A patient is having elective surgery under general anesthesia. Who is responsible for obtaining the informed-consent?

Correct Answer: A

Rationale: The primary responsibility for obtaining informed consent lies with the surgeon who will be performing the procedure. Informed consent is a process where the healthcare provider explains the procedure, benefits, risks, and alternatives to the patient, allowing them to make an informed decision about their care. While other healthcare team members may also participate in this process, the ultimate responsibility typically rests with the surgeon as they are the one performing the surgery.

Correct Answer: D

Rationale: Population structure is a diagram that presents the distribution of a population based on age and sex. It is typically displayed in a pyramid-like style format, with the horizontal axis showing the age groups and the vertical axis showing the percentage or number of individuals in each age group, divided by sex. This helps to visualize how the population is distributed in terms of age and sex, providing important insights into demographic trends, such as age dependency ratio and potential future trends in population growth or decline. Age and sex are the key demographic variables used to construct a population structure diagram.

Correct Answer: A

Rationale: Patients with COPD are at increased risk for developing ventilator-induced lung injury (VILI) due to their underlying lung pathology. Using a low tidal volume strategy (6-8 ml/kg predicted body weight) has been shown to reduce the risk of VILI in these patients. Additionally, applying high positive end-expiratory pressure (PEEP) helps to recruit collapsed alveoli, improve oxygenation, and decrease the risk of barotrauma by keeping the alveoli open throughout the respiratory cycle. Therefore, the most appropriate ventilator settings to minimize the risk of VILI in a COPD patient with acute exacerbation and respiratory failure requiring mechanical ventilation would be low tidal volume and high PEEP.

Correct Answer: B

Rationale: In quantitative research, randomness plays a crucial role in eliminating bias. Random sampling ensures that every individual or element in the population has an equal chance of being selected for the study. This helps in reducing the possibility of bias creeping into the results due to selective sampling or favoritism towards certain groups. By using random sampling methods, researchers can increase the generalizability of their findings and have a higher level of confidence that the results are unbiased and representative of the entire population. Therefore, randomness is a key mechanism to eliminate bias in quantitative research studies.

Correct Answer: A

Rationale: The priority nursing action for a woman diagnosed with uterine rupture during labor is to prepare for immediate cesarean section. Uterine rupture is a serious obstetric emergency that can lead to severe maternal and fetal complications, including hemorrhage, fetal distress, and injury to both mother and baby. A cesarean section is necessary to deliver the baby promptly and address any potential complications, such as controlling bleeding and ensuring the safety of both the mother and the baby. Time is critical in these situations, and prompt surgical intervention is essential to optimize outcomes. Administering intravenous oxytocin or assisting the mother into a hands-and-knees position would not address the immediate risks associated with uterine rupture. Initiating cardiopulmonary resuscitation (CPR) is only necessary if the mother's condition deteriorates to the point of cardiac or respiratory arrest, which may occur as a result of significant hemorrhage or other complications associated with uterine

Correct Answer: C

Rationale: When a patient with terminal cancer experiences dyspnea (difficulty breathing) and anxiety, opioid medications are often prioritized by palliative care providers for symptom management. Opioids are effective in relieving dyspnea by acting as respiratory depressants and reducing the feeling of air hunger. Additionally, opioids have sedative effects that can help alleviate anxiety and promote relaxation. Therefore, in this situation, prescribing opioid medications would be the most appropriate intervention to address both the dyspnea and anxiety symptoms simultaneously. Oxygen therapy, relaxation techniques, and breathing exercises may also be useful adjunctive interventions, but opioid medications are typically prioritized for immediate symptom relief in this context.

Correct Answer: D

Rationale: An example of what can be elicited from a social history is how the disease started. This statement is true because a social history typically includes information about factors such as the onset of the illness, the child's living environment, family dynamics, and any recent events that may have contributed to the child's current condition. Understanding how the disease started can provide valuable insights into possible triggers or underlying causes, helping healthcare providers develop an appropriate treatment plan. A comprehensive social history is essential for providing holistic care to the child and addressing all relevant factors that may impact their health and well-being.

Correct Answer: A

Rationale: The presentation of chest pain, dyspnea, hypotension, right ventricular dilation, and hypokinesis on echocardiogram is highly suggestive of a pulmonary embolism. In pulmonary embolism, a blood clot obstructs the pulmonary artery or one of its branches, leading to increased pressure in the right ventricle, which can cause right ventricular dilation and dysfunction. This results in the classic signs of right heart strain on echocardiogram. The patient may also present with symptoms of acute right heart failure, such as chest pain, dyspnea, and signs of hypotension. It is crucial to consider pulmonary embolism as a potential cause of these symptoms, given the high morbidity and mortality associated with this condition.

Correct Answer: B

Rationale: The nurse's priority action when noticing an abnormal heart rhythm on the patient's cardiac monitor during surgery is to assess the patient's vital signs and symptoms. This is important because the nurse needs to gather more information about the patient's condition to determine the significance of the abnormal rhythm and the potential impact on the patient's health. By assessing the vital signs and symptoms, the nurse can obtain a more complete picture of the situation and make informed decisions about the next steps in caring for the patient. Once the assessment is done, appropriate actions such as administering medication or notifying the anesthesiologist can be taken based on the findings.