The patient during labor would anticipate some emotional support. Which of the following nursing interventions should Nurse Sarah provide to keep the patient calm?

Correct Answer: B

Rationale: Support in maintaining a sense of control is essential in keeping the patient calm during labor. Giving the patient a sense of control allows them to feel empowered and more in charge of their experience. This can help reduce anxiety and fear, ultimately promoting a more positive and calm labor experience. Providing emotional support by assisting the patient in maintaining control can greatly benefit their overall emotional well-being during this stressful time.

Correct Answer: C

Rationale: The patient's presentation of jaundice, ascites, spider angiomas, elevated serum bilirubin levels, prolonged prothrombin time, and hypoalbuminemia are all indicative of cirrhosis. Cirrhosis is a late stage of liver disease characterized by liver scarring and poor liver function. Jaundice, which is the yellowing of the skin and eyes due to elevated bilirubin levels, is a common manifestation of liver dysfunction seen in cirrhosis. Ascites, the accumulation of fluid in the abdomen, is also a common complication of cirrhosis. Spider angiomas, which are small blood vessels near the skin's surface, are a result of altered blood flow in the liver due to cirrhosis. Prolonged prothrombin time and hypoalbuminemia are consequences of reduced liver synthesis function in cirrhosis. Hepatic encephalopathy and hepatorenal syndrome

Correct Answer: A

Rationale: The most important intervention for managing ventilator-associated pneumonia (VAP) caused by methicillin-resistant Staphylococcus aureus (MRSA) in a patient undergoing mechanical ventilation in the ICU is to start appropriate antimicrobial therapy targeting MRSA. Vancomycin or linezolid are commonly used antibiotics for MRSA infections. These medications are effective against MRSA and can help in treating the infection and preventing further complications. It is crucial to initiate antimicrobial therapy promptly once the diagnosis of VAP caused by MRSA is suspected or confirmed to improve patient outcomes. Other interventions such as bronchoalveolar lavage for diagnostic purposes, contact precautions, or antifungal therapy may be relevant but the priority is to start effective antibiotic therapy to target the specific pathogen causing the infection.

Correct Answer: C

Rationale: Bursitis is characterized by inflammation of the bursa, which is a small, fluid-filled sac that cushions and reduces friction between bones, tendons, and muscles near joints. In the shoulder, bursitis commonly affects the subacromial bursa, located between the rotator cuff tendons and the top of the shoulder blade. The inflammation of this bursa can lead to pain and restricted movement around the shoulder joint.

Correct Answer: D

Rationale: Spiral CT angiography is the most appropriate test for confirming the diagnosis of pulmonary embolism (PE) in a patient with suspected PE. It is a non-invasive imaging modality that can detect filling defects within the pulmonary vasculature indicative of a clot. This diagnostic test has high sensitivity and specificity for diagnosing PE, making it a valuable tool in the management of patients with suspected PE.

Correct Answer: C

Rationale: Osteoarthritis in the hip joint can lead to weakness or dysfunction in the hip abductor muscles, causing a Trendelenburg gait. This gait abnormality is characterized by a dropping of the pelvis on the opposite side of the affected hip during weight-bearing on the affected leg. It is a common clinical manifestation of hip osteoarthritis due to the muscle weakness and altered mechanics in the hip joint. Baker's cyst is associated with knee osteoarthritis, Heberden's nodes are commonly seen in osteoarthritis of the fingers, and Swan-neck deformity is typically seen in rheumatoid arthritis, not osteoarthritis.

Correct Answer: B

Rationale: Cohort studies are types of epidemiological studies that involve a group of individuals who share a common characteristic or experience and are followed over time to observe the development of a particular health outcome. This type of study is useful in determining the incidence of a disease, identifying risk factors, and studying the natural history of a disease. Cohort studies allow researchers to investigate the relationship between exposure and outcome by following participants forward in time. It helps in establishing causality and is particularly useful for studying rare exposures or outcomes. In contrast, cross-sectional studies involve collecting data from a population at a single point in time, experimental studies involve interventions and control groups, and case-control studies involve comparing individuals with a particular health outcome (cases) to those without the outcome (controls) retrospectively.

Correct Answer: D

Rationale: The engagement of the fetus refers to the baby's head moving down into the mother's pelvis in preparation for birth. This factor is not typically used to distinguish between true and false labor because it is a sign of progress in labor rather than a defining characteristic of true labor. In contrast, the factors that are commonly used to differentiate between true and false labor include contractions (e.g., regularity, intensity, duration), cervical changes observed through vaginal examination (e.g., effacement and dilation), and monitoring vital signs.

Correct Answer: A

Rationale: Thrombotic thrombocytopenic purpura (TTP) is a rare but serious condition characterized by microangiopathic hemolytic anemia, thrombocytopenia, neurological abnormalities, fever, and renal dysfunction. The classic pentad of symptoms includes fever, neurologic changes, renal impairment, thrombocytopenia, and microangiopathic hemolytic anemia. The presence of petechiae, purpura, and mucosal bleeding along with thrombocytopenia, elevated serum creatinine, and schistocytes on peripheral blood smear are consistent with TTP. In TTP, there is usually a deficiency of ADAMTS13 (a von Willebrand factor-cleaving protease) leading to excessive platelet adhesion, aggregation, and microthrombi formation within small blood vessels. Treatment typically