A woman in active labor experiences frequent and intense uterine contractions with minimal rest intervals, leading to maternal fatigue and decreased fetal oxygenation. What maternal condition should the nurse assess for that may contribute to this abnormal labor pattern?

Correct Answer: B

Rationale: Uterine hyperstimulation is a condition in which the uterus contracts too frequently or too intensely, leading to decreased blood flow and oxygenation to the placenta. This can result in maternal fatigue and decreased fetal oxygenation due to the lack of sufficient rest intervals between contractions. Uterine hyperstimulation can be caused by factors such as the use of synthetic oxytocin (Pitocin) to induce or augment labor, uterine abnormalities, or maternal conditions like pre-eclampsia. It is important for the nurse to assess for uterine hyperstimulation in a woman experiencing frequent and intense contractions to intervene promptly and prevent adverse outcomes for both the mother and the baby.

Correct Answer: B

Rationale: Bulimia nervosa is best defined as a pathological disorder involving recurrent episodes of binge eating followed by inappropriate compensatory behaviors to prevent weight gain, such as self-induced vomiting, excessive exercise, or misuse of laxatives. It is categorized as an eating disorder rather than a phobic disorder as it involves behaviors related to food consumption and body image, not just fears or phobias. Bulimia is not solely associated with starving oneself, as individuals with bulimia tend to consume large amounts of food during binge episodes. Therefore, the most accurate definition of bulimia is a pathological disorder of binging and vomiting.

Correct Answer: D

Rationale: The causative agent of dengue fever is a virus. Dengue fever is primarily transmitted to humans by the bite of infected Aedes mosquitoes, particularly Aedes aegypti and Aedes albopictus. These mosquitoes act as vectors, carrying and transmitting the dengue virus (specifically four closely related but antigenically different serotypes: DEN-1, DEN-2, DEN-3, and DEN-4) to humans during the feeding process. The virus then replicates in the human body, causing symptoms of dengue fever. Therefore, the correct answer is D. Virus.

Correct Answer: C

Rationale: Tetanus toxoid provides long-lasting active immunity. When a person is vaccinated with tetanus toxoid, their immune system is stimulated to produce antibodies against the tetanus toxin. These antibodies provide protection against tetanus infection by recognizing and neutralizing the toxin if the person is exposed to the bacteria that causes tetanus in the future. This active immune response can last for many years, providing ongoing protection against tetanus. However, booster doses are recommended every 10 years to maintain adequate levels of protection.

Correct Answer: D

Rationale: The ethical principle of beneficence, which is the basis of every nursing action in all work settings, emphasizes the importance of doing good at all times for the benefit of the patient. Nurses are expected to act in the best interest of their patients and strive to promote their well-being and welfare. This principle guides nurses to provide care that is compassionate, effective, and in line with the patient's needs and preferences. By prioritizing the good of the patient in all actions and decisions, nurses uphold the principle of beneficence and demonstrate their commitment to promoting positive outcomes for those under their care.

Correct Answer: A

Rationale: Myxedema is a severe form of hypothyroidism that is characterized by the accumulation of mucopolysaccharides in subcutaneous and other interstitial tissues. This condition leads to puffiness, swelling, and thickening of the skin, giving it a waxy appearance. Other symptoms of myxedema include fatigue, weight gain, cold intolerance, and hair loss. It is important to recognize and treat myxedema promptly as it can lead to serious complications such as myxedema coma, which is a life-threatening condition requiring immediate medical attention.

Correct Answer: A

Rationale: Endometriosis is the most likely condition responsible for the symptoms described in this scenario. Endometriosis is a chronic condition in which endometrial-like tissue grows outside the uterus, commonly affecting the pelvic structures such as the ovaries, fallopian tubes, and pelvic peritoneum. The main symptoms include cyclic pelvic pain, dysmenorrhea (painful periods), and dyspareunia (pain during intercourse). The retroverted and fixed uterus on examination may be due to adhesions from endometriosis, causing the uterus to be fixed in position. Endometriosis should be considered in women of reproductive age presenting with these symptoms and pelvic examination findings.

Correct Answer: B

Rationale: When a patient receiving palliative care for end-stage COPD expresses a desire to discuss advance care planning, the palliative nurse should initiate a conversation about advance directives and future care preferences. Advance care planning involves discussing and documenting a patient's preferences regarding future medical care, particularly in situations where the patient may no longer be able to make decisions. This discussion helps ensure that the patient's wishes are respected and followed in the event they are unable to communicate their preferences. By engaging in advance care planning discussions, the nurse can help the patient feel empowered, supported, and in control of their medical care decisions. It also allows healthcare providers to align care with the patient's values and goals, ultimately improving quality of life and ensuring dignity at the end of life.

Correct Answer: D

Rationale: Third-degree perineal lacerations are significant injuries that require careful monitoring for signs of infection or wound dehiscence, which are potential complications that could hinder optimal wound healing. Signs of infection may include increased redness, warmth, swelling, pain, and purulent drainage from the wound site. Dehiscence refers to the separation of the wound edges, which can be a serious complication requiring immediate attention. By closely monitoring the incision site for these signs, the nurse can promptly intervene if any complications arise, ensuring proper healing and preventing further complications. While providing perineal care, proper application of peri-pads, and encouraging sitz baths are important for comfort and cleanliness, monitoring for complications takes priority in promoting optimal wound healing in this scenario.