Which of the following interventions is appropriate for managing a conscious patient with a severe nosebleed (epistaxis)?

Correct Answer: B

Rationale: When managing a conscious patient with a severe nosebleed (epistaxis), the appropriate intervention is to have the patient sit upright and lean slightly forward to prevent blood from flowing into the throat and causing choking or swallowing. Pinching the soft part of the nose just below the bony part can help apply pressure to the bleeding vessel and stop the bleeding. This maneuver also helps compress the blood vessels in the nose, promoting clot formation and stopping the bleeding. It is important not to tilt the head back as this can cause blood to flow into the throat and potentially lead to swallowing, choking, or aspiration. Packing the nose with cotton gauze should be done by medical professionals if the bleeding does not stop with direct pressure. Applying direct pressure to the forehead is not effective for managing nosebleeds; pressure should be applied to the nostrils instead.

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: C

Rationale: The description provided is classical for fungal keratitis. Fungal keratitis typically presents with a yellowish-white spot on the cornea, often surrounded by a ring of inflammation. Branching, filamentous opacities extending from the corneal lesion are commonly seen on slit-lamp examination in cases of fungal keratitis. This condition is often associated with risk factors such as trauma with organic material or contact lens wear. Prompt diagnosis and treatment with antifungal agents are crucial in managing fungal keratitis to prevent potential complications.

Correct Answer: D

Rationale: The planning function of Nurse Ellen in her role as a nurse manager best corresponds to option D, which is to determine how to achieve the mandate of work. Planning involves setting objectives, developing strategies, and outlining the steps to accomplish those objectives. As a nurse manager, Nurse Ellen would be responsible for creating plans to ensure the effective delivery of patient care, efficient allocation of resources, and meeting the organizational goals of the unit. By determining how to achieve the work mandate, Nurse Ellen can effectively lead her team, allocate resources efficiently, and navigate any challenges that may arise in the operation of the nursing unit.

Correct Answer: C

Rationale: In a postpartum client exhibiting signs of anxiety, restlessness, and palpitations, it is essential to prioritize notifying the healthcare provider immediately. These symptoms could indicate a serious condition such as postpartum preeclampsia, postpartum hemorrhage, or postpartum cardiomyopathy, which require urgent medical attention. It is crucial to rule out any life-threatening conditions and ensure the client receives appropriate treatment promptly. While relaxation techniques and deep breathing exercises can be helpful for anxiety management in some cases, in this situation, the priority is to ensure the client's safety and well-being by seeking medical evaluation and intervention. Administering a benzodiazepine without consulting the healthcare provider first could potentially mask symptoms or interact with other medications the client may be taking, making it unsafe to proceed without professional guidance.

Correct Answer: A

Rationale: Administering a stool softener as ordered is the most appropriate nursing intervention for a postpartum client experiencing severe perineal pain and difficulty passing stools following a vaginal delivery. Stool softeners help to soften the stool, making it easier for the client to pass without straining, which can exacerbate perineal pain. It is important to follow the healthcare provider's orders when administering medications to ensure proper dosing and effectiveness. Encouraging the client to refrain from defecation may lead to constipation and worsen the situation. Applying ice packs to the perineum can provide temporary pain relief, but addressing the underlying issue of constipation with a stool softener is more effective in the long term. Providing education on proper perineal hygiene is important for overall postpartum care, but addressing the immediate issue of constipation with a stool softener takes precedence in this scenario.

Correct Answer: C

Rationale: Progesterone in oral contraceptives works primarily by inhibiting ovulation. It suppresses the secretion of luteinizing hormone (LH) from the pituitary gland, which is essential for triggering the release of an egg (ovulation) from the ovary. By blocking ovulation, progesterone helps prevent pregnancy by making it less likely for a mature egg to be available for fertilization. This mechanism of action is a key factor in the effectiveness of progesterone-containing contraceptives in preventing pregnancy.

Correct Answer: B

Rationale: Cardiogenic shock is a life-threatening condition where the heart is unable to pump enough blood to meet the body's demands. Monitoring the patient's cardiac index, which is a measure of cardiac output adjusted for body surface area, can help detect the risk of developing cardiogenic shock. A decrease in cardiac index would indicate a decrease in the heart's ability to effectively pump blood, putting the patient at risk for cardiogenic shock. Monitoring cardiac index is essential in assessing cardiac function and guiding interventions to prevent the progression to cardiogenic shock. The other factors listed may provide important information in assessing the patient's condition, but specifically in detecting the risk of developing cardiogenic shock, monitoring the cardiac index is crucial.

Correct Answer: C

Rationale: Mastitis is an infection of the breast tissue that may occur in postpartum clients. When a postpartum client exhibits signs of mastitis, including breast tenderness, erythema, and warmth, it is crucial to notify the healthcare provider immediately. Prompt medical evaluation is necessary to determine the appropriate treatment plan, which may include antibiotics. Delay in treatment can lead to complications, such as abscess formation. Encouraging the client to continue breastfeeding and applying warm compresses may provide some relief but do not address the underlying infection. Administering oral antibiotics would require a prescription from the healthcare provider, hence notifying the provider is the most appropriate initial nursing action in this situation.