve hours after vaginal delivery, Nurse Kayla palpates the fundus of a primiparous patient and finds it to be firm, above the umbilicus and deviated to the right. What is the BEST thing for Nurse Kayla to do for the patient?
- A. Contact the physician for an order of methylergonovine
- B. Gently massage the fundus to expel the clots
- C. Encourage patient to ambulate and to void
- D. Document this is a normal finding in the patient's records
Correct Answer: C
Rationale: The best thing for Nurse Kayla to do for the patient is to encourage her to ambulate and to void. In this scenario, the fundus being firm, above the umbilicus, and deviated to the right indicates uterine atony with a full bladder. This finding is suggestive of a distended bladder pushing the uterus upwards and to the right. Encouraging the patient to ambulate helps promote uterine contractions, which can aid in the firming up of the uterus. Additionally, emptying the bladder will help the uterus to contract and return to its midline position. This intervention is non-invasive and promotes normal postpartum recovery without the need for medication or excessive manipulation.
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The mother of the family asked Nurse Emma how to apply the anti -scabies lotion. The nurse should teach the family to apply anti -scabies lotion to _________.
- A. all skin areas
- B. open lesions
- C. affected skin
- D. Reddened areas
Correct Answer: A
Rationale: The correct way to apply anti-scabies lotion is to cover all skin areas, not just the affected areas or red areas. Scabies is a contagious skin condition caused by mites burrowing into the skin, so applying the lotion to all skin areas helps to eliminate the mites and prevent reinfestation. It is important to follow the instructions provided by the healthcare professional for proper application and treatment of scabies.
A document that lists the medical treatment a person chooses to refuse if unable to make decisions is the:
- A. Durable power of attorney
- B. Living will
- C. Informed consent
- D. Advance directives
Correct Answer: B
Rationale: A living will is a legal document that allows an individual to express their wishes regarding medical treatment in the event they become unable to make decisions. It specifically outlines the medical treatments a person chooses to refuse or accept under certain circumstances. It is important to differentiate a living will from a durable power of attorney, which designates someone to make healthcare decisions on behalf of the individual when they are unable to do so, and advance directives, which encompass both a living will and a durable power of attorney for healthcare. The living will serves as a guide for healthcare professionals and family members to honor the individual's preferences for medical care.
A patient presents with a palpable, non-tender mass in the right neck, just below the angle of the mandible. Ultrasound imaging demonstrates a well-defined, hypoechoic lesion with cystic components. Which of the following conditions is most likely responsible for this presentation?
- A. Branchial cleft cyst
- B. Thyroglossal duct cyst
- C. Lymphadenopathy
- D. Parotid gland tumor
Correct Answer: A
Rationale: The presentation of a palpable, non-tender mass in the right neck, just below the angle of the mandible, along with ultrasound imaging findings of a well-defined, hypoechoic lesion with cystic components, is classic for a branchial cleft cyst. Branchial cleft cysts are congenital anomalies that arise from remnants of the branchial clefts or pouches during embryonic development. They are typically located along the anterior border of the sternocleidomastoid muscle, just below the mandible. Ultrasound imaging often shows a cystic lesion with well-defined borders and hypoechoic content, which is consistent with the described findings. Thyroglossal duct cysts usually present as midline neck masses that move with swallowing or tongue protrusion, not in the location described in the scenario. Lymphadenopathy would present as enlarged lymph nodes that may be tender and associated with systemic symptoms.
Which of the following salivary glands is located superior and anterior to the ear and produces mainly serous saliva?
- A. Parotid gland
- B. Sublingual gland
- C. Submandibular gland
- D. Submaxillary gland
Correct Answer: A
Rationale: The parotid gland is the salivary gland that is located superior and anterior to the ear. It mainly produces serous saliva, which is a thin, watery fluid rich in enzymes. The other salivary glands mentioned are the sublingual gland, submandibular gland, and submaxillary gland, all of which have different locations and produce different types of saliva.
A patient with obstructive sleep apnea (OSA) presents with excessive daytime sleepiness, loud snoring, and witnessed apneic episodes during sleep. Which of the following interventions is most appropriate for managing OSA and improving symptoms?
- A. Weight loss and lifestyle modifications
- B. Continuous positive airway pressure (CPAP) therapy
- C. Oral appliance therapy
- D. Surgical uvulopalatopharyngoplasty (UPPP)
Correct Answer: B
Rationale: CPAP therapy is considered the gold standard treatment for obstructive sleep apnea (OSA) and is the most appropriate intervention for managing OSA and improving symptoms. CPAP therapy involves using a machine that delivers a continuous flow of air through a mask worn over the nose or mouth during sleep. This air pressure helps keep the airway open, preventing the collapse that causes apneas and snoring during sleep.