Nokea
A 55-year-old postmenopausal woman presents with vaginal bleeding. On pelvic examination, the cervix appears healthy, and there is no cervical motion tenderness. Which of the following conditions is most likely to be responsible for these findings?
- A. Cervical cancer
- B. Endometrial cancer
- C. Vaginal cancer
- D. Cervical polyp
Correct Answer: D
Rationale: In a 55-year-old postmenopausal woman presenting with vaginal bleeding and a healthy cervix on examination, the most likely cause would be a cervical polyp. Cervical polyps are benign growths that can occur on the cervix and are often asymptomatic but can occasionally cause postmenopausal bleeding. Their appearance on examination would typically be a non-malignant finding with no cervical motion tenderness. Cervical cancer, endometrial cancer, and vaginal cancer would typically present with different examination findings and risk factors.
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Which nursing intervention constitutes false imprisonment?
- A. A client is hospitalized as an involuntary admission and attempts to leave the unit. The nurse calls the security team per hospital protocol. They prevent the client from leaving.
- B. A psychotic client is admitted as an involuntary client and runs out of the psychiatric unit. The nurse runs after the client and succeeds in talking the client into returning to the unit.
- C. The client has been "pesky," seeking the attention of nurses in the nurses' station much of the day.
- D. The client is confused, combative, and insists that no one can stop him from leaving. The nurse restrains the client without a physician's order, then seeks the order.
Correct Answer: D
Rationale: False imprisonment occurs when a client is physically restrained or confined without legal justification. In this scenario, the nurse restraining the confused and combative client without a physician's order constitutes false imprisonment. Restraints should only be used when necessary to ensure the safety of the client or others, and a physician's order is required to authorize their use. In this case, the nurse acted without proper authorization, making it a violation of the client's rights and false imprisonment. It is essential to follow proper protocols and obtain necessary orders before restraining a client.
Which of the following laboratory findings is most consistent with acute respiratory distress syndrome (ARDS)?
- A. Elevated serum bicarbonate (HCO3-) level
- B. Decreased serum albumin level
- C. Elevated white blood cell count (WBC)
- D. Increased lactate dehydrogenase (LDH) level
Correct Answer: D
Rationale: Acute respiratory distress syndrome (ARDS) is a severe condition characterized by widespread inflammation in the lungs leading to increased pulmonary vascular permeability, non-cardiogenic pulmonary edema, and respiratory failure. In ARDS, the alveolar-capillary barrier is disrupted, resulting in fluid accumulation in the alveoli and impaired gas exchange.
Patient's health teaching for Lamotrigine (Lamictal} should include which of the following?
- A. Take each dose with food to avoid nausea.
- B. Eat a balanced diet to avoid weight gain.
- C. Report any rashes to your doctor immediately.
- D. This drug may cause psychological dependence.
Correct Answer: C
Rationale: Lamotrigine (Lamictal) is known to cause a serious rash, such as Stevens-Johnson syndrome or toxic epidermal necrolysis, which can be life-threatening. Therefore, it is crucial for patients taking Lamotrigine to be aware of this potential side effect and report any skin rashes to their healthcare provider promptly. Early detection and appropriate management are essential in preventing serious complications related to these rashes.
Because of the failure to replace the defective electric fan immediately, a fire broke out and it became big enough to burn a major portion of the unit because the fire extinguisher was missing. What lesson can be gained from this?
- A. Punishment must be imposed on erring employees
- B. Reorientation of the new staff.
- C. Refer the erring employee to HR.
- D. Every protocol must be followed .
Correct Answer: D
Rationale: The lesson that can be gained from this scenario is that every protocol must be followed. In this situation, failure to replace the defective electric fan immediately and having a missing fire extinguisher directly led to the fire escalating and causing significant damage. By ensuring that all safety protocols and procedures are followed promptly and consistently, potential hazards and risks can be mitigated or prevented. It is crucial for employees to understand the importance of adhering to established protocols in order to maintain a safe working environment and prevent accidents or emergencies.
After washing her hands and gently cleaning any discharge that can be removed easily from the outer ear, Nurse Selma positions the child. Which of the following steps follows?
- A. Gently press the tragus of the ear four times in a pumping motion.
- B. Gently pull the outer ear
- C. Drop the medicine into the ear canal.
- D. Keep the ear up for five minutes.
Correct Answer: C
Rationale: The correct next step after positioning the child is to drop the medicine into the ear canal. This is typically the next step in administering ear drops for a child. The cleaning and positioning steps are to prepare the ear for receiving the medication. Dropping the medicine into the ear canal ensures that the medication can reach the affected area effectively. Once the medicine is dropped into the ear canal, it is important to follow any additional instructions provided by the healthcare provider regarding keeping the ear in a certain position or any other post-administration care steps.