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: C

Rationale: Republic Act 9173, also known as the Philippine Nursing Act of 2002, mandates the compulsory immunization of children below 8 years. This law ensures that young children receive necessary vaccines to protect them from preventable diseases and promote public health. RA 9173 is a significant legislation that highlights the importance of immunization in safeguarding the well-being of children in the Philippines.

Correct Answer: C

Rationale: Prolonged labor is a condition in which labor lasts for an extended period, typically more than 20 hours for first-time mothers and more than 14 hours for experienced mothers. Prolonged labor can contribute to slowing down uterine involution because the prolonged pressure and strain on the uterus can affect its ability to return to its pre-pregnancy size and position. The prolonged contractions and stretching of the uterine muscles can hinder the normal process of uterine involution, leading to a delay in the uterus shrinking back to its non-pregnant state. Additionally, prolonged labor can increase the risk of postpartum complications such as excessive bleeding and infection, which can further impact uterine involution. Therefore, it is crucial for healthcare providers to monitor labor progress closely to prevent prolonged labor and its potential effects on uterine involution.

Correct Answer: D

Rationale: All of the components -explanation of the procedure and alternatives to the procedure (I), discussion of potential risks and benefits of the procedure (II), and confirmation that the patient understands the risks, benefits, and any alterations (III) -are essential parts of informed consent. Providing information about the procedure and its alternatives, disclosing potential risks and benefits, and ensuring that the patient comprehends this information are crucial to obtaining valid informed consent prior to any medical procedure.

Correct Answer: C

Rationale: Placing the patient on an alternating pressure mattress demonstrates evidence-based practice in pressure injury prevention. Alternating pressure mattresses are designed to change pressure points by alternating pressure across different parts of the body, reducing the risk of pressure injuries. Regularly turning and repositioning the patient (Choice B) is also important in preventing pressure injuries, but an alternating pressure mattress provides additional support and prevention measures. Applying moisturizing lotion (Choice A) and massaging bony prominences (Choice D) may be beneficial for skin care, but they are not proven strategies for pressure injury prevention.

Correct Answer: A

Rationale: Breastfeeding is actually a protective factor against acute otitis media (AOM) in children due to the antibodies and nutrients present in breast milk that help strengthen the immune system and the Eustachian tube function. Swimming, exposure to cigarette smoke, and poor hygiene are all risk factors for AOM. Swimming can introduce water into the ears, which can lead to infections. Exposure to cigarette smoke can irritate the mucous membranes in the respiratory tract and increase the risk of infections. Poor hygiene can lead to the spread of bacteria that can cause AOM.

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: D

Rationale: In research involving adults who are capable of providing informed consent, such as a 21-year-old subject, the absolute way to ensure autonomy and respect for the individual's rights is to obtain informed and written consent directly from the subject herself. The subject's autonomy and right to self-determination should be respected, and obtaining consent directly from the subject ensures that they are fully informed about the research, its risks, benefits, and their rights regarding anonymity and confidentiality. In this case, Nurse Carmi must explain the research process clearly to the 21-year-old subject, obtain her informed consent in writing, and ensure that her anonymity, confidentiality, and human rights are protected throughout the study.

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.