A patient at 36 weeks gestation is undergoing a nonstress (NST) test. The nurse observes the fetal heart rate baseline at 135 beats per minute (bpm) and four nonepisodic patterns of the fetal heart rate reaching 160 bpm for periods of 20 to 25 seconds each. How will the nurse record these findings?

Correct Answer: C

Rationale: Step 1: The baseline fetal heart rate is 135 bpm, which is within the normal range of 110-160 bpm. Step 2: The four nonepisodic patterns of fetal heart rate reaching 160 bpm for 20-25 seconds each indicate accelerations, a positive sign. Step 3: A reactive NST requires at least two accelerations of the fetal heart rate within a 20-minute window, which this scenario meets. Step 4: Therefore, the nurse will record these findings as NST reactive, reassuring because the fetal heart rate responded appropriately to stimuli. Summary of Other Choices: A: NST positive, nonreassuring - Inaccurate, as the findings indicate a reassuring response. B: NST negative, reassuring - Incorrect, as the test results are actually reactive, not negative. D: NST nonreactive, nonreassuring - Wrong, as the test is reactive and reassuring, not nonreactive and nonreassuring.

Correct Answer: C

Rationale: The correct answer is C) Adult children up to age 26 are allowed coverage on the parent’s plan. This provision is a key aspect of the Affordable Care Act (ACA), allowing young adults to remain on their parents' health insurance until the age of 26. This provision helps increase access to healthcare for young adults who may be transitioning into the workforce or pursuing higher education. Option A is incorrect because under the ACA, there are penalties for not having health insurance, so families cannot choose to be uninsured without consequences. Option B is incorrect as Medicaid and Medicare are two separate programs with different payment structures, so their payments do not equal each other. Option D is incorrect as one of the key provisions of the ACA is that private insurance companies cannot deny coverage based on pre-existing conditions, which was a significant change brought about by the ACA. In an educational context, understanding the key provisions of the Affordable Care Act is crucial for healthcare professionals, especially those working with vulnerable populations like pregnant women. By knowing the details of the ACA, nurses can better educate families about their healthcare options and help them make informed decisions regarding their health insurance coverage.

Correct Answer: C

Rationale: In this scenario, the correct answer is C) Restorative. When working with a home care organization specializing in spinal cord injury, a nurse would ideally want to work in a restorative health care facility. Restorative care focuses on helping individuals regain their maximum level of function, independence, and quality of life after an injury or illness. Option A) Secondary acute facilities provide care for patients who require short-term treatment for acute conditions but do not specifically focus on restorative care for spinal cord injuries. Option B) Continuing care facilities offer a range of services for individuals who need ongoing care and support but may not specifically target the specialized needs of spinal cord injury patients. Option D) Tertiary care facilities are advanced medical centers that provide specialized consultative care, but they may not offer the comprehensive restorative care approach needed for spinal cord injury patients in a home care setting. Understanding the different levels of care facilities and their specific focuses is crucial for nurses to align their expertise with the needs of the patient population they will be serving, especially in specialized areas like spinal cord injury care.

Correct Answer: A

Rationale: In pharmacology education, understanding quality improvement processes like the PDSA cycle is crucial for ensuring safe and effective patient care. In this context, selecting the correct action for the letter “A” in the PDSA cycle, which is "Act," is essential. The nurse, after planning (P), implementing (D), and analyzing (S), needs to take decisive action to implement the necessary changes identified through the quality improvement process. Acting allows for the actual implementation of changes in practice based on the data and insights gathered. Regarding why the other options are incorrect: - "Alter": While altering may be a step in the improvement process, the immediate action required after planning, testing, and analyzing is to act on the findings. - "Assess": Assessment is essential in the PDSA cycle, but at this stage, the nurse has already gathered data and needs to move beyond assessment to implementation. - "Approach": This term does not align with the specific action required at this stage of the PDSA cycle, which is to act on the results obtained. Educationally, understanding the PDSA cycle in the context of pharmacology prepares nurses to engage in evidence-based practice and continuous quality improvement, ultimately leading to better patient outcomes and enhanced healthcare delivery. By grasping the significance of each step in the cycle, nurses can contribute effectively to improving medication safety and efficacy, especially in critical situations like pregnancy assessments where precision and quality are paramount.

Correct Answer: D

Rationale: In this scenario, the correct facility that the nurse should discuss with the older adult patient who has extensive wound care needs after discharge from the hospital is option D) Skilled nursing. Rationale for option D: Skilled nursing facilities provide specialized care for patients who require medical and rehabilitative services, such as wound care. These facilities have trained healthcare professionals, including nurses and therapists, who can address the complex needs of older adults, ensuring proper wound management and monitoring to promote healing and prevent complications. Skilled nursing facilities also offer 24-hour nursing care, which is crucial for patients with extensive wound care needs. Rationale for why the other options are wrong: A) Hospice: Hospice care is provided for patients who have a terminal illness and are no longer seeking curative treatment. It focuses on comfort and quality of life rather than aggressive medical interventions like wound care. B) Respite care: Respite care provides short-term relief for caregivers and is not intended for long-term wound care management. C) Assisted living: Assisted living facilities provide assistance with activities of daily living but do not typically offer the level of medical care and wound management required for extensive wound care needs. Educational context: Understanding the appropriate level of care for older adults with complex medical needs is crucial for healthcare professionals, especially nurses. By choosing the correct facility, such as a skilled nursing facility in this case, the nurse ensures that the patient receives the necessary care and support for optimal recovery and well-being. This knowledge helps nurses make informed decisions and advocate for the best interests of their patients.