Whose responsibility is it to obtain informed consent?

Correct Answer: B

Rationale: The responsibility of obtaining informed consent typically falls on the physician or the healthcare provider who is performing the procedure or treatment. Informed consent is a process where the healthcare provider explains the procedure, its risks, benefits, possible alternatives, and potential outcomes to the patient or their legal representative. The patient must have a comprehensive understanding of these aspects before agreeing to the treatment. While nurses, nurse managers, anesthesiologists, midwives, and other healthcare professionals may assist in the consent process by providing information or clarifications, the ultimate responsibility lies with the physician. This is because the physician is usually the one with the expertise and knowledge about the specific procedure or treatment being performed.

Correct Answer: A

Rationale: The combination of recurrent joint pain, swelling, and limited range of motion in multiple joints along with elevated ESR, positive RF, and presence of anti-CCP antibodies is classic for rheumatoid arthritis (RA). Elevated ESR indicates inflammation, positive rheumatoid factor (RF) is an autoantibody commonly found in the serum of patients with RA, and the presence of anti-cyclic citrullinated peptide (anti-CCP) antibodies further supports the diagnosis of RA. These laboratory findings along with the clinical presentation are highly suggestive of rheumatoid arthritis. Systemic lupus erythematosus (SLE), ankylosing spondylitis (AS), and psoriatic arthritis (PsA) can have overlapping symptoms with RA, but the specific combination of elevated ESR, positive RF, and anti-CCP antibodies points more towards RA in this scenario.

Correct Answer: A

Rationale: A tension pneumothorax is a life-threatening condition where air accumulates in the pleural space and cannot escape, causing increased pressure in the chest cavity. This can lead to compression of the lung and major blood vessels, leading to inadequate oxygenation and circulation.

Correct Answer: D

Rationale: The most appropriate oxygen delivery device for a patient with chronic respiratory failure secondary to severe restrictive lung disease requiring continuous supplemental oxygen is a non-rebreather mask. A non-rebreather mask is designed to deliver high-flow oxygen and is typically used for short-term medical treatment in emergency situations or for critically ill patients. It is ideal for providing the highest concentration of oxygen available for inhalation, making it suitable for patients with severe hypoxemia.

Correct Answer: B

Rationale: Tilt back Claudia's head slightly would have been the correct action to prevent her from blinking during eye drop instillation. By tilting her head back, you create a more stable position for instilling the eye drops, reducing the likelihood of accidental contact with her eyelid. Additionally, tilting the head back slightly helps in making it easier for the drops to enter the eye and stay within the conjunctival sac, improving the efficacy of the medication.

Correct Answer: B

Rationale: One of the signs and symptoms of Benign Prostatic Hyperplasia (BPH) is not pain on urination. BPH is a non-cancerous enlargement of the prostate gland which can cause urinary symptoms such as frequency of urination, dribbling of urine, hesitancy in starting urination, weak urine flow, feeling of incomplete bladder emptying, and increased urination at night (nocturia). Pain on urination is not typically associated with BPH, and it may suggest other urinary tract issues such as a urinary tract infection or a different medical condition.

Correct Answer: C

Rationale: The element involved when a nurse initiates interpersonal communication is the sender. In the communication process, the sender is the person who initiates the message or information to be conveyed to the receiver. In this case, the nurse is taking on the role of the sender by initiating the communication with the patient, another healthcare professional, or any other individual. The sender is responsible for encoding the message and selecting the appropriate channel to convey it effectively. Therefore, in this scenario, the nurse is the one initiating communication, making her the sender in the communication process.

Correct Answer: A

Rationale: Von Willebrand disease is a hereditary bleeding disorder that results from a deficiency or dysfunction of von Willebrand factor (vWF), a protein that plays a key role in platelet adhesion and the initiation of primary hemostasis. The clinical manifestations of von Willebrand disease include recurrent mucocutaneous bleeding, such as nosebleeds, easy bruising, and gum bleeding. Laboratory findings typically show a prolonged bleeding time due to impaired platelet function, while platelet count, PT (prothrombin time), and aPTT (activated partial thromboplastin time) are usually normal. This distinguishes von Willebrand disease from other bleeding disorders such as hemophilia A (Factor VIII deficiency), which would show abnormal PT and aPTT due to deficiencies in specific clotting factors. Thrombocytopenia, on the other hand, would be characterized by a low platelet count

Correct Answer: D

Rationale: When someone is bitten by a dog, the most important first aid step is to wash the wound thoroughly with running water. This helps to remove any dirt or bacteria from the wound, reducing the risk of infection. Washing the wound with garlic (choice A) is not recommended as it can irritate the skin and may not effectively clean the wound. Feeding the dog (choice B) is not relevant to treating the bite wound. Bleeding the bitten area (choice C) is also not necessary and can actually increase the risk of infection. Therefore, the best advice the nurse should give in case of a dog bite is to wash the wound thoroughly with running water.