A woman in active labor demonstrates persistent occiput posterior fetal position, contributing to prolonged labor and severe back pain. What nursing intervention should be prioritized to facilitate fetal rotation and optimize labor progress?

Correct Answer: A

Rationale: Placing the mother in a hands-and-knees position can help facilitate fetal rotation from occiput posterior to the desired occiput anterior position. This position utilizes gravity to assist in the repositioning of the baby, ultimately helping to alleviate back pain and promoting more efficient labor progress. It allows the baby's head to descend properly into the pelvis, potentially reducing the risk of a prolonged labor or the need for instrumental delivery. Additionally, being in this position can help the mother feel more comfortable and empowered during labor. Overall, assisting the mother into a hands-and-knees position is a non-invasive, low-risk intervention that can have a positive impact on both the mother and baby's well-being during labor.

Correct Answer: A

Rationale: The patient with a history of COPD presenting with increased dyspnea, cough productive of purulent sputum, and coarse crackles on auscultation is most likely experiencing an acute exacerbation of COPD. Acute exacerbations in COPD are defined as sustained worsening of the patient's respiratory symptoms beyond normal day-to-day variations, leading to a change in medication. Common triggers for exacerbations include respiratory infections, air pollution, and non-compliance with medications.

Correct Answer: B

Rationale: Loop diuretics, such as furosemide, are potent diuretics commonly used to manage conditions like edema, heart failure, and hypertension. Loop diuretics work by inhibiting the reabsorption of sodium and chloride in the loop of Henle in the kidney, leading to increased diuresis. However, this mechanism of action can also lead to increased excretion of other electrolytes, such as magnesium.

Correct Answer: B

Rationale: Benign prostatic hyperplasia (BPH) is a condition characterized by an abnormal enlargement of the prostate gland, which is non-cancerous. This enlargement can lead to lower urinary tract symptoms such as urinary hesitancy (difficulty starting the urine stream), weak urinary stream, incomplete bladder emptying, frequent urination, urgency, and nocturia. BPH is a common condition in aging men and is not usually associated with prostate cancer. Other conditions like prostate cancer, prostatitis, and prostate adenoma may present with similar symptoms, but BPH is specifically characterized by the non-cancerous enlargement of the prostate gland. Treatment for BPH may include medications to improve symptoms or surgical procedures to reduce the size of the prostate gland.

Correct Answer: C

Rationale: The most effective strategy in preventing more incidence of dengue infection is to target the breeding places of the Aedes mosquitoes, which are the vectors responsible for transmitting the dengue virus. By eliminating stagnant water sources where these mosquitoes breed, such as uncovered containers, flower pots, and discarded tires, the mosquito population can be significantly reduced. This, in turn, helps to lower the risk of dengue transmission to humans. While healthy nutritious food, burning of leaves and garbage, and adequate rest and sleep are important for overall health and immune function, they do not directly address the primary cause of dengue transmission, which is the Aedes mosquito population.

Correct Answer: E

Rationale: All of the statements (A-D) are true when discussing the testing of vision in infants and children separately from testing in adults. However, statement E is NOT true. The course of visual and cognitive development MUST be taken into account in evaluating infants and children's visual abilities. It is crucial to consider the stage of development a child is in when evaluating their vision, as their visual abilities can change rapidly during early childhood. Ignoring the course of development could lead to incorrect assessments and misunderstandings about the child's visual capabilities.

Correct Answer: D

Rationale: The patient's presentation of central obesity, moon face, buffalo hump, purple striae, and elevated cortisol levels strongly suggest Cushing's syndrome. Cushing's syndrome is a disorder characterized by excessive levels of cortisol, either due to an endogenous (e.g., adrenal tumor) or exogenous (e.g., prolonged steroid use) source. The classic physical features of Cushing's syndrome include central obesity with thin extremities (truncal obesity), moon face (rounding and reddening of the face), buffalo hump (accumulation of fat between the shoulders), and purple striae (stretch marks that are wide and purple in color). In the context of the elevated cortisol levels, these clinical signs are highly indicative of Cushing's syndrome. Hyperthyroidism, hypothyroidism, and diabetes mellitus would not typically present with the specific combination of symptoms described.

Correct Answer: B

Rationale: In the community setting, the essential record about the patient is the patient's chart. This chart contains all important information about the patient, including medical history, treatment plans, medications, progress notes, and any other pertinent information related to the patient's care. It serves as a crucial document for healthcare providers to track and monitor the patient's health status, facilitate communication among team members, ensure continuity of care, and make informed clinical decisions. The patient's chart is a comprehensive and centralized source of information that guides the delivery of quality care in the community setting.

Correct Answer: D

Rationale: Nurse Rey can be liable for committing malpractice. Malpractice refers to professional negligence or failure to provide the standard of care expected in a particular medical situation. In this scenario, Nurse Rey is not qualified or authorized to perform circumcisions, as it falls outside of the scope of practice for a nurse. By participating in performing circumcisions without the necessary qualifications and training, Nurse Rey is potentially putting patients at risk and not providing the appropriate standard of care expected from a healthcare professional. This could be considered as malpractice, for which Nurse Rey may be held liable.