A woman in active labor demonstrates persistent fetal malpresentation, with the fetus in a transverse lie position. What nursing intervention should be prioritized to address this abnormal labor presentation?

Correct Answer: C

Rationale: In cases of persistent fetal malpresentation, such as a transverse lie position, a cesarean section is often the safest and most effective intervention to address the abnormal labor presentation. Delivering a baby in a transverse lie position vaginally is associated with high risks, including fetal complications such as umbilical cord prolapse and head entrapment. Therefore, to ensure the safety of both the mother and the baby, a cesarean section is usually the most appropriate and timely intervention to address this situation. It is crucial to prioritize the immediate preparation and facilitation of a cesarean section in cases of persistent fetal malpresentation to prevent potential complications and ensure the best outcome for the mother and the baby.

Correct Answer: D

Rationale: In-service training programs are specifically designed to provide continuing education and professional development for employees within a particular organization, in this case, a hospital. These programs are tailored to meet the needs of the staff and enhance their skills and knowledge within their work environment. Since the CPD program in the tertiary hospital is aimed at enriching and supporting the growth of the nurses' knowledge and expertise within the hospital setting, it falls under the category of an in-service training program.

Correct Answer: A

Rationale: Administering intravenous fluids as ordered is the most appropriate nursing action for a postpartum client exhibiting signs of severe dehydration. Severe dehydration, as indicated by dry mucous membranes, decreased skin turgor, and oliguria, requires immediate intervention to restore fluid balance effectively. Intravenous fluids deliver fluids directly into the bloodstream, ensuring rapid rehydration and addressing the critical situation promptly. Offering oral rehydration solutions may not be sufficient to address severe dehydration, and providing education on fluid intake can be important for prevention but is not the immediate priority in this scenario. Notifying the healthcare provider is essential, but initiating intravenous fluids promptly is crucial in managing severe dehydration.

Correct Answer: D

Rationale: When a patient is crying and continuously pulling at a specific body part, such as Catherine pulling her right ear, it indicates discomfort or pain in that area. Nurse Selma's most appropriate action would be to further assess the description and frequency of the pain. This will help her identify the possible cause of the pain, whether it is due to an ear infection, injury, or any other underlying issue. Understanding the nature and intensity of the pain will guide Nurse Selma in providing appropriate care and intervention for Catherine. It is crucial to address the patient's pain promptly to ensure their comfort and well-being. Referring to the attending physician may be necessary after this initial assessment but assessing the pain should be the immediate priority.

Correct Answer: C

Rationale: Providing oral rehydration with electrolyte solutions is the appropriate action for managing a conscious patient with suspected heat cramps. Heat cramps are muscle pains or spasms that often occur during intense exercise in hot environments when a person sweats excessively, losing both fluids and electrolytes. Replenishing lost fluids and electrolytes through oral rehydration helps address the underlying cause of the cramps and provides relief to the patient. Massaging the affected muscles vigorously can potentially worsen the condition, applying cold packs is not usually recommended for heat-related conditions, and encouraging the patient to continue strenuous activity can lead to further complications.

Correct Answer: B

Rationale: The epigastrium is the upper middle region of the abdomen, lying above the umbilical region and between the hypochondriac regions. It contains several organs including the duodenum, pancreas, portion of the liver, and the pyloric end of the stomach. The duodenum is the first part of the small intestine, the pancreas is a crucial organ for digestion and hormone regulation, the liver aids in digestion and detoxification, and the pyloric end of the stomach connects the stomach to the small intestine for further digestion and absorption of nutrients. These organs are typically assessed and examined when focusing on the epigastrium during a physical examination.

Correct Answer: C

Rationale: Carvedilol is a beta-blocker primarily used to manage heart failure and hypertension. Monitoring blood pressure closely during carvedilol therapy is crucial because it helps assess the drug's effectiveness in managing heart failure and controlling hypertension. Carvedilol works by blocking certain receptors in the heart and blood vessels, which can lower blood pressure. Monitoring blood pressure fluctuations allows healthcare providers to adjust the dosage accordingly to achieve optimal results and prevent potential complications in patients with heart failure. While monitoring blood glucose levels, serum potassium levels, and liver function tests are essential in managing other conditions or medications, the priority in a patient being prescribed carvedilol for heart failure is to monitor blood pressure levels.

Correct Answer: B

Rationale: A living will is a legal document that allows an individual to express their wishes regarding medical treatment in the event they become unable to make decisions. It specifically outlines the medical treatments a person chooses to refuse or accept under certain circumstances. It is important to differentiate a living will from a durable power of attorney, which designates someone to make healthcare decisions on behalf of the individual when they are unable to do so, and advance directives, which encompass both a living will and a durable power of attorney for healthcare. The living will serves as a guide for healthcare professionals and family members to honor the individual's preferences for medical care.

Correct Answer: D

Rationale: An example of what can be elicited from a social history is how the disease started. This statement is true because a social history typically includes information about factors such as the onset of the illness, the child's living environment, family dynamics, and any recent events that may have contributed to the child's current condition. Understanding how the disease started can provide valuable insights into possible triggers or underlying causes, helping healthcare providers develop an appropriate treatment plan. A comprehensive social history is essential for providing holistic care to the child and addressing all relevant factors that may impact their health and well-being.