A patient with a history of chronic liver disease presents with ecchymoses, mucosal bleeding, and altered mental status. Laboratory tests reveal prolonged PT and aPTT, low fibrinogen levels, and elevated D-dimer. Which of the following conditions is most likely to cause these findings?

Correct Answer: B

Rationale: The correct answer is B: Disseminated intravascular coagulation (DIC). In DIC, there is widespread activation of coagulation leading to consumption of clotting factors, resulting in prolonged PT and aPTT, low fibrinogen levels, and elevated D-dimer. This pattern matches the laboratory findings in the patient. In liver cirrhosis (choice A), there is a decrease in clotting factors synthesis, leading to prolonged PT but not aPTT. Hemophilia A (choice C) is a genetic disorder that affects specific clotting factors, typically leading to prolonged aPTT but not PT. Vitamin K deficiency (choice D) impairs the synthesis of clotting factors, leading to prolonged PT but not aPTT and low levels of factors II, VII, IX, and X.

Correct Answer: D

Rationale: The correct answer is D: Ventricular tachycardia. Ventricular tachycardia is a serious arrhythmia that can lead to palpitations, dizziness, and syncope due to the rapid and abnormal heart rhythm originating in the ventricles. This arrhythmia can be life-threatening if not promptly treated. A: Stable angina is characterized by chest discomfort or pain due to reduced blood flow to the heart muscle, usually during physical exertion or stress. It does not typically present with palpitations, dizziness, or syncope. B: Unstable angina is a more severe form of angina where symptoms occur even at rest. While it can lead to serious complications like heart attack, it does not commonly present with palpitations, dizziness, or syncope. C: Atrial fibrillation is a common arrhythmia originating in the atria, leading to an irregular and often rapid heartbeat. While it can cause palpitations and dizziness,

Correct Answer: C

Rationale: The correct answer is C because checking the completeness of the charting by doctors and nurses ensures that all necessary information is accurately documented, facilitating proper patient care and treatment. This step helps identify any missing or incorrect information that may impact patient safety. A: Storing the charts in respective shelves is a routine task that does not involve verifying the accuracy or completeness of the information. B: Separating medico-legal charts is important but does not directly address the completeness of charting by doctors and nurses. D: Binding the charts immediately is not necessary before ensuring the completeness and accuracy of the information documented.

Correct Answer: A

Rationale: Correct Answer: A Rationale: 1. Confirming the patient's identity ensures the right patient is receiving the intended procedure. 2. Verifying the procedure site using two identifiers prevents errors in site selection. 3. This step aligns with the World Health Organization's Surgical Safety Checklist, reducing the risk of wrong-site procedures. 4. Positioning, sedation, and local anesthesia are important but secondary to ensuring the correct patient and site. Summary: - Option B: Positioning is essential but not the top priority for procedural accuracy. - Option C: Sedation aims to minimize discomfort but does not guarantee procedural accuracy. - Option D: Administering local anesthesia is crucial but not as critical as confirming patient identity and procedure site.

Correct Answer: D

Rationale: The correct answer is D because a journal article about a study using large, previously unpublished databases is a primary source as it presents original research findings firsthand. It contributes new knowledge to the field. A textbook (A) compiles existing information, not original research. A doctoral dissertation (B) critiques research but is not a primary source. A published commentary (C) interprets others' findings, making it a secondary source.

Correct Answer: C

Rationale: The most appropriate nursing action in this situation is to notify the healthcare provider immediately. The client presenting with persistent, severe perineal pain and swelling, along with ecchymosis and tenderness of the perineum, could be indicative of complications such as a perineal hematoma. A perineal hematoma is a collection of blood in the perineal tissues and can be a serious postpartum complication requiring prompt medical attention. Therefore, it is crucial to alert the healthcare provider so that appropriate assessment, management, and treatment can be initiated promptly. Applying ice packs or encouraging the client to sit on a donut cushion may not be sufficient in this situation, and administering additional analgesic medication should be done only after the healthcare provider has assessed and determined the cause of the symptoms.

Correct Answer: A

Rationale: The correct answer is A: Scabies. This presentation is classic for scabies infestation caused by the Sarcoptes scabiei mite. The intensely pruritic linear burrows are pathognomonic. Close contact with an individual with scabies increases the likelihood of transmission. The other choices, B: Pediculosis, C: Tinea corporis, and D: Contact dermatitis, do not typically present with linear burrows on the hands and wrists. Pediculosis presents with lice infestation, Tinea corporis with circular lesions, and contact dermatitis with erythema and edema.

Correct Answer: B

Rationale: The correct answer is B: Smoking cessation. Smoking is the leading cause of lung cancer, so quitting smoking is crucial in preventing and improving survival rates. Smoking cessation reduces the risk of developing lung cancer and improves treatment outcomes. High-dose chemotherapy (A) may be part of the treatment plan, but quitting smoking is more impactful. Early bronchoscopy (C) and early detection (D) are important, but without addressing the root cause (smoking), the survival rates will not significantly increase.

Correct Answer: D

Rationale: The correct answer is D, Broad opening. Nurse Rica should use this communication technique to encourage the patient to freely express themselves without leading or interrupting. This technique helps build rapport and trust, setting a positive tone for the conversation. A: Clarifying may be too direct and might make the patient feel pressured. B: Challenging can create defensiveness and hinder open communication. C: Restating may not be as effective in initiating a conversation as broad opening. In summary, broad opening allows for a more open and relaxed conversation, fostering a conducive environment for effective communication with the patient.