A patient presents with swelling of the ankles, dyspnea on exertion, and orthopnea. An echocardiogram reveals decreased left ventricular ejection fraction and dilated left ventricle. Which cardiovascular disorder is most likely responsible for these symptoms?

Correct Answer: C

Rationale: The patient's presentation of swelling of the ankles, dyspnea on exertion, and orthopnea is highly suggestive of heart failure. The echocardiogram findings of decreased left ventricular ejection fraction and dilated left ventricle are characteristic of heart failure with reduced ejection fraction (HFrEF), also known as systolic heart failure. In this condition, the heart's ability to pump blood effectively is compromised, leading to symptoms of congestion and decreased cardiac output. The decreased ejection fraction indicates that the heart is not able to efficiently pump out blood with each contraction. Dilatation of the left ventricle is a compensatory mechanism in response to increased volume overload.

Correct Answer: C

Rationale: Excessive bleeding during a surgical procedure is a critical situation that requires immediate attention. The surgeon should be notified promptly so that appropriate interventions can be initiated to control the bleeding, such as applying pressure, administering hemostatic agents, or performing additional surgical measures. The surgeon is ultimately responsible for addressing the source of bleeding and ensuring the patient's safety during the procedure. It is important for the nurse to communicate effectively and collaborate with the surgical team to manage the situation efficiently and effectively.

Correct Answer: B

Rationale: The primary purpose of interdisciplinary collaboration in nursing practice is to improve communication and coordination of patient care. When healthcare providers from different disciplines work together as a team, they can share their unique perspectives, knowledge, and skills to develop comprehensive care plans that address all aspects of a patient's well-being. This collaborative approach helps ensure that the patient receives holistic and coordinated care, leading to better outcomes and patient satisfaction. Effective communication and coordination among team members also help prevent errors, reduce duplication of efforts, and promote efficient use of resources. Overall, interdisciplinary collaboration is essential for delivering high-quality, patient-centered care in healthcare settings.

Correct Answer: A

Rationale: Calcium carbonate should be taken with meals because it requires the presence of stomach acid to be properly absorbed. Taking it with meals helps ensure optimal absorption and effectiveness as a phosphate binder in patients with chronic kidney disease. Administering calcium carbonate on an empty stomach may lead to gastrointestinal side effects such as upset stomach, bloating, and constipation. Taking it with a full glass of water is also recommended to help prevent potential gastrointestinal issues and to ensure proper hydration. Crushing tablets before administration is not advised unless specifically instructed by a healthcare provider, as it can alter the drug's release and absorption properties.

Correct Answer: A

Rationale: Endometriosis is the most likely condition responsible for the symptoms described in this scenario. Endometriosis is a chronic condition in which endometrial-like tissue grows outside the uterus, commonly affecting the pelvic structures such as the ovaries, fallopian tubes, and pelvic peritoneum. The main symptoms include cyclic pelvic pain, dysmenorrhea (painful periods), and dyspareunia (pain during intercourse). The retroverted and fixed uterus on examination may be due to adhesions from endometriosis, causing the uterus to be fixed in position. Endometriosis should be considered in women of reproductive age presenting with these symptoms and pelvic examination findings.

Correct Answer: B

Rationale: Ectopic pregnancy is a common complication of untreated gonorrhea or chlamydia infection in women. This occurs when a fertilized egg implants and grows outside the uterus, typically in one of the fallopian tubes. Both gonorrhea and chlamydia can lead to scarring of the fallopian tubes due to untreated inflammation and infection. This scarring may obstruct the fallopian tubes, making it difficult for the fertilized egg to travel to the uterus for implantation. As a result, the egg may implant and grow in the fallopian tube, leading to an ectopic pregnancy. Ectopic pregnancies are dangerous and can result in serious complications for the woman, including rupture of the fallopian tube, internal bleeding, and potentially life-threatening situations. It is crucial to seek prompt treatment for gonorrhea and chlamydia to prevent such severe outcomes.

Correct Answer: C

Rationale: Uterine rupture is the most likely cause of these symptoms in a pregnant woman presenting with sudden onset of severe abdominal pain, vaginal bleeding, rigidity of the abdomen, and palpable fetal parts abdominally. Uterine rupture is a rare but serious complication of pregnancy, typically occurring during labor in women with a previous cesarean delivery or other uterine scars. The sudden onset of severe abdominal pain can be associated with vaginal bleeding due to the tearing of the uterine wall, causing fetal parts to be palpable abdominally. This is a life-threatening emergency that requires immediate medical intervention. Ectopic pregnancy, pelvic inflammatory disease, and ovarian torsion may present with abdominal pain and vaginal bleeding but would not typically present with palpable fetal parts abdominally in a pregnant woman.

Correct Answer: A

Rationale: Menopause is the most important risk factor for osteoporosis because it leads to a decrease in estrogen levels, which plays a crucial role in maintaining bone density. After menopause, women are at a higher risk of developing osteoporosis due to loss of estrogen's protective effects on bone mass. Other risk factors like history of previous fracture, being male, and short stature can also contribute to osteoporosis, but menopause has the strongest association with the development of the condition. It is essential for postmenopausal women to be aware of this risk factor and take preventive measures such as regular exercise, adequate calcium and vitamin D intake, and appropriate medical evaluation and treatment as needed.

Correct Answer: C

Rationale: Children with ADHD often display hyperactive and impulsive behaviors, such as excessive running, climbing, and fidgeting. These behaviors are characteristic symptoms of the hyperactive-impulsive subtype of ADHD. Children with ADHD may struggle to sit still, have difficulty engaging in quiet activities, and often seem on the go. Therefore, the nurse would expect to see signs of excessive movement and restlessness in a child with ADHD.