A patient presents with multiple, flesh-colored, papular lesions with a central dell on the face and trunk. The lesions have a tendency to bleed upon minor trauma and have been increasing in number over time. Which of the following conditions is most likely responsible for this presentation?

Correct Answer: A

Rationale: The description of multiple flesh-colored papular lesions with a central dell that tend to bleed upon minor trauma and have been increasing in number over time is characteristic of basal cell carcinoma. Basal cell carcinoma is the most common type of skin cancer and typically presents as pearly or flesh-colored papules with telangiectasias (tiny blood vessels) and a characteristic central dell or ulceration. This type of skin cancer often occurs on sun-exposed areas like the face and trunk and can manifest as slow-growing lesions that may bleed easily with minor trauma. In contrast, squamous cell carcinoma typically presents as a scaly or crusted lesion, seborrheic keratosis is a benign skin growth with a waxy, stuck-on appearance, and actinic keratosis is a precancerous lesion characterized by rough, scaly patches on sun-exposed areas.

Correct Answer: D

Rationale: It is NOT recommended to use the same syringe and needle in administering two different vaccines. This is to prevent contamination or mixing of different vaccines, which could potentially affect their effectiveness or pose a risk to the individual receiving the vaccines. It is important to use separate syringes and needles for each vaccine to ensure proper administration and prevent any adverse reactions.

Correct Answer: D

Rationale: The purpose of record keeping in healthcare is primarily to ensure quality health care. Maintaining accurate and up-to-date records of patient information, including medical history, treatments, medications, and test results, allows healthcare providers to make informed decisions about patient care. Access to complete and organized records helps in providing timely and effective treatments, reducing errors, and ensuring continuity of care. By tracking and documenting patient care, healthcare professionals can assess outcomes, monitor progress, and improve overall quality of healthcare services. Additionally, thorough record keeping also supports communication between healthcare providers and facilitates coordination of care across different healthcare settings.

Correct Answer: A

Rationale: Utilitarianism is an ethical theory that focuses on producing the greatest overall balance of good over bad consequences for everyone involved. In the context of the situation described, nurses being floated to areas of most need during a nursing shortage is an example of utilitarianism in action. The decision to float nurses is aimed at maximizing the benefit to the greatest number of patients by ensuring that critical care is provided where it is most needed, even if it may cause inconvenience or discomfort to the nurses being floated. This decision aligns with the principle of maximizing overall utility and promoting the greater good, which are central tenets of utilitarianism.

Correct Answer: B

Rationale: Patient's uterine contractions lasting 70 seconds and occurring every 90 seconds signify hyperstimulation, which can be a serious complication associated with oxytocin administration. This may result in decreased uterine perfusion, fetal distress, and other adverse effects. The first action should be to discontinue the oxytocin infusion to prevent further complications and allow the uterus to relax. Observations and assessment should continue to monitor the patient's condition and response after discontinuing the infusion. Giving an emergency bolus of oxytocin or increasing the IV infusion rate would exacerbate the hyperstimulation, and turning the client to her left side and breathing deeply would not address the underlying issue of oxytocin-induced hyperstimulation.

Correct Answer: C

Rationale: Used wet diapers and gloves should be disposed of in a black waste bin. Black waste bins are designated for general waste, which includes non-infectious materials that do not pose a risk of infection to others. Wet diapers and gloves fall under this category as they are considered non-infectious waste. Proper disposal in the black bin helps in maintaining cleanliness and hygiene in the healthcare setting.

Correct Answer: B

Rationale: In a pregnant woman presenting with severe abdominal pain and vaginal bleeding at 8 weeks gestation with a closed cervix, the most likely cause of these symptoms is a threatened abortion. A threatened abortion is a common complication of early pregnancy characterized by vaginal bleeding and lower abdominal pain without cervical dilation. The cervix remains closed, indicating that the pregnancy is still intact but at risk of potential miscarriage. Placenta previa typically presents with painless vaginal bleeding in the second or third trimester, whereas ectopic pregnancy usually presents with abdominal pain and vaginal bleeding in the setting of a closed cervix but is less likely at 8 weeks gestation. Gestational trophoblastic disease is a rare cause of vaginal bleeding in pregnancy and typically presents in the first trimester with signs of hyperemesis gravidarum, uterine enlargement, and elevated β-hCG levels.

Correct Answer: C

Rationale: The nurse should prioritize checking the patency of the NG tube by aspirating gastric contents before initiating tube feeding. This is important to ensure that the NG tube is in the correct position and that it is functioning properly. By aspirating gastric contents, the nurse can confirm that the tube is in the stomach and not in the lungs or surrounding tissues. If no gastric contents are obtained upon aspiration, it may indicate that the tube is not properly placed or may be occluded, which would require further assessment and intervention before proceeding with tube feeding. Checking the patency of the NG tube is a crucial step in ensuring the safety and effectiveness of enteral nutrition delivery.

Correct Answer: B

Rationale: The most critical action to prioritize for ensuring patient safety during a cardiopulmonary exercise stress test is to monitor the patient's electrocardiogram (ECG) rhythm continuously during the test (Option B). This monitoring allows the healthcare team to promptly detect any abnormal heart rhythms or signs of cardiac distress, enabling timely intervention if necessary. Continuous ECG monitoring is essential during exercise testing as it helps in assessing the heart's response to physical activity and identifying any potential cardiac abnormalities or complications that may arise during the test. By closely monitoring the ECG rhythm, the nurse can ensure the patient's safety and well-being throughout the procedure. Administering a beta-blocker medication before the test (Option A) may be indicated in some cases but is not as crucial as continuous ECG monitoring during the test. Encouraging the patient to consume a heavy meal before the test (Option C) is contraindicated as it can interfere with the accuracy of the results