A pregnant woman presents with vaginal bleeding and crampy abdominal pain at 22 weeks gestation. On examination, the cervix is dilated, and the amniotic sac is visible at the cervical os. Which of the following conditions is the most likely cause of these symptoms?

Correct Answer: D

Rationale: Incompetent cervix, also known as cervical insufficiency, is the most likely cause of the symptoms described. Incompetent cervix is a condition where the cervix begins to dilate and efface prematurely, typically in the second trimester, without contractions or labor. This can lead to painless cervical dilation and bulging of the amniotic sac into the vagina, which can cause vaginal bleeding and crampy abdominal pain. It is a leading cause of second-trimester pregnancy loss. Treatment may involve a cervical cerclage, a surgical procedure where the cervix is stitched closed to provide additional support.

Correct Answer: D

Rationale: Postpartum hemorrhage is defined as a blood loss of more than 500 ml within the first 24 hours after vaginal delivery or more than 1000 ml following a cesarean delivery. Excessive bleeding can lead to hypovolemic shock and can be life-threatening if not promptly addressed. Therefore, a blood loss of more than 500 ml/24 hours would lead the nurse to suspect a postpartum hemorrhage and prompt further assessment and intervention.

Correct Answer: B

Rationale: The primary objective of a birth plan is to provide a pregnant woman the opportunity to outline her wishes and preferences regarding her labor, delivery, and postpartum care. It allows the mother-to-be to communicate her desires to the healthcare team in advance, ensuring that her preferences are considered and respected during the birthing process. A birth plan typically covers various aspects such as pain management options, who she wants present during labor, interventions she may want to avoid, plans for after birth care, and any other specific requests she may have. Ultimately, a birth plan aims to empower the woman to have a more personalized and satisfying birth experience by actively involving her in the decision-making process.

Correct Answer: D

Rationale: Regular health check-ups play a crucial role in the prevention, early detection, and management of health issues, especially for the elderly. By ensuring that the elderly receive regular health check-ups, healthcare providers can monitor their health status, detect any potential health problems early on, and provide appropriate medical interventions. This proactive approach can help protect the elderly from developing serious health issues or complications. Additionally, regular health check-ups can also promote overall health and well-being, allowing healthcare professionals to address any existing health concerns and provide necessary treatments or recommendations to maintain the elderly's health and quality of life.

Correct Answer: B

Rationale: The nurse's best approach to address the patient's fear of pain is to provide accurate information about pain management strategies and options. In doing so, the nurse can help alleviate the patient's concerns by empowering them with knowledge and potential solutions for managing pain during and after the procedure. By acknowledging the patient's fear and addressing it with practical information, the nurse can build trust, reduce anxiety, and create a more supportive and collaborative environment for the patient. Dismissing, ignoring, or invalidating the patient's fear would not be effective in addressing the underlying concerns and could potentially lead to increased distress and resistance to the recommended procedure.

Correct Answer: C

Rationale: The hypothalamus is the link between the nervous system and the endocrine system. It plays a crucial role in maintaining homeostasis in the body by communicating with the pituitary gland, which is often referred to as the "master gland" of the endocrine system. The hypothalamus produces hormones that regulate the release of hormones from the pituitary gland, which then controls the functions of other endocrine glands throughout the body. This connection allows the nervous system to influence and coordinate various hormonal responses in the body, helping to regulate processes such as metabolism, growth, stress responses, and reproduction.

Correct Answer: B

Rationale: Record-keeping is not an optional task; it is a critical aspect of professional nursing practice. As a nurse, maintaining accurate and timely records is essential for providing quality care, ensuring legal and ethical standards are met, and promoting patient safety. Failure to keep thorough records can lead to serious consequences such as compromising patient care, violating regulations, and even facing legal consequences. Thus, record-keeping should be seen as a mandatory part of the professional duty of nurses rather than an optional task that can be done when circumstances allow.

Correct Answer: C

Rationale: Meperidine (Demerol) is an opioid analgesic. Overdose of Meperidine can lead to respiratory depression, characterized by slow and shallow breathing. As a result of respiratory depression, hypercapnia, which is an increased level of carbon dioxide in the blood, can occur. This is a serious concern and requires immediate medical intervention to support respiratory function. Therefore, hypercapnia would be the assessment by the nurse that causes a concern for Meperidine overdose.

Correct Answer: B

Rationale: The most effective treatment for addressing the underlying pathophysiology of cystic fibrosis (CF) and preventing disease progression is the use of mucolytic agents, such as dornase alfa. CF is a genetic disorder that leads to the production of thick, sticky mucus in the respiratory tract. This mucus buildup can obstruct airways, lead to recurrent infections, and contribute to pulmonary exacerbations. Mucolytic agents work by reducing the viscosity of the mucus, making it easier to clear from the airways. This helps to improve lung function, reduce the frequency of exacerbations, and slow down disease progression in CF patients. Inhaled corticosteroids may be used for managing airway inflammation, but they do not target the underlying mucus production in CF. Antibiotic therapy is important for treating respiratory infections in CF patients, but it does not address the primary