A woman in active labor experiences irregular and ineffective uterine contractions, resulting in prolonged cervical dilation. What nursing intervention should be implemented to address this abnormal labor pattern?

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: A

Rationale: The patient's presentation with fatigue, pallor, dyspnea on exertion, low hemoglobin level, decreased MCV, and decreased MCHC are all consistent with iron deficiency anemia. Iron deficiency anemia is the most common type of anemia and occurs when there is insufficient iron available for hemoglobin production. The low hemoglobin level results in symptoms such as fatigue and pallor, while the decreased MCV and MCHC indicate microcytic and hypochromic red blood cells, respectively, which are characteristic of iron deficiency anemia. Vitamin B12 deficiency anemia and thalassemia typically present with a different pattern of laboratory findings and clinical manifestations. Sickle cell anemia is characterized by sickle-shaped red blood cells due to a genetic mutation, and the laboratory findings in sickle cell anemia are different from those seen in the patient described in this scenario.

Correct Answer: C

Rationale: The presentation described with a sensation of fullness and pressure in the left ear, along with hearing loss and occasional tinnitus, and the findings of a retracted tympanic membrane with decreased mobility on pneumatic otoscopy are most consistent with serous otitis media, also known as otitis media with effusion (OME). OME is characterized by the presence of non-infected fluid in the middle ear space, leading to symptoms such as ear fullness, hearing loss, and occasionally tinnitus.

Correct Answer: C

Rationale: When the nurse collects data at one point in time, it is referred to as a cross-sectional study. Cross-sectional studies are observational research designs that provide a snapshot of a population or a sample at a specific point in time. This type of study can help identify associations or relationships between variables at a single time point but cannot establish causality or determine changes over time. In contrast, time series involve collecting data over multiple time points, longitudinal studies follow individuals or samples over time to track changes or outcomes, and crossover studies involve multiple interventions or treatments over different periods.

Correct Answer: A

Rationale: Administering systemic analgesia, such as pain medications or anesthesia, before the wound debridement procedure is the most effective way to minimize patient discomfort. These medications will help manage and reduce the pain experienced by the patient during the procedure, making it more tolerable for them. Topical anesthetic cream may provide some localized relief but may not be sufficient for significant pain management during a wound debridement procedure. Using sharp debridement techniques or performing the procedure quickly may help reduce manipulation or duration, respectively, but these actions alone may not adequately address the patient's pain and discomfort. Administering systemic analgesia ensures that the patient's overall pain is managed, promoting a more comfortable and successful wound debridement procedure.

Correct Answer: B

Rationale: A vegetative state, now more commonly referred to as unresponsive wakefulness syndrome, describes a condition where the patient is awake but with no awareness of themselves or their surroundings. This state usually follows a severe brain injury, such as traumatic brain injury. Patients in a vegetative state may have sleep-wake cycles, open their eyes, and even exhibit reflex movements, but they do not demonstrate any meaningful interaction with the environment. Differentiating between coma and vegetative state is important, as coma implies a complete lack of consciousness, while patients in a vegetative state have preserved wakefulness without awareness. Minimally conscious state (choice C) refers to a condition where there are some minimal signs of awareness or purposeful interaction, making it a different state than the one described in the scenario. Locked-in syndrome (choice D) is a condition where the patient is conscious and aware but unable to move or communicate due to paralysis, which is not consistent

Correct Answer: A

Rationale: The given patient's symptoms of chest pain that occurs during heavy lifting or physical exertion and is relieved by rest are consistent with stable angina. Stable angina is characterized by predictable chest pain that occurs with exertion and is typically relieved by rest or nitroglycerin. The transient ST-segment depression on ECG is also a common finding in patients with stable angina, which reflects myocardial ischemia during episodes of chest pain triggered by exertion. In contrast, unstable angina is characterized by chest pain at rest or with minimal exertion that is of increasing frequency, severity, or duration. Acute myocardial infarction is associated with persistent ST-segment elevation or new Q-waves on ECG, and Prinzmetal's angina is characterized by chest pain at rest due to coronary artery spasm rather than exertion.

Correct Answer: A

Rationale: In a community clinic providing primary care for patients, the most common healthcare professional who manages patient care is a physician. Physicians, also known as doctors, are trained and licensed to diagnose and treat a wide range of medical conditions. They are responsible for conducting exams, prescribing medications, ordering tests, and developing treatment plans for patients. While other healthcare professionals such as nurses, midwives, and barangay health workers also play important roles in providing care, physicians typically lead the team, make critical decisions, and provide overall management of patient care in a primary care setting like a community clinic.

Correct Answer: A

Rationale: In the case of a woman in active labor with placenta previa, the priority nursing intervention is to prepare for an immediate cesarean section. Placenta previa is a condition in which the placenta covers part or all of the cervix, which can lead to severe bleeding during labor and delivery. The risk of hemorrhage is significant, making a cesarean section the safest option for both the mother and the baby in this situation. It is crucial to act promptly to prevent complications and ensure the well-being of both the mother and the baby. Administering intravenous oxytocin to augment labor or inserting a Foley catheter to monitor urine output would not address the immediate risk of hemorrhage associated with placenta previa. Implementing bed rest and continuous fetal monitoring may be part of the overall care plan but not the priority intervention in this urgent situation.