Following a severe traumatic brain injury, a patient is experiencing alterations in consciousness characterized by periods of wakefulness but with no meaningful interaction with the environment. Which term best describes this state?

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: D

Rationale: Papillary thyroid carcinoma is a type of thyroid cancer that arises from follicular cells of the thyroid gland. It often presents as a thyroid nodule that can cause symptoms of compression due to its enlarging size. The compression symptoms, such as difficulty swallowing and breathing in this case, occur when the thyroid nodule becomes large enough to press on adjacent structures in the neck. Fine-needle aspiration biopsy can confirm the presence of malignant cells with nuclear features typical of papillary thyroid carcinoma, further supporting the diagnosis.

Correct Answer: D

Rationale: Postpartum hemorrhage is defined as a blood loss of more than 500 ml within the first 24 hours after vaginal delivery or more than 1000 ml following a cesarean delivery. Excessive bleeding can lead to hypovolemic shock and can be life-threatening if not promptly addressed. Therefore, a blood loss of more than 500 ml/24 hours would lead the nurse to suspect a postpartum hemorrhage and prompt further assessment and intervention.

Correct Answer: C

Rationale: Rabies has a shorter incubation period if the bite is located on the hand. This is because bites on the hand are more likely to have direct access to nerve pathways, which can lead to a faster spread of the rabies virus to the central nervous system. In general, bites on parts of the body closer to the brain and spinal cord, such as the hand and face, can result in a quicker onset of rabies symptoms compared to bites on farther extremities like the leg or abdomen.

Correct Answer: B

Rationale: Medical records are typically required to be retained for a certain period of time as mandated by legal and regulatory requirements. The retention period for medical records is generally between 5 to 10 years, depending on the jurisdiction and specific regulations governing healthcare facilities. Keeping medical records for this duration ensures that they are available for reference, audits, legal purposes, and continuity of care for patients. Storing medical records for an adequate length of time also helps in ensuring continuity of care and tracking patients' medical history over time, which is crucial for quality healthcare delivery. Therefore, storing charts in the Medical Records or storage room for at least 5-10 years aligns with standard practices in healthcare compliance and patient care.

Correct Answer: C

Rationale: NSAIDs are known to increase the risk of gastrointestinal complications, particularly gastrointestinal bleeding, ulcers, and perforation. This risk is higher in patients who are elderly, have a history of peptic ulcer disease, are taking high doses of NSAIDs, or are using them for a prolonged period. It is important for the nurse to closely monitor the patient for signs and symptoms of gastrointestinal bleeding, such as abdominal pain, black or tarry stools, vomiting blood, and anemia. Prompt identification and management of these complications are essential to prevent serious consequences. Monitoring for gastrointestinal adverse effects is crucial when a patient is prescribed NSAIDs for managing conditions like osteoarthritis.

Correct Answer: C

Rationale: The nurse's best approach to address the patient's confusion about their medication regimen is to use a teach-back method to assess understanding and clarify any misconceptions. This method involves the nurse asking the patient to explain in their own words how they will take their medications, what each medication is for, and any potential side effects they should watch for. By using the teach-back method, the nurse can confirm the patient's comprehension and correct any misunderstandings in a supportive and non-judgmental manner. This approach promotes patient education, empowerment, and adherence to the medication regimen. Providing written instructions alone (Choice A) may not be sufficient if the patient has difficulty reading or understanding written information. Explaining the medication regimen using complex medical terminology (Choice B) can further confuse the patient, making it harder for them to grasp the information. Dismissing the patient's concerns and reassuring them that the medication is safe (Choice D) does not address the root of the issue and

Correct Answer: A

Rationale: Nurse Cris should employ the communication technique of summarizing to successfully capture the details of the meeting. Summarizing involves condensing the information provided into a concise and organized form, which would help Nurse Cris remember and retain the key points discussed during the meeting. By summarizing the details, Nurse Cris can ensure that no important information is missed and can also confirm understanding by reflecting back the main points discussed. This technique promotes effective communication by enhancing clarity and reinforcing comprehension.

Correct Answer: B

Rationale: For a displaced femoral neck fracture, the most appropriate surgical procedure is usually an open reduction and internal fixation (ORIF). This procedure involves making an incision to reposition the fractured bone fragments and securing them in place with screws or other fixation devices. ORIF allows for better alignment of the fracture, which is crucial for proper healing and minimizing the risk of complications like avascular necrosis or nonunion. Closed reduction and internal fixation (CRIF) may not be as effective for displaced femoral neck fractures due to the complex nature of the fracture and the need for precise realignment and stability provided by an open surgical approach. External fixation is less commonly used for femoral neck fractures and is typically reserved for certain specific cases where internal fixation is not feasible. Closed reduction alone is unlikely to provide adequate stability for a displaced femoral neck fracture and is generally not recommended as the primary surgical treatment for this type of injury.