Which of the following conditions is characterized by chronic hypoxemia, pulmonary hypertension, and right heart failure?
- A. Chronic obstructive pulmonary disease (COPD)
- B. Idiopathic pulmonary fibrosis (IPF)
- C. Pulmonary embolism (PE)
- D. Cor pulmonale
Correct Answer: D
Rationale: Cor pulmonale is a condition characterized by right heart failure secondary to pulmonary hypertension, which is often caused by chronic hypoxemia. Chronic hypoxemia occurs in conditions such as chronic obstructive pulmonary disease (COPD) where there is limited airflow in and out of the lungs, leading to low oxygen levels in the blood. However, the specific characteristic of pulmonary hypertension leading to right heart failure distinguishes cor pulmonale from COPD. Other conditions like idiopathic pulmonary fibrosis (IPF) and pulmonary embolism (PE) may also lead to hypoxemia but are not primarily associated with pulmonary hypertension and right heart failure as in cor pulmonale.
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The unit manager the planning to take her regular official business leave for the year. She has written a letter of recommendation to her Immediate supervisor for her assistant unit manager to assume her position while she is on leave. This is an example of delegation by _____.
- A. rank
- B. authority
- C. succession
- D. authority
Correct Answer: C
Rationale: Delegation by succession is the act of assigning a specific task or responsibility to someone temporarily while the usual person in charge is absent or unavailable. In this scenario, the unit manager is delegating her responsibilities to her assistant unit manager while she is on leave, indicating a temporary transfer of duties. This allows for a smooth continuity of operations within the unit during the manager's absence.
A woman in active labor is diagnosed with an amniotic fluid embolism. What is the priority nursing intervention?
- A. Administering oxygen via face mask
- B. Preparing for immediate cesarean section
- C. Initiating cardiopulmonary resuscitation (CPR)
- D. Inserting an indwelling urinary catheter
Correct Answer: C
Rationale: An amniotic fluid embolism is a rare and life-threatening complication during labor and delivery. It occurs when amniotic fluid or fetal cells enter the maternal circulation, triggering a rapid immune response that can lead to cardiovascular collapse and respiratory failure. The priority nursing intervention for a woman in active labor diagnosed with an amniotic fluid embolism is to initiate cardiopulmonary resuscitation (CPR) to support her vital functions and circulation. Providing immediate CPR can help sustain her until further medical interventions can be implemented. Administering oxygen and preparing for a cesarean section may be necessary but should occur after CPR is initiated to stabilize the woman's condition. Inserting an indwelling urinary catheter is not the priority in this emergency situation, as maintaining adequate cardiac and respiratory function takes precedence.
A patient presents with a thyroid nodule and compressive symptoms such as difficulty swallowing and breathing. Fine-needle aspiration biopsy reveals colloid nodules. Which endocrine disorder is most likely responsible for these symptoms?
- A. Hashimoto's thyroiditis
- B. Graves' disease
- C. Diabetes mellitus
- D. Thyroid nodules
Correct Answer: D
Rationale: Thyroid nodules are abnormal growths of thyroid cells that form a lump within the thyroid gland. When a thyroid nodule becomes large enough, it can cause compressive symptoms such as difficulty swallowing and breathing. The presence of colloid nodules on fine-needle aspiration biopsy indicates a benign and common type of thyroid nodule. In this case, the symptoms are likely due to the physical pressure exerted by the thyroid nodule, rather than an underlying endocrine disorder like Hashimoto's thyroiditis, Graves' disease, or diabetes mellitus. Therefore, the most likely cause of the patient's symptoms is the thyroid nodule itself.
Nurse Merle has to renew her license on or before _____.
- A. 6-Jan-21
- B. 16-Nov-21
- C. 16-Nov-22
- D. 6-Jan-22
Correct Answer: D
Rationale: Nurse Merle has to renew her license on or before January 6, 2022, as that date falls at the end of the standard two-year license renewal cycle for nurses in many jurisdictions. Renewing on or before this date will ensure that Nurse Merle maintains her active licensure status and can continue practicing legally without any interruptions. It is important for healthcare professionals like nurses to stay current with their licensure to uphold professional standards and provide quality care to patients.
What specific term should Nurse Gladys write in her charting when a patient is suffering from a change in the angle between the nail base greater than 180 degrees due to congenital heart disease?
- A. Peripheral neuropathy
- B. Inflammation of the fingers
- C. Peripheral cyanosis
- D. Clubbing of the fingers
Correct Answer: D
Rationale: Clubbing of the fingers is a specific term that Nurse Gladys should write in her charting when a patient is suffering from a change in the angle between the nail base greater than 180 degrees due to congenital heart disease. Clubbing of the fingers is a diagnostic sign associated with various medical conditions, including congenital heart disease. It is characterized by changes in the angle and shape of the nails, typically involving softening of the nail bed, enlargement of the fingertips, and a loss of the normal angle between the nail and the nail bed. Peripheral neuropathy, inflammation of the fingers, and peripheral cyanosis are different conditions and do not specifically describe the nail changes seen in clubbing.