Patient Josephine asks why her labor is much shorter compared to previous deliveries. Which of the following is the BEST RESPONSE?

Correct Answer: B

Rationale: The statement "Multigravida patient has shorter labor" is the best response to Patient Josephine's question about her shorter labor compared to previous deliveries. In obstetrics, it is commonly observed that labor tends to be shorter in patients who have had previous pregnancies (multigravida patients) due to factors such as prior cervical changes and previous stretching of the birth canal. This phenomenon is known as "multigravida cervical efficiency," and it can lead to faster and more efficient labors in subsequent pregnancies for women who have had previous deliveries.

Correct Answer: C

Rationale: Verbal abuse is the most common form of abuse experienced by nurses in their workplace. This may include insults, yelling, threats, or intimidation directed towards the nurse. Verbal abuse can have a significant impact on the nurse's mental and emotional well-being, leading to stress, anxiety, and burnout. It is important for healthcare institutions to address and prevent verbal abuse to create a safe and respectful work environment for nurses and other healthcare professionals.

Correct Answer: C

Rationale: The scenario described is suggestive of a meniscus injury. A twisting injury during sports activity leading to acute knee pain and swelling, accompanied by joint effusion and tenderness along the joint line, is commonly associated with meniscus tears. The meniscus is a C-shaped cartilage structure located between the femur and tibia in the knee joint, providing cushioning and stability. The symptoms of a meniscus tear typically include pain, swelling, joint line tenderness, and sometimes mechanical symptoms like locking or clicking. Treatment may involve rest, physical therapy, or in some cases, surgery to repair or remove the torn meniscus.

Correct Answer: B

Rationale: The nurse's priority action after noticing a sudden drop in blood pressure after administering anesthesia is to assess the patient's airway, breathing, and circulation (ABCs). This is crucial to determine the immediate cause of the sudden drop in blood pressure and to ensure the patient's safety and stability. Assessment of the ABCs will help identify any potential airway obstruction, respiratory distress, or circulatory issues that may be contributing to the drop in blood pressure. Once the assessment is done, appropriate interventions can be initiated to stabilize the patient's condition. Administering vasopressors, documenting the blood pressure readings, and notifying the anesthesiologist are important actions but assessing the ABCs takes precedence in this situation to ensure the patient's immediate needs are addressed.

Correct Answer: C

Rationale: Acute appendicitis is the most likely cause of the symptoms described in the pregnant woman. The classic presentation of acute appendicitis includes fever, chills, abdominal pain localized to the right lower quadrant, rebound tenderness, and guarding. Pregnant women are at a slightly higher risk of developing appendicitis due to anatomic changes and increased abdominal pressure during pregnancy, which can lead to an atypical presentation of symptoms. Prompt diagnosis and surgical intervention are crucial to prevent complications such as perforation, which can be detrimental for both the mother and the fetus.

Correct Answer: C

Rationale: Nurse Sandra should consider Cindy, 7 years old who has been absent due to skin lesions, as a priority for home visitation. Skin lesions can indicate potential health issues that need to be addressed promptly. Cindy's frequent absences could be a sign that her condition is affecting her school attendance and overall well-being. By conducting a home visit, Nurse Sandra can assess Cindy's living environment, provide appropriate care recommendations, and ensure that she receives necessary medical attention. This proactive approach can help address Cindy's health concerns and support her academic performance.

Correct Answer: D

Rationale: Before any procedure, it is crucial to ensure that you have the proper authorization and guidelines in place. By checking the physician's order and the patient care plan, you confirm that suctioning is indeed needed and that you follow the specific instructions for that patient. This step helps ensure patient safety and effective care delivery. Once you have verified this information, you can proceed with gathering equipment, performing hand hygiene, and assessing the patient's condition as necessary.

Correct Answer: A

Rationale: Neonatal Opioid Withdrawal Syndrome (NOWS), previously known as Neonatal Abstinence Syndrome (NAS), can occur when a newborn is exposed to opioids in utero. Opioid exposure in utero can lead to physical dependence in the fetus, and when the drug is no longer available after birth, withdrawal symptoms can occur.

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.