While performing the admission assessment of a new client, the nurse observed that the client brought a bottle of over-the-counter pain medication to the hospital. The nurse failed to document this or remove the medication from the room. Subsequently, the client experienced a serious adverse drug reaction as a result of the interaction between this drug and one of the drugs that the client was prescribed in the hospital. This nurse may be guilty of what?

Correct Answer: A

Rationale: The correct answer is A: Malpractice. The nurse's failure to document and remove the over-the-counter medication, which led to a serious adverse drug reaction, constitutes malpractice. Malpractice refers to negligence or failure to provide the standard of care expected in a professional setting. In this case, the nurse's actions directly resulted in harm to the client, which is a clear example of malpractice. Incorrect Choices: B: Failure of duty to warn - This choice implies that the nurse had a duty to warn the client about the potential drug interaction, which may not necessarily be the case. The primary issue here is the nurse's failure to document and remove the medication, not a failure to warn. C: Assault - Assault involves intentional harm or threat of harm, which is not applicable in this scenario where the harm was due to negligence. D: Incompetence - While the nurse's actions may demonstrate incompetence, the more specific legal term for this situation would be malpractice, as it directly

Correct Answer: B

Rationale: The correct answer is B: Ectopic pregnancy. In this scenario, the combination of missed periods, positive pregnancy test, and empty uterus on ultrasound with fluid in the cul-de-sac is highly suggestive of an ectopic pregnancy. Ectopic pregnancy occurs when the fertilized egg implants outside the uterus, commonly in the fallopian tube. The presence of fluid in the cul-de-sac indicates possible blood from a ruptured ectopic pregnancy, causing the severe lower abdominal pain. Ovarian cyst rupture (A) typically presents with less severe pain. Septic abortion (C) would present with signs of infection and products of conception in the uterus. Ovarian torsion (D) would present with acute onset of unilateral lower abdominal pain and a palpable adnexal mass, not fluid in the cul-de-sac.

Correct Answer: C

Rationale: The correct answer is C: Abrasion. Abrasion is the wearing away of tooth structure due to friction from external sources like toothbrushing or abrasive toothpaste. Dental caries (A) refers to tooth decay caused by bacteria. Attrition (B) is the wearing down of tooth structure due to tooth-to-tooth contact. Erosion (D) is the loss of tooth structure from acid attacks, not friction. Therefore, option C is the most fitting choice based on the description given.

Correct Answer: D

Rationale: The correct answer is D because referring the patient to a pain management specialist for evaluation is essential in this scenario. The specialist can conduct a comprehensive assessment to identify the underlying causes of the intractable pain and recommend a tailored pain management plan. This approach ensures a multidisciplinary approach to address the complex nature of the patient's pain. Choice A is incorrect because simply increasing the dosage of the current opioid medication may not effectively address the underlying cause of the pain and can lead to potential side effects or opioid tolerance. Choice B is incorrect as switching to a different opioid medication without a thorough evaluation may not guarantee better pain control and can increase the risk of adverse effects or inadequate pain relief. Choice C is incorrect as administering adjuvant analgesic medications without addressing the root cause of the pain may not provide adequate pain relief and does not address the need for a specialized pain management plan.

Correct Answer: D

Rationale: The correct answer is D, Broad opening. Nurse Rica should use this communication technique to encourage the patient to freely express themselves without leading or interrupting. This technique helps build rapport and trust, setting a positive tone for the conversation. A: Clarifying may be too direct and might make the patient feel pressured. B: Challenging can create defensiveness and hinder open communication. C: Restating may not be as effective in initiating a conversation as broad opening. In summary, broad opening allows for a more open and relaxed conversation, fostering a conducive environment for effective communication with the patient.

Correct Answer: C

Rationale: The correct answer is C, to have a limited intake of sodium. Lithium can lead to increased sodium levels in the body, potentially causing toxicity. By limiting sodium intake, the patient can maintain a balance and prevent adverse effects. Choice A is incorrect as tyramine content is not directly related to lithium intake. Choice B is incorrect as fluid intake does not have a significant impact on lithium levels. Choice D is incorrect because an adequate intake of sodium can lead to worsening lithium toxicity.

Correct Answer: C

Rationale: The correct answer is C: Platelet count. Platelet count should be monitored closely during clopidogrel therapy because it works by inhibiting platelet aggregation, reducing the risk of clot formation. Monitoring platelet count helps assess the drug's effectiveness and prevent potential complications like bleeding or clotting events. Prothrombin time (A), activated partial thromboplastin time (B), and international normalized ratio (D) are tests that primarily assess the coagulation factors and are not directly affected by clopidogrel therapy, making them less relevant for monitoring this specific medication.

Correct Answer: A

Rationale: The correct answer is A: Active artificial immunity. This is because the person's immune system is actively stimulated by the vaccine to produce antibodies against Covid-19. It is considered artificial because it is acquired through vaccination rather than natural exposure to the disease. B: Active natural immunity is incorrect because it refers to immunity acquired through natural exposure to the disease. C: Passive natural immunity is incorrect because it refers to temporary immunity passed from mother to baby through breast milk or placenta. D: Passive artificial immunity is incorrect because it refers to receiving pre-formed antibodies, such as through an injection of antibodies rather than the body producing them itself.

Correct Answer: C

Rationale: In a postpartum client who presents with severe abdominal pain, nausea, and vomiting, it is crucial to assess for signs of peritonitis or surgical abdomen. These signs may include rebound tenderness, guarding, rigidity, and fever. Peritonitis is a serious condition that may require immediate surgical intervention. Administering antiemetic medication, encouraging clear fluids, or providing a heating pad may not address the underlying cause of the symptoms and delay appropriate treatment. Assessing for signs of peritonitis or surgical abdomen is crucial for prompt identification and management of the client's condition.