A woman in active labor requests pain relief. Which pharmacological option is safe and effective for pain management during labor?

Correct Answer: B

Rationale: Nitrous oxide, also known as "laughing gas," is a safe and effective pharmacological option for pain management during labor. Nitrous oxide is commonly used in labor and delivery settings as it has minimal effects on the baby and allows the woman to remain in control of her pain management. It provides quick pain relief when inhaled and can be adjusted to the woman's needs during labor. Ibuprofen, morphine, and diazepam are not typically used for pain management during labor due to their potential risks and side effects, especially for the baby.

Correct Answer: B

Rationale: Nephrotic syndrome is a kidney disorder characterized by increased glomerular permeability, leading to protein loss in the urine. One of the hallmarks of nephrotic syndrome is hypoalbuminemia, which refers to low levels of albumin in the blood due to its excessive loss in the urine. This loss of albumin results in decreased oncotic pressure, leading to edema and ascites. Hematuria (choice A) is not typically found in nephrotic syndrome but may be present in other kidney conditions. Hyperkalemia (choice C) is not specific to nephrotic syndrome and may be more common in conditions affecting potassium regulation. Hypocalcemia (choice D) is also not a characteristic feature of nephrotic syndrome.

Correct Answer: C

Rationale: Scabies is a contagious skin infestation caused by the Sarcoptes scabiei mite. The classic presentation of scabies includes a rash characterized by erythematous papules and vesicles that are arranged in a linear or burrow-like distribution. These linear tracks are often seen in areas such as the interdigital spaces, wrists, elbows, axillae, belt line, and genitalia. It is commonly associated with intense itching, especially at night. Unlike psoriasis, which presents with silvery scales and well-defined borders, or contact dermatitis, which results from exposure to a specific allergen or irritant, scabies is caused by a parasitic mite infestation. Atopic dermatitis, on the other hand, is a chronic inflammatory skin condition characterized by pruritic eczematous lesions, but it typically does not manifest with a linear distribution of lesions like scabies.

Correct Answer: A

Rationale: The presentation described in the question is most consistent with anterior uveitis. Anterior uveitis, also known as iritis, is characterized by redness, pain, and photophobia in the affected eye. Slit-lamp examination typically reveals ciliary injection (reddening of the conjunctiva and episclera), corneal edema, and a mid-dilated pupil with a fixed reaction to light (miosis). This occurs due to inflammation within the anterior chamber of the eye involving the iris and ciliary body.

Correct Answer: D

Rationale: It is important for the nurse to acknowledge the patient's preference and respect their choice. By responding with "So then you would prefer to speak with your doctor?" the nurse is showing understanding and willingness to accommodate the patient's request. This response helps to maintain a positive and respectful interaction with the patient.

Correct Answer: B

Rationale: Ella's statement "I will hang myself" directly indicates a desire and intent to commit suicide. This is classified as a suicidal intent, which is a serious concern that requires immediate attention and intervention. It is crucial to take any mention or indication of suicide seriously and seek help from mental health professionals or crisis intervention services.

Correct Answer: A

Rationale: The presentation described, involving multiple grouped vesicles on an erythematous base in the genital area, is classic for herpes simplex genitalis. This condition is caused by the herpes simplex virus (HSV) and is characterized by recurrent outbreaks of painful vesicles in the genital or perianal area. The history of similar lesions occurring during periods of stress is also suggestive of herpes simplex virus reactivation. Genital warts (condyloma acuminata) typically present as painless, fleshy growths in the genital area caused by human papillomavirus (HPV). Syphilis manifests as a painless ulcer known as a chancre, which is not described in the presentation. Molluscum contagiosum presents with pearly, dome-shaped papules with central umbilication, rather than vesicles.

Correct Answer: B

Rationale: Uterine hyperstimulation, also known as tachysystole, is a condition where the uterus contracts too frequently and/or too forcefully, leading to a decreased uterine blood flow. This can result in maternal fatigue and decreased oxygenation to the fetus, as mentioned in the scenario. Uterine hyperstimulation can be caused by several factors, including the excessive use of uterotonic medications, such as oxytocin, or the presence of uterine abnormalities.

Correct Answer: D

Rationale: The clinical presentation of a patient with chronic kidney disease (CKD) presenting with weakness, anorexia, confusion, severe anemia, low reticulocyte count, elevated serum creatinine, and decreased erythropoietin levels is most consistent with renal failure-associated anemia. In CKD, the kidneys are unable to produce adequate amounts of erythropoietin, a hormone responsible for stimulating red blood cell production in the bone marrow. The decreased erythropoietin levels lead to a state of anemia, characterized by low hemoglobin levels and subsequent symptoms of fatigue and weakness. The anemia in renal failure is typically normocytic and normochromic. Additionally, the elevated serum creatinine in this patient is a hallmark of kidney dysfunction.