A woman in active labor is diagnosed with postpartum hemorrhage (PPH) due to uterine atony. What is the priority nursing intervention?

Correct Answer: A

Rationale: The priority nursing intervention for a woman in active labor diagnosed with postpartum hemorrhage (PPH) due to uterine atony is to massage the uterus to promote contraction. Uterine massage helps to stimulate uterine muscle tone and contraction, which can help control bleeding by reducing the size of blood vessels and promoting hemostasis. It is important to address the uterine atony promptly to prevent further blood loss and stabilize the patient's condition. Other interventions such as blood transfusion, administering antibiotics, and elevating the mother's legs can be considered based on the patient's response to the initial intervention of uterine massage.

Correct Answer: C

Rationale: To create personal time as a nurse with rotating shifts, it is important to prioritize personal well-being and make time for oneself. By eliminating tasks that add no value, nurses can streamline their workload and focus on essential responsibilities. This can help in reducing unnecessary stress and allowing for more personal time outside of work. Delegating work to others and filling every moment with tasks or chores may not necessarily create personal time, as it can keep nurses constantly busy and overwhelmed. Hiring someone else to do the work may not always be feasible or practical in a nursing setting, but by eliminating non-essential tasks, nurses can better manage their time and have more opportunities for personal activities and self-care.

Correct Answer: A

Rationale: In a pregnant woman presenting with severe abdominal pain, syncope, signs of hypovolemic shock, and gestational age of 6 weeks, the most likely cause is an ectopic pregnancy. An ectopic pregnancy occurs when a fertilized egg implants outside the uterus, commonly in the fallopian tube. As the pregnancy grows and the tube stretches, it can lead to rupture, causing severe abdominal pain, internal bleeding, and signs of shock. This is a life-threatening emergency that requires prompt diagnosis and management. It is important to consider ectopic pregnancy in any pregnant woman presenting with abdominal pain and signs of shock, especially in the first trimester.

Correct Answer: A

Rationale: Hashimoto's thyroiditis is an autoimmune disorder characterized by chronic inflammation of the thyroid gland. In this condition, lymphocytic infiltration and germinal centers can be seen in the thyroid tissue. This inflammation can lead to the formation of thyroid nodules and enlargement of the thyroid gland, causing symptoms such as difficulty swallowing and breathing due to compression of surrounding structures. Additionally, Hashimoto's thyroiditis can result in hypothyroidism over time, further contributing to the symptoms. Therefore, the patient in this case is most likely experiencing these symptoms due to Hashimoto's thyroiditis. Graves' disease, on the other hand, typically presents with hyperthyroidism and is less likely to manifest as compressive symptoms of the thyroid gland.

Correct Answer: C

Rationale: The palliative nurse's most appropriate response in this scenario is to offer empathetic listening and explore the patient's concerns about the future. By providing a compassionate and supportive environment for the patient to express their fears and anxieties, the nurse can help the patient feel heard and understood. This approach allows the nurse to address the patient's emotional needs and provide appropriate support to help them cope with their feelings. Avoiding discussions or minimizing the patient's concerns may invalidate their emotions and hinder the therapeutic relationship. Encouraging distraction techniques or focusing solely on positive thoughts may not address the underlying fears and anxieties that the patient is experiencing. Therefore, offering empathetic listening and exploring the patient's concerns is the most appropriate way for the nurse to provide holistic care for the patient with advanced heart failure.

Correct Answer: D

Rationale: When admitting a patient to the unit after abdominal surgery, the initial priority assessment performed by the nurse should focus on assessing the patient's respiratory function and airway. This is crucial because post-surgical patients are at risk for complications such as respiratory depression, atelectasis, and airway obstruction. Monitoring the patient's breathing pattern, oxygen saturation levels, and ensuring a patent airway are essential in preventing respiratory distress or failure. Prompt assessment and intervention in this area can help prevent respiratory complications and ensure the patient's safety and well-being. Once the patient's respiratory status is stable, the nurse can then proceed to assess other aspects such as the surgical site, skin color, temperature, and responsiveness to stimuli.

Correct Answer: D

Rationale: When administering Rilutek (riluzole), the medication should be taken with food. This is because taking Rilutek with food helps to reduce the likelihood of experiencing stomach upset as a side effect. Administering the medication on an empty stomach may increase the risk of gastrointestinal issues such as nausea, vomiting, or stomach pain. Therefore, it is recommended to administer Rilutek with food to ensure better tolerability for the patient.

Correct Answer: C

Rationale: Vocal cord nodules are benign growths on the vocal cords, typically caused by vocal abuse or misuse. The most appropriate intervention for managing vocal cord nodules is voice therapy and vocal hygiene education. Voice therapy aims to correct vocal habits and techniques that contribute to the formation of nodules, while vocal hygiene education focuses on maintaining vocal health through proper hydration, rest, and avoiding behaviors that strain the vocal cords. These interventions have been shown to be effective in reducing and eliminating vocal cord nodules without the need for surgical intervention. Surgery, such as vocal cord polypectomy or injection with corticosteroids, is typically reserved for cases that do not respond to conservative management or if there are significant complications. Partial laryngectomy is a more extensive surgical procedure that is not typically indicated for vocal cord nodules.

Correct Answer: B

Rationale: In Stage I of Hodgkin's disease, the most commonly seen early symptom is usually unexplained fever and night sweats. Other common symptoms at this stage may include unexplained weight loss, itching, and enlarged lymph nodes in the neck, underarms, or groin. Chest and back pains, subnormal body temperature, and swelling of extremities are not typically early indicators of Stage I Hodgkin's disease.