Which of the following interventions is most appropriate for a patient experiencing an acute asthma exacerbation with severe respiratory distress and hypoxemia?

Correct Answer: B

Rationale: In a patient experiencing an acute asthma exacerbation with severe respiratory distress and hypoxemia, the most appropriate intervention is to initiate non-invasive positive pressure ventilation (NIPPV). NIPPV can help improve ventilation, decrease work of breathing, and correct hypoxemia by providing positive pressure to keep the airways open, reduce air trapping, and increase the elimination of carbon dioxide. This intervention can help improve oxygenation and reduce the need for invasive mechanical ventilation in patients with severe asthma exacerbations. Administering high-flow oxygen via nasal cannula alone may not provide enough support for patients with severe respiratory distress. Nebulized albuterol/ipratropium combination therapy and intravenous corticosteroid therapy are also important treatments for asthma exacerbations but are not the first-line interventions for patients with severe respiratory distress and hypoxemia.

Correct Answer: A

Rationale: Encouraging frequent position changes, including the hands-and-knees position, is the most appropriate nursing intervention in this scenario. This position is known to help rotate the baby from a persistent posterior position to an optimal anterior position for delivery. The hands-and-knees position can help take pressure off the mother's back, alleviate back pain, and facilitate the rotation of the baby's head to engage in the mother's pelvis, thus promoting labor progress. It is a non-invasive and effective way to promote fetal rotation without the need for immediate instrumental delivery or intravenous analgesics. Continuous fetal monitoring is important for assessing fetal well-being but would not directly address the issue of posterior fetal position and the associated prolonged labor.

Correct Answer: C

Rationale: The most appropriate intervention for a patient with end-stage dementia experiencing agitation and restlessness is to create a calm and soothing environment to promote relaxation. Patients with dementia often respond positively to a familiar and tranquil setting, which can help reduce their symptoms of agitation and restlessness. This approach is preferred over administering antipsychotic medications or recommending physical exercise, as these may not be feasible or beneficial for patients in the advanced stages of dementia. Referring the patient to a psychiatrist may not address the immediate need for symptom management and can be considered if other interventions are ineffective. Creating a calm environment, such as dim lighting, soft music, and familiar objects, can help provide comfort and reduce distress for the patient.

Correct Answer: B

Rationale: Unstable angina is characterized by chest pain at rest, which is not relieved by nitroglycerin. The ECG findings in unstable angina typically show ST-segment depression or T-wave inversion. It is considered a medical emergency as it can progress to a myocardial infarction. Stable angina, on the other hand, is chest pain or discomfort that occurs with exertion and is relieved by rest or medications like nitroglycerin. Acute myocardial infarction would typically present with ST-segment elevation on ECG, while Prinzmetal's angina is characterized by transient ST-segment elevation due to coronary artery vasospasm.

Correct Answer: C

Rationale: The patient is likely infected with Cryptosporidium parvum based on the symptoms of watery diarrhea, abdominal cramps, and nausea after consuming contaminated water. Cryptosporidium is a protozoan parasite that can be transmitted through contaminated water sources, such as streams. Laboratory tests revealing oocysts in the stool sample further support the diagnosis of Cryptosporidium infection, as these oocysts are characteristic of this parasite. Giardia lamblia is another common protozoan parasite that can cause similar symptoms but is usually associated with more foul-smelling, greasy diarrhea. Entamoeba histolytica causes amoebic dysentery, which presents with bloody diarrhea and abdominal pain. Cyclospora cayetanensis also causes watery diarrhea, but it is usually associated with foodborne outbreaks rather than waterborne transmission.

Correct Answer: B

Rationale: Nephrotic syndrome is a kidney disorder characterized by increased glomerular permeability, leading to protein loss in the urine. One of the hallmarks of nephrotic syndrome is hypoalbuminemia, which refers to low levels of albumin in the blood due to its excessive loss in the urine. This loss of albumin results in decreased oncotic pressure, leading to edema and ascites. Hematuria (choice A) is not typically found in nephrotic syndrome but may be present in other kidney conditions. Hyperkalemia (choice C) is not specific to nephrotic syndrome and may be more common in conditions affecting potassium regulation. Hypocalcemia (choice D) is also not a characteristic feature of nephrotic syndrome.

Correct Answer: D

Rationale: Nurse Trining explained about confidentiality in relation to observing respect for privacy. Confidentiality is the duty to keep patient information private and not disclose it without the patient's consent. It is a fundamental principle in healthcare that helps build trust between patients and healthcare providers. By maintaining confidentiality, healthcare professionals uphold the ethical obligation to protect patients' privacy and sensitive information, ensuring that they feel safe and respected during their interactions with the healthcare system.

Correct Answer: C

Rationale: A dental abscess is characterized by a localized collection of pus that results from a bacterial infection of the tooth pulp, leading to swelling, pain, and inflammation. The infection typically occurs when bacteria enter the tooth through a cavity, crack, or other dental injury. The abscess can cause significant pain and discomfort and must be treated promptly by a dentist to prevent further complications. Dental caries refer to tooth decay or cavities that result from the breakdown of tooth structure by acids produced by bacteria. Periodontitis is a severe gum infection that damages the soft tissue and destroys the bone that supports the teeth. Oral candidiasis is a fungal infection that affects the mouth and throat.

Correct Answer: A

Rationale: The patient's lack of sensation in her right leg, allowing her cat to scratch her without her noticing, is indicative of neuropathy. Neuropathy is a common diabetic complication characterized by nerve damage that can result in loss of sensation or altered sensation in different parts of the body, including the extremities. In this case, neuropathy has likely affected the patient's right lower extremity, leading to her inability to feel the cat scratching her leg and resulting in the unnoticed scratches, infection, and subsequent cellulitis.