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: B

Rationale: For a displaced femoral neck fracture, the most appropriate surgical procedure is usually an open reduction and internal fixation (ORIF). This procedure involves making an incision to reposition the fractured bone fragments and securing them in place with screws or other fixation devices. ORIF allows for better alignment of the fracture, which is crucial for proper healing and minimizing the risk of complications like avascular necrosis or nonunion. Closed reduction and internal fixation (CRIF) may not be as effective for displaced femoral neck fractures due to the complex nature of the fracture and the need for precise realignment and stability provided by an open surgical approach. External fixation is less commonly used for femoral neck fractures and is typically reserved for certain specific cases where internal fixation is not feasible. Closed reduction alone is unlikely to provide adequate stability for a displaced femoral neck fracture and is generally not recommended as the primary surgical treatment for this type of injury.

Correct Answer: C

Rationale: The nurse should reposition the patient to alleviate pressure on vulnerable areas. Pressure injuries can develop when there is prolonged pressure on specific areas of the skin, leading to reduced blood flow and tissue damage. Repositioning the patient helps to relieve the pressure and prevent the development of pressure injuries. Applying a pressure-relieving device may also be helpful, but the immediate action should be to reposition the patient to address the issue. Documenting the observation is important for documentation purposes, but the priority is to take action to prevent harm to the patient. Continuing with the positioning as planned without addressing the inadequate skin protection could lead to the development of pressure injuries, which should be avoided.

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: C

Rationale: In this situation, the most appropriate way for the nurse to handle it would be to encourage the mother to keep calm because the health care team is doing their best to help Ramon recover. This response acknowledges the mother's concerns and reassures her that everything possible is being done for her son's well-being. It also helps to foster trust and rapport between the nurse, mother, and the healthcare team, which is important for effective communication and support during a challenging time. Promoting a sense of calm and trust in the healthcare professionals can help alleviate the mother's anxiety and stress, allowing her to focus on being a supportive presence for her son.

Correct Answer: C

Rationale: The theory of Nursing as Caring was developed by Dr. Jean Watson, a renowned nurse theorist and professor. Watson's Theory of Human Caring focuses on the importance of the nurse-patient relationship, emphasizing the significance of caring in promoting healing and promoting holistic well-being. This theory emphasizes the humanistic aspects of nursing care and highlights the nurse's role in fostering a caring environment that encompasses physical, emotional, social, and spiritual dimensions. Watson's theory emphasizes the importance of empathy, compassion, and authentic presence in nursing practice, making it a valuable framework for guiding nursing care and promoting healing outcomes.

Correct Answer: A

Rationale: A woman experiencing irregular and ineffective uterine contractions with prolonged cervical dilation may indicate labor dystocia, also known as abnormal labor progression. To address this issue, the nursing intervention that should be implemented is to encourage the mother to ambulate and change positions frequently. This can help optimize fetal positioning and encourage descent through the birth canal by using gravity to aid in the progression of labor. Changing positions can also potentially improve the quality and effectiveness of contractions, leading to more successful cervical dilation and labor progress. Encouraging ambulation and position changes are non-invasive, patient-centered interventions that can be helpful in managing labor dystocia before considering more invasive interventions like cesarean section.

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: A

Rationale: The patient's presentation of sudden-onset, painless vision loss in the right eye, along with a cherry-red spot at the macula and attenuated retinal vessels, is classic for central retinal artery occlusion (CRAO). In CRAO, there is a sudden blockage of the central retinal artery, leading to ischemia of the retina. The cherry-red spot represents the preserved choroid blood flow against the ischemic retina. The attenuated retinal vessels are a result of decreased blood flow in the retinal circulation. This condition is considered an ophthalmic emergency and requires immediate evaluation and management to prevent permanent vision loss.