A pregnant woman presents with sudden onset of severe abdominal pain and vaginal bleeding. On examination, her abdomen is rigid, and fetal parts are palpable abdominally. Which of the following conditions is the most likely cause of these symptoms?

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: The behavior of repetitive cleaning in someone diagnosed with obsessive-compulsive disorder is likely an attempt to decrease the anxiety to a tolerable level. People with OCD often engage in compulsive behaviors, such as cleaning, in an effort to alleviate the distress and anxiety caused by obsessive thoughts. This repetitive action provides a sense of control and temporary relief from the anxiety associated with their obsessive thoughts. By engaging in cleaning rituals, individuals with OCD can try to reduce their anxious feelings and create a sense of order and cleanliness in their environment.

Correct Answer: C

Rationale: Rapid capillary refill is a sign indicative of shock in a trauma patient. Shock is a life-threatening condition where the body's organs and tissues do not receive adequate blood flow and oxygen, leading to cellular damage and eventual organ failure. In a trauma patient, rapid capillary refill suggests poor perfusion, which is a common feature of shock. The capillary refill time is an important clinical assessment that measures the time it takes for color to return to the nail bed after pressure is applied. In cases of shock, the refill time is faster than normal, indicating a systemic circulatory disturbance. Other signs of shock may include tachycardia (increased heart rate), hypotension (not hypertension), and hypothermia (not hyperthermia).

Correct Answer: A

Rationale: Molluscum contagiosum is a viral skin infection caused by the poxvirus. It commonly presents as flesh-colored, dome-shaped papules with central umbilication on the face, trunk, and extremities. The central umbilication indicates the presence of a crater-like indentation in the center of the lesion. It is a benign condition and usually self-limited, but it can be persistent and contagious. Treatment options include cryotherapy, curettage, topical therapies, and observation. Acne vulgaris presents with comedones, papules, pustules, and nodules primarily on the face, chest, and back. Sebaceous hyperplasia is characterized by yellowish papules with central dell on the face. Basal cell carcinoma typically presents as a pearly papule with telangiectasias and may have ulceration or bleeding.

Correct Answer: C

Rationale: Erythropoietin-stimulating agents (ESAs) are prescribed to manage anemia in patients with chronic kidney disease. Monitoring the hemoglobin level closely during ESA therapy is crucial to ensure that the treatment is effective in increasing red blood cell production without causing excessive elevation. Hemoglobin levels should be checked regularly to adjust the ESA dosage accordingly and prevent risks associated with high hematocrit levels, such as increasing blood viscosity and cardiovascular events. Monitoring serum potassium, creatinine, and platelet count are important in the management of chronic kidney disease for different reasons, but for ESA therapy, monitoring hemoglobin is the most essential parameter.

Correct Answer: B

Rationale: The patient's presentation of severe headache, blurred vision, and fatigue, along with the laboratory findings of elevated white blood cell count, thrombocytosis, and JAK2 V617F mutation, are characteristic of essential thrombocythemia. This is a myeloproliferative neoplasm characterized by the clonal proliferation of megakaryocytes, leading to an increased platelet count. The JAK2 V617F mutation is commonly found in essential thrombocythemia and other myeloproliferative disorders. The symptoms of essential thrombocythemia can be related to the increased blood viscosity and risk of thrombosis due to the elevated platelet count. Polycythemia vera would present with elevated red blood cell count, hemoglobin, and hematocrit, along with other features such as pruritus after a hot bath. Chronic myeloid leukemia (CML

Correct Answer: C

Rationale: Benzodiazepines are commonly prescribed for the management of insomnia due to their sedative effects. One of the most common adverse effects of benzodiazepines is daytime drowsiness, which can impair the patient's ability to function normally during the day. Monitoring the patient closely for daytime drowsiness is important to ensure their safety and well-being, as it can affect their daily activities and increase the risk of accidents or falls. It is essential for the nurse to educate the patient on the potential for daytime drowsiness and advise them to avoid activities that require full alertness, such as driving or operating heavy machinery, until they know how the medication affects them. If the patient experiences severe or persistent daytime drowsiness, the healthcare provider may need to adjust the dosage or consider alternative treatment options.

Correct Answer: A

Rationale: The priority intervention in managing acute pancreatitis is to administer intravenous fluids to maintain adequate hydration. Acute pancreatitis can lead to significant fluid loss and dehydration due to factors such as vomiting and third-spacing of fluids into the retroperitoneal space. Adequate hydration helps to optimize perfusion to the pancreas, prevent hypovolemic shock, and support overall organ function. This intervention also aids in flushing out inflammatory mediators and preventing complications such as acute kidney injury. Monitoring fluid status and adjusting the rate of intravenous fluid administration based on the patient's response is crucial in the management of acute pancreatitis. While other interventions such as imaging studies, nutritional support, and gastric acid suppression may be important in managing acute pancreatitis, ensuring adequate hydration is the most critical initial step.

Correct Answer: A

Rationale: A retrospective audit involves reviewing past cases or data to evaluate processes, outcomes, or compliance with standards. In this scenario, the nursing team plans to audit post-op patients who developed pressure sores over the past year at the Orthopedic unit. By looking at historical data from the past year, the audit is considered retrospective as it assesses what has occurred over a specified period. This type of audit helps identify trends, patterns, and areas for improvement based on past events.