A patient presents with recurrent episodes of deep vein thrombosis (DVT) and pulmonary embolism (PE). Laboratory tests reveal elevated levels of antiphospholipid antibodies (anticardiolipin and lupus anticoagulant). Which of the following conditions is most likely to cause these findings?

Correct Answer: D

Rationale: Antiphospholipid syndrome is characterized by abnormal antiphospholipid antibodies, which can lead to an increased risk of blood clots such as deep vein thrombosis (DVT) and pulmonary embolism (PE). The two most common antiphospholipid antibodies are anticardiolipin and lupus anticoagulant. Patients with antiphospholipid syndrome can present with recurrent thrombotic events, such as DVT and PE, due to the pro-thrombotic effects of these antibodies. Protein C deficiency, Protein S deficiency, and Antithrombin III deficiency are other causes of hypercoagulability but would not typically present with elevated antiphospholipid antibodies.

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.

Correct Answer: B

Rationale: Uterine hyperstimulation, also known as tachysystole, is a condition characterized by frequent and intense uterine contractions with minimal rest intervals. This can lead to maternal fatigue and decreased fetal oxygenation due to the insufficient time for the uterus to relax and refill with oxygenated blood between contractions. Uterine hyperstimulation can be caused by various factors such as excessive use of uterotonics (oxytocin or prostaglandins), improper labor induction techniques, or maternal conditions like previous uterine surgery. It is essential for the nurse to assess for signs of uterine hyperstimulation and take appropriate interventions to prevent potential complications for both the mother and the baby.

Correct Answer: C

Rationale: Primary health care encompasses a wide range of essential health services. While services such as the use of appropriate technology, safe water supply, and maternal child care are components of primary health care, providing free medicines is not typically considered a core element. Primary health care emphasizes accessibility, affordability, and basic health services, but free medicines may not always be sustainable or feasible in every healthcare setting. Patients may be required to pay for medications, utilize health insurance, or receive medications through public health programs, rather than always receiving them for free.

Correct Answer: C

Rationale: Sudden, severe chest pain and dyspnea in a postpartum client could be indicative of a potential serious condition, such as a pulmonary embolism or postpartum cardiomyopathy, which require immediate medical attention. Therefore, the most appropriate nursing action would be to notify the healthcare provider immediately for further evaluation and management. Placing the client in a semi-Fowler's position may provide some comfort but does not address the underlying cause of the symptoms. Administering supplemental oxygen therapy may be necessary once the healthcare provider assesses the client. Encouraging deep breathing exercises may not be appropriate if the client is experiencing severe chest pain and dyspnea, as it could worsen the situation.

Correct Answer: D

Rationale: Scabies is caused by an infestation of the microscopic mite Sarcoptes scabiei. This parasitic mite burrows into the upper layer of the skin, where it lays eggs and causes intense itching and skin irritation. The transmission of scabies usually occurs through close and prolonged skin-to-skin contact with an infested person. Unlike viruses, bacteria, and fungi, which are microorganisms that can also cause skin infections, scabies specifically refers to an infestation by a parasitic mite.

Correct Answer: B

Rationale: The nurse should monitor the International Normalized Ratio (INR) closely during anticoagulant therapy for the prevention of VTE. The INR measures the clotting ability of the blood and is used to monitor the effectiveness of anticoagulant therapy, such as warfarin. Maintaining the INR within the target therapeutic range is crucial to prevent both excessive bleeding due to over-anticoagulation and clotting events due to under-anticoagulation. Close monitoring of the INR helps healthcare providers adjust the anticoagulant dosage as needed to ensure optimal therapeutic outcomes and minimize risks. Platelet count, serum sodium levels, and blood urea nitrogen (BUN) are important laboratory parameters to monitor for other medical conditions but are not specific to anticoagulant therapy.

Correct Answer: A

Rationale: A normal thyroid state is referred to as euthyroid, which means the thyroid gland is functioning within normal parameters and the levels of thyroid hormones in the body are balanced. In contrast, hyperthyroid refers to an overactive thyroid gland, causing excessive production of thyroid hormones, while parathyroid is a different gland responsible for regulating calcium levels in the body. Panthroid is not a recognized medical term related to thyroid function. Therefore, the best response to the patient's question about the normal thyroid state is "Euthyroid."

Correct Answer: A

Rationale: When planning for a client's care, a primary consideration is to prevent problems related to immobility. Immobility can lead to a range of complications such as pressure ulcers, muscle weakness, joint contractures, and decreased circulation. To maintain the client's overall health and well-being, it is essential to address mobility issues and implement strategies to prevent complications associated with immobility. By prioritizing interventions that promote movement and prevent immobility-related problems, the client's quality of life can be improved and potential health risks mitigated.