The patient asks Nurse Vera, when could you hear the fetal heart of my baby? Which of the following should be the BEST answer of Nurse Vera?

Correct Answer: C

Rationale: The correct answer is C: Fifth month. Nurse Vera should explain that the fetal heart can typically be heard using a Doppler ultrasound device around the fifth month of pregnancy. This is because the baby's heart is developed enough to produce audible sounds by this time. Choices A, B, and D are incorrect because in the ninth month, the baby is ready for delivery, in the third month the heart is still developing, and in the first month the heart is just beginning to form and is not yet audible.

Correct Answer: C

Rationale: Step-by-step rationale for the correct answer (C: I and II): 1. Choice I (The expression of pain is affected by learned behavior) is correct because cultural beliefs and upbringing influence how individuals express and perceive pain. 2. Choice II (Physiologically, all individuals experience pain in a similar manner) is correct because pain perception is largely influenced by biological factors that are universal. 3. Choice III (Some Asian people have a high response to pain medications) is incorrect as it focuses on a specific cultural group, which is not a general characteristic emphasized in culturally sensitive care. 4. Choice IV (Patients should be assessed for pain regardless of overt symptomatology) is incorrect as it is not specifically related to cultural sensitivity in pain management.

Correct Answer: A

Rationale: The correct answer is A: Empiric antibiotic therapy directed against common pathogens. This is recommended for managing PID because it helps treat the infection and prevent complications. Antibiotics target the underlying bacterial infection causing PID. Surgical exploration (B) is not the initial treatment for PID. Hormonal therapy (C) is not indicated for PID management. Symptomatic treatment with NSAIDs (D) can help with pain but does not address the infection itself.

Correct Answer: C

Rationale: The correct answer is C because positioning oneself at eye level helps the patient see the nurse's facial expressions and lip movements, aiding in communication. Speaking clearly and slowly allows the patient to better understand. Speaking loudly can distort sound and may not be necessary. Avoiding visual aids or gestures limits communication channels. Speaking quickly can overwhelm the patient and hinder comprehension.

Correct Answer: C

Rationale: The correct answer is C: Hyponatremia. SSRI medications can lead to the syndrome of inappropriate antidiuretic hormone secretion (SIADH), causing hyponatremia. This occurs due to increased levels of serotonin affecting the hypothalamus, leading to excessive ADH release. Hyponatremia can result in neurological symptoms and must be closely monitored. A: Bradycardia is not a common adverse effect of SSRIs. B: Hyperkalemia is not typically associated with SSRIs. D: Hypertension is not a common adverse effect of SSRIs; they may actually lower blood pressure.

Correct Answer: D

Rationale: The correct answer is D: Diabetic retinopathy. This condition is a common complication of diabetes that occurs due to the thickening of capillaries and arterioles in the eye, leading to damage to the retina. This can result in vision problems and even blindness if left untreated. A: Papilledema is the swelling of the optic disc due to increased intracranial pressure, not related to diabetes. B: Glaucoma is a condition characterized by increased pressure within the eye, not directly caused by diabetes. C: Retinal detachment is the separation of the retina from the underlying tissues, which is not primarily caused by diabetes-related capillary changes.

Correct Answer: B

Rationale: The correct answer is B: Acute myocardial infarction (MI) is the most common cause of cardiogenic shock. During an MI, there is significant damage to the heart muscle, leading to a decrease in cardiac output and subsequent shock. This results in inadequate tissue perfusion and oxygen delivery. Choices A, C, and D are incorrect because decreased hemoglobin level (A) may lead to anemia but is not the most common cause of cardiogenic shock. Hypotension (C) is a symptom of shock, not the cause. Coronary artery disease (D) is a risk factor for MI but not the direct cause of cardiogenic shock.

Correct Answer: B

Rationale: The correct answer is B: establish a credit body of evidence to support and improve the delivery of care. Conducting research in nursing aims to generate a robust evidence base to inform and enhance the quality of care provided to patients. This evidence helps in identifying best practices, improving patient outcomes, and advancing the nursing profession as a whole. Choice A is incorrect because the main goal of research is not to solely justify the role of nurses, but rather to improve care delivery. Choice C is incorrect as the goal is not to justify an oversupply of nurses, but to address healthcare needs effectively. Choice D is incorrect because the focus of nursing research is on nursing-related issues, not non-nursing problems.

Correct Answer: B

Rationale: The correct answer is B: Initiate non-invasive positive pressure ventilation (NIPPV) for respiratory support. In acute exacerbations of COPD, NIPPV helps improve ventilation and oxygenation, reducing the work of breathing and preventing the need for intubation. This intervention is a priority as it can rapidly stabilize the patient's respiratory status. A: Administering bronchodilator medications is important in COPD management, but in severe exacerbations, NIPPV takes precedence. C: Arterial blood gas analysis is important for assessing oxygenation and ventilation status, but it does not directly address the acute respiratory distress. D: Chest physiotherapy can help with airway clearance in COPD, but in acute exacerbations, respiratory support with NIPPV is more urgent.