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Which of the following interventions is most appropriate for managing a patient with acute respiratory failure and hypercapnia due to chronic obstructive pulmonary disease (COPD) exacerbation?
- A. Administration of supplemental oxygen via non-rebreather mask
- B. Initiation of non-invasive positive pressure ventilation (NIPPV)
- C. Placement of an indwelling arterial catheter for continuous monitoring
- D. Titration of inhaled bronchodilators and corticosteroids
Correct Answer: B
Rationale: In a patient with acute respiratory failure and hypercapnia due to a COPD exacerbation, the most appropriate intervention is the initiation of non-invasive positive pressure ventilation (NIPPV). NIPPV helps improve ventilation and oxygenation by providing mechanical support to the patient's breathing without the need for endotracheal intubation. It can reduce the work of breathing, decrease carbon dioxide retention, and improve respiratory muscle function. This intervention is particularly beneficial for COPD exacerbations as it can help alleviate hypercapnia and hypoxemia, leading to improved outcomes and potentially reducing the need for invasive ventilation methods. Therefore, NIPPV is the recommended management strategy in this scenario.
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The newly-hired nurse oriented the caregiver hired by the couple. Which of the following should the nurse encourage the parents to do?
- A. Relate to each twin individually to, enhance the attachment process .
- B. Avoid assistance from other family members and support groups.
- C. Bottle-feed the twins to prevent maternal exhaustion.
- D. Plan for each parent to spend equal amounts of time with each twin.
Correct Answer: A
Rationale: The nurse should encourage the parents to relate to each twin individually to enhance the attachment process. Building a strong attachment between the parents and each twin individually is vital for their emotional and psychological development. By spending quality one-on-one time with each twin, the parents can foster a unique bond with them, which can positively impact their relationship and overall development. This approach also helps prevent favoritism and ensures that each twin receives the attention and care they need to thrive.
A patient with a history of chronic obstructive pulmonary disease (COPD) is experiencing respiratory distress. Which nursing intervention is the priority for managing the patient's respiratory status?
- A. Administering bronchodilators
- B. Positioning the patient in high Fowler's position
- C. Performing chest physiotherapy
- D. Administering oxygen therapy
Correct Answer: D
Rationale: Administering oxygen therapy is the priority nursing intervention for managing a patient with COPD experiencing respiratory distress. In COPD, the patient's lungs are less efficient at oxygen exchange, leading to hypoxemia. Oxygen therapy helps improve oxygenation in the body and alleviates respiratory distress in these patients. Positioning the patient in high Fowler's position can also help improve lung expansion, but providing supplemental oxygen takes precedence in addressing the underlying hypoxemia. Administering bronchodilators and performing chest physiotherapy aim to manage airway obstruction and promote airway clearance, but ensuring the patient has adequate oxygenation is crucial in the immediate management of respiratory distress in COPD.
A "full understanding" in research should be understood by the nurse researcher as _____.
- A. ensuring that participants are not placed at risk
- B. explaining the study including risks and ben
- C. the right to decide voluntarily
- D. not exploiting information shared by participants
Correct Answer: B
Rationale: A "full understanding" in research should be understood by the nurse researcher as explaining the study including risks and ben . When conducting research involving participants, it is crucial for nurse researchers to provide all necessary information about the study, including potential risks and benefits, in a clear and understandable manner. This ensures that participants are well-informed and can make informed decisions about their participation. By explaining the study thoroughly, nurse researchers uphold ethical principles such as informed consent and respect for participants' autonomy. It also helps in building trust between the researcher and participants, ultimately leading to more reliable and ethical research outcomes.
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.
The inappropriate use of restraints or seclusion is considered which form of intentional tort?
- A. False imprisonment
- B. Assault
- C. Battery
- D. Causation
Correct Answer: A
Rationale: The inappropriate use of restraints or seclusion is considered a form of false imprisonment, which is an intentional tort. False imprisonment occurs when someone intentionally restricts another person's freedom of movement without their consent or legal justification. In healthcare settings, using restraints or seclusion inappropriately on a patient can constitute false imprisonment if it is not done for the safety of the patient or others and without proper authorization. This act can lead to legal consequences and liabilities for healthcare providers.