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: A

Rationale: The nurse should prioritize screening the patient for contraindications to MRI, such as metal implants or claustrophobia, to ensure procedural safety. Metallic objects can be hazardous in an MRI environment as they can be attracted to the magnet, potentially causing harm to the patient or staff. Claustrophobia can also be a significant issue for patients undergoing an MRI scan, and identifying this beforehand allows for appropriate measures to be taken to address the patient's anxiety or discomfort. Prioritizing this screening step helps ensure the safety and well-being of the patient during the MRI procedure.

Correct Answer: B

Rationale: The presentation of a painful, vesicular rash in a dermatomal distribution on the left thorax, specifically in a patient with a history of chickenpox, is most suggestive of herpes zoster, commonly known as shingles. Herpes zoster is caused by the reactivation of the varicella-zoster virus, the same virus responsible for chickenpox. After a person recovers from chickenpox, the virus remains dormant in the nerve cells and can reactivate years later to cause shingles. The rash in herpes zoster typically progresses through different stages, including red patches leading to fluid-filled blisters. The characteristic rash typically appears unilaterally and is usually preceded by pain, burning, or tingling in the affected area. Unlike herpes simplex virus infection, which can cause similar lesions but is not typically localized to a specific dermatome, herpes zoster presents as a distinct unilateral cluster of vesicles along

Correct Answer: C

Rationale: Anticonvulsant medications, such as phenytoin and phenobarbital, can interfere with pregnancy tests by affecting the levels of human chorionic gonadotropin (hCG) in the body. HCG is the hormone detected in pregnancy tests. These medications may potentially lead to a false-negative result on a pregnancy test for women who are actually pregnant. Therefore, in the case of Almira, who is 6 months pregnant and taking anticonvulsant medication due to the risk of producing a false-negative pregnancy test result, healthcare providers should consider other clinical indicators, such as abdominal cramps and vaginal spotting, to assess her pregnancy status.

Correct Answer: B

Rationale: The presentation of a pruritic, erythematous rash with edematous plaques and vesicles on the hands and fingers in a patient with a history of exposure to detergents and frequent hand washing is most indicative of contact dermatitis. Contact dermatitis can be caused by direct contact with irritants such as detergents or chemicals, leading to skin irritation and inflammation. In this case, the history of exposure to detergents and hand washing suggests that the rash is likely due to irritant contact dermatitis. Atopic dermatitis, psoriasis, and pityriasis rosea do not typically present with the same pattern of rash in response to irritant exposure.

Correct Answer: A

Rationale: The patient's presentation of a pruritic, annular rash with fine scaling and central clearing, affecting the trunk and proximal extremities, following exposure to a new soap and laundry detergent is most consistent with tinea corporis, commonly known as ringworm. Ringworm is a superficial fungal infection caused by dermatophytes that can present with circular or annular lesions with central clearing and scaling. The exposure to new soap and laundry detergent may have disrupted the skin's microbiome, making it more vulnerable to fungal infections like tinea corporis. Nummular eczema typically presents as coin-shaped plaques rather than annular lesions, while pityriasis rosea presents with a herald patch followed by smaller similar lesions in a "Christmas tree" distribution. Lichen planus would not typically be associated with exposure to new soap and laundry detergent but can have distinct purple, polygonal papules.

Correct Answer: A

Rationale: In primary care nursing, typically, one nurse is designated to have 24-hour responsibility for care planning and coordination for each patient. This helps ensure continuity of care and accountability. By having one nurse overseeing all aspects of the patient's care, it allows for a more personalized and coordinated approach that puts the patient at the center of the care structure. Having one primary care nurse also promotes better communication, efficiency, and consistency in managing the patient's health and well-being.

Correct Answer: B

Rationale: Dental caries, commonly known as tooth decay, is characterized by the irreversible demineralization of the enamel and dentin due to acids produced by bacterial activity. This process leads to cavitation and destruction of the tooth structure, ultimately resulting in the formation of a cavity. Gingivitis is inflammation of the gums, periodontitis is inflammation and infection of the supporting structures of the teeth (gums, bone, and ligaments), and a dental abscess is a collection of pus in the tissues surrounding the tooth, none of which are specifically related to the irreversible demineralization of enamel and dentin seen in dental caries.

Correct Answer: D

Rationale: The principles of guidance in handling Richard involve understanding and addressing the behaviors and needs of the child, such as controlling temper tantrums, basing expectations within the child's limitations, and acceptance of certain behaviors like masturbation as normal but to be discouraged in public. However, reinforcing the correct use of language is not typically included as a principle specifically in handling Richard. Therefore, this choice is NOT included among the principles of guidance in this context.